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Common Myths about Sexuality and Aging
 Sexuality is a critical component of one’s identity and remains an important part of life as we age.1-3 The Duke longitudinal study of aging reports that 96% of women and 98% of men aged 65 years and older are sexually active and still find this aspect of their lives pleasurable.4 Despite an increased focus on research in this area, several myths related to the impact of normal aging on sexuality persist.
Myth #1: Older adults are not interested in sex. False. The majority of older adults are indeed interested in sex, have active sex lives and enjoy sexual activity, including masturbation. For example, while rates of sexual behavior and levels of sexual enjoyment do drop off somewhat as individuals age, 65% of women and 79% of men age 70 years and older describes themselves as still sexually active and even report an increased frequency in sexual activity after age seventy.1
Myth #2: Older adults do not have to worry about HIV/AIDS. Unfortunately, also not true. An estimated 19% of HIV/AIDS patients in the U.S. are over age 50.5 Older adults may see contraception as a non-issue and thus forgo barrier contraception; an important protection against sexually transmitted disease. As in any sexually active partnership, full and honest disclosure, including discussion of HIV status and testing, should be engaged in prior to any mutual discontinuation of barrier contraception.
Myth #3: Although older men may be interested in sex, older women are not. While there is data to support this finding, several mitigating factors are worth mentioning. First, women live longer than men, and thus there is an average decrease in interest that outstrips the actual within-cohort disparity. Second, regardless of age, overall, women report lower levels of sexual interest than do men. Third, findings may vary as a function of the behavior of interest studied. For example, if partnered sex is the target behavior, there are many more widows in the U.S. than there are widowers, due to longevity disparities. Further, if non-partnered sex is the target behavior, women of all ages tend to report lower rates of masturbation than do men.
Myth #4: Sexual problems that accompany aging are normal, irreversible, and essentially trivial. This myth has led to the sexually symptomatic older adult feeling unsuitable for treatment, and an accompanying belief that treatments are not appropriate or available. For example, there is a common belief among older men that younger men are more entitled to drugs such as Viagra and that these drugs are an interference with the ‘natural’ progression of old age.6 In fact, sexual dysfunction is more often related to co-morbid illness than to aging alone, and lack of interest in sex tends to be a more reliable symptom of depression than of any normal changes as a result of aging. Research suggests that while a gradual decline in sexual activity occurs around age fifty, it actually accelerates after age seventy; reinforcing that sexuality remains an important part of life as we age.1
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Featured Course
Human Sexuality: The Role of Aging and Illness
(3 CEs) by Tinesha Banks, MPH & Ayana Bradshaw, MPH
 Normal aging should not compromise sexual functioning as long as individuals maintain overall good health.7-8 However, it is a fact that as age increases the chance of becoming ill also increases. Not surprisingly, changes in sexual behavior related to age are often the result of coexisting systemic illnesses.9-10 Specifically, the diagnosis and/or treatment of an underlying acute and/or chronic disease (e.g., cardiovascular disease, cancer, diabetes, dementia, arthritis) has been associated with a negative impact on libido, sexual performance, and satisfaction with sex among adults over age 60.11-12
Although the advent of medications such as Viagra and Cialis has led to a paradigm shift in how we view and treat certain age-related and/or health-related sexual dysfunctions, it is not uncommon for issues of a sexual nature to be absent and/or minimized in the course of an older patient’s psychological care. Understandably, since many older patients experience sexual dysfunction as secondary to a primary acute medical illness, therapy may be more focused on immediate, sometimes life-saving, medical decisions and/or issues. As problems related to sexuality emerge from the background of medical illness and become more salient, older patients, for the most part, may still not be comfortable addressing issues of a sexual nature, even in a therapeutic context. Moreover, given their existential nature, sexuality, illness and aging can be threatening or anxiety-provoking topics, even for skilled clinicians.
Taken together, the evidence suggests that it is imperative that the sexual concerns of the older medically ill individual be adequately addressed to ensure the patient’s optimal biological, as well as psychological, adaptation to illness. Needless to say, left unattended, health-related issues regarding sexuality can persist, even escalate, regardless of how high functioning an individual, or couple, was prior to the disease experience.13 In turn, this distress can not only lead to diminished physical health, but can negatively impact overall quality of life and shake the foundation of the very relationships that may be essential for coping with health-related stress.
It is essential that clinicians working with a geriatric population confront their own feelings about sexuality and aging in order to be more secure and comfortable with this material. Clinicians who do not facilitate a frank, non-threatening invitation to have a dialogue about the impact of aging and illness on sexual identity and sexual functioning are doing a disservice to their elderly patients. This online continuing education course provides the tools necessary for health professionals to feel more secure with the facts about sexuality with regard to the “normal” aging process and to be more knowledgeable about how common medical illnesses within a geriatric sample can impact sexuality. The information presented can raise personal and professional awareness on the subject and render mental health professionals more competent to sensitively address these issues in the psychological care of their older patients. |
About the Authors
 Tinesha Banks, MPH – Deputy Executive Director of the Health Promotion Council of Southeastern Pennsylvania, Inc. (HPC); Adjunct Professor, Temple University. Interests: Health communication among minority populations, with a special emphasis on health literacy and patient-provider communication; cultural responsiveness as it relates to health professionals; social marketing; and human sexuality.
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References
- Sanders, S.A. (1999). Midlife Sexuality: The need to integrate biological, psychological, and social perspectives, SIECUS Report, 27(3), 3-7.
- Morley, J. E. (2006). Sexuality and Aging. Principles and Practice of Geriatric Medicine, Volume 1 (Fourth Edition), pp 115-122.
- Lindau, S., Schumm, L., Laumann, E., Levinson, W. O'Muircheartaigh, C. & Waite, L. (2007). A Study of Sexuality and Health Among Older Adults in the United States The New England Journal of Medicine, 357(8), 762-774.
- American Association for Geriatric Psychiatry (2003). Medical Associations Communication. Axis III and Beyond: Social Function and Sexuality in Late Life. Proceedings of the American Association for Geriatric Psychiatry’s 2003 Annual Meeting.
- http://www.nia.nih.gov/healthinformation/publications/hiv-aids.htm
- Gott, M., & Hincliff, S. (2003). Barriers to seeking treatment for sexual problems in care: a quantitative study with older people. Family Practice, 20(6), 690-695.
- Crooks, R, & Baur, K. (2002). Our Sexuality (Eighth Edition). Pacific Grove: Wadsworth Group.
- Thienhaus, O.J. (1988). Practical overview of sexual function and advancing age. Geriatrics, 43, 63-67.
- Greenberg J., Bruess, C., & Haffner, D. (2004). Exploring the Dimensions of Human Sexuality (Second Edition). Sudbury: Jones and Bartlett Publishers, Inc.
- Hansen, L., Mann, J., McMahon, S., & Wong, T. (2004). Sexual Health. Biomedical Central Women’s Health, 4(Suppl 1), S1-S24.
- Laumann, E.O., Glasser, D.B., Boreira, E.D. Jr., Paik, A., & Gingell, C. (2004). Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology, 64(5), 991-997.
- http://www.niapublications.org/agepages/sexuality.asp
- Weihs, C.R. (1996). Family reorganization in response to cancer: a developmental perspective., L. Baider, Cooper, C.L., & De-nout, P.D., Editor. 1996, Wiley: Chichester, 3-30.
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