Declining sexual activity in old age has more to do with ill health than lack of desire, new research has found.
A wide-ranging study of sexuality and health among older adults in the United States, published in Thursday's edition of The New England Journal of Medicine, examines sexual attitudes, behaviours and problems among men and women between the ages of 57 and 85.
Based on 3,005 participants, the survey found that many men and women remain sexually active – participating in vaginal intercourse, oral sex and masturbation – in their 60s, 70s and 80s.
The frequency of sexual activity among the study's cohort was similar to that reported among 18-to-59-year-olds in a 1992 National Health and Social Life Survey, the researchers noted.
Sexual activity does decline with age, but that is usually the result of not having an intimate partner or experiencing problems with physical health.
“Physical health is more strongly associated with many sexual problems than is age alone,” said Stacey Lindau, the University of Chicago gynecologist who led the study. “If you have a partner, the frequency of sexual activity doesn't change that much across age groups.”
Researchers believe the findings could provide an important incentive for doctors to discuss sexual activity with their aging patients.
“This is a public-health issue because sexual problems may be a warning sign or consequence of an underlying health issue,” said Georgeanne Patmios, of the National Institute on Aging, a partner in the study.
Women with diabetes were less likely to be sexually active, the study found, and men with the disease often suffered erectile difficulties.
Dr. Lindau said physicians should be aware of this connection, and also take into account that older men and women may stop taking medication for other ailments if it negatively affects their sex lives.
“If we regard older people as asexual, we really miss an opportunity to do important counselling and interventions,” she said.
But few doctors are having those conversations, she said. Of those surveyed, only 38 per cent of men and 22 per cent of women had discussed sex with their doctors since the age of 50.
Dr. Lindau would like to see physicians begin asking aged patients if they are sexually active, how their sex lives are going, or if there is anything preventing them from having sex.
The most commonly reported reason for sexual inactivity among individuals with a partner was the male partner's physical health.
“It may comfort people to know that they are not alone in enjoying sexual activity as they age or in experiencing sexual problems, some of which could be alleviated with medical attention,” said Dr. Lindau.
The number of older adults engaging in sexual activity may be surprising for younger generations who prefer to picture their grandparents playing shuffleboard than pitching woo.
Even among the oldest respondents – those between the ages of 75 and 85 – 54 per cent of sexually active persons reported having sex at least two to three times per month, and 23 per cent reported having sex once a week or more.
Fifty-eight per cent of sexually active respondents in the youngest age group – between 57 and 64 – reported engaging in oral sex within the past 12 months, as did 31 per cent in the oldest age group.
And over all, 52 per cent of men and 25 per cent of women in a relationship reported masturbating in the past 12 months, as did 55 per cent of men and 23 per cent of women who were single.
There were, however, some differences between respondents depending on gender.
Women were more likely than men to rate sex as “not at all important” (35 per cent of women compared with 13 per cent of men). Forty-one per cent of respondents in the oldest age group also characterized sex as unimportant.
