Sex and aging – Men’s issues

Will sex change as you get older?

The issues surrounding sex in older people are still not openly discussed. Older people have been stereotyped as asexual and devoid of feelings or emotion, but this of course is wrong. The way people express themselves sexually varies widely. While sex in older couples is likely to be different to that in younger couples, it doesn’t have to be any less pleasurable.

Today men and women are living longer, healthier lives. As a result of this improvement in health, many older couples continue to enjoy intimacy and sex. A global study showed that sexual desire and sexual activity are common in middle-aged and elderly people of both sexes and these continue into old age. Over 80% of men and 65% of women aged 40-80 years had had intercourse in the last year. However, sexual problems were common in both sexes and few people sought help for these.

Older couples who have been in long-term relationships do not necessarily find it easier than anyone else when it comes to discussing sexual difficulties (see our factsheet ‘Explaining sexual problems to your GP’).

Will you still be able to have sex as you get older?

The ageing process causes many normal changes in the body, some of which affect sexual desire (‘sex drive’) and response. But sexuality extends beyond the genitals. Often couples can find new ways to stimulate each other, such as reading erotic literature or watching erotic videos. Being able to talk to your partner and discuss sexual desires, fantasies and experimentation is important.

For more tips about erection, read this WebMD article.

Some men may notice that it takes them longer to get aroused (‘turned on’) and develop an erection, and their erections may not seem as hard. The sensation of ejaculation may be reduced, the orgasm may not feel as powerful as it once did, and smaller amounts of semen may be produced. The length of time between erections can increase and just thinking about sex may no longer be enough. Reduced sensitivity may mean more direct physical stimulation of the penis is required for a longer time. Ejaculation may take longer to achieve, but this can be a positive side of getting older as it may give more satisfaction to the partner. While some men may notice that their desire for sex reduces with age, others may remain sexually active throughout their life.

If you are finding it more difficult to get and keep an erection, you are not alone. Half of men between the ages of 40 and 70 years will experience this to some degree. However, help is available. Your GP may be able to prescribe one of the oral drugs (tablets) that can help erectile dysfunction (ED), known as phosphodiesterase (pronounced phos- pho- di- es- ter- ase) inhibitors (PDE5i). If these drugs do not work or are not suitable for you, there are other options available, such as penile injections, urethral pellets, topical creams, vacuum pump devices and surgical implants (see our factsheets ‘Oral treatment for erectile dysfunction’, ‘Injection, urethral and topical treatments for erectile dysfunction’, ‘Vacuum pump treatment for erectile dysfunction’. You may also want to consider sex therapy (see the following section on ‘Sex therapy’). Do not buy drugs online, as they may be fakes!

Does illness affect sex?

Yes, it can. As people grow older, they are more likely to experience disabling conditions and illnesses that can affect their sex lives. These may have physical effects (in the body) and psychological effects (in the mind).

Painful physical problems like arthritis may make it difficult to find a comfortable position for having sex. Neurological problems such as Parkinson’s disease may reduce sexual desire and cause erectile problems, as may some drugs. Diabetes may also cause erectile difficulties.

The psychological effects of illness can also affect sexual function, especially if a life-threatening or life-limiting illness has been diagnosed, or the illness affects a person’s appearance and/or self esteem. Cardiovascular problems such as high blood pressure, heart disease or a previous stroke may make you nervous about having sex.

Illness can also change a couple’s relationship in other ways, as previously independent people become dependent on their partner/carer. One partner may feel it is inappropriate to still have sexual desire if their partner is ill. While for many carers, the sheer stress and exhaustion of the role may reduce their desire. Lifestyle can also affect how you see yourself. Retirement and children leaving home is viewed by some as an end of a chapter in their lives, whereas for others it can mean the freeing up of time for each other.

Lifestyle factors can also play a part. Smoking, excessive alcohol consumption, recreational drug use, poor diet and a lack of exercise can all contribute to sexual problems.

If you find that illness is preventing you from enjoying sex with your partner, it is sensible to see your GP. They should be able to offer you help and advice or refer you for sex therapy (see the following section on ‘Sex therapy’).

If you are a widower: Is it wrong to look for love again?

We all need to be loved and wanted, and these needs do not lessen over time. However, you may find you are looking for a different kind of relationship than when you were younger. You may just require companionship and someone to share your favourite TV programmes with. If you are looking to rekindle your love life you may feel awkward and embarrassed, not knowing where or how to start. These are perfectly normal feelings, particularly if your partner had a long illness, or you have feelings of guilt and betrayal. It will help to talk to someone about those feelings. To help you to move forward in a new relationship, you may like to speak to your GP or contact a sex therapist (see the following section on ‘Sex therapy’). When sexuality is affected, it is often a matter of learning to adapt and adjust rather than accepting an end to all forms of sexual expression.

If you are embarrassed to seek help: What can you do?

The only person who will find this embarrassing is you. You have nothing to be afraid of and everything to gain by seeking help. Discussing sex later in life can sometimes be difficult, but there is no reason to think that because you are older, you cannot use all the services that are available to younger people. Sex is not abnormal after middle age and for many individuals it does not stop just because they are no longer able to conceive a child. Older age should not prevent you from seeking or receiving help from whatever source is most suitable for you. If you don’t want to discuss sexual problems with your GP, you can see a sex therapist (see the following section on ‘Sex therapy).

What is sex therapy?

Sex therapy is talking therapy where an individual or couple work with an experienced therapist to assess and treat their sexual and/or relationship problems. Together they will identify factors that trigger the problems and design a specific treatment programme to resolve or reduce their impact.
Sex therapy is considered highly effective in addressing the main causes and contributing factors of sexual difficulties. And it helps people to develop healthier attitudes towards sex, improve sexual intimacy, become more confident sexually, and improve communication within the relationship.

Learn more about sex therapy in this Health Line Article.

Sex therapy can also be used in combination with other forms of treatment.
Your GP or another health professional on the NHS may be able to refer you for sex therapy (depending on area), or you can contact a therapist directly and pay privately. It is important to make sure that they are qualified and are registered with an appropriate professional body. You can find more information on sex therapy in our factsheets ‘Sex therapy’ and ‘How to find, choose and benefit from counselling support’