Abstract
Recent research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-related physiological changes do not render a meaningful sexual relationship impossible or even necessarily difficult. In men, greater physical stimulation is required to attain and maintain erections, and orgasms are less intense. In women, menopause terminates fertility and produces changes stemming from estrogen deficiency. The extent to which aging affects sexual function depends largely on psychological, pharmacological, and illness-related factors. In this article I review the physiological sex-related changes that occur as part of the normal aging process in men and women. I also summarize the effects on sexual function of age-related psychological issues, illness factors, and medication use. An understanding of the sexual changes that accompany normal aging may help physicians give patients realistic and encouraging advice on sexuality. Although it is important that older men and women not fall into the psychosocial trap of expecting (or worse, trying to force) the kind and degree of sexual response characteristic of their youth, it is equally as important that they not fall prey to the negative folklore according to which decreased physical intimacy is an inevitable consequence of the passage of time.
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- Bachmann G. A. Influence of menopause on sexuality. Int J Fertil Menopausal Stud. 1995;40 (Suppl 1):16–22. [PubMed] [Google Scholar]
- Bachmann G. A., Leiblum S. R., Grill J. Brief sexual inquiry in gynecologic practice. Obstet Gynecol. 1989 Mar;73(3 Pt 1):425–427. [PubMed] [Google Scholar]
- Bretschneider J. G., McCoy N. L. Sexual interest and behavior in healthy 80- to 102-year-olds. Arch Sex Behav. 1988 Apr;17(2):109–129. doi: 10.1007/BF01542662. [DOI] [PubMed] [Google Scholar]
- Cawood E. H., Bancroft J. Steroid hormones, the menopause, sexuality and well-being of women. Psychol Med. 1996 Sep;26(5):925–936. doi: 10.1017/s0033291700035261. [DOI] [PubMed] [Google Scholar]
- Diokno A. C., Brown M. B., Herzog A. R. Sexual function in the elderly. Arch Intern Med. 1990 Jan;150(1):197–200. [PubMed] [Google Scholar]
- Dupont W. D., Page D. L. Menopausal estrogen replacement therapy and breast cancer. Arch Intern Med. 1991 Jan;151(1):67–72. [PubMed] [Google Scholar]
- Edwards A. E., Husted J. R. Penile sensitivity, age, and sexual behavior. J Clin Psychol. 1976 Jul;32(3):697–700. doi: 10.1002/1097-4679(197607)32:3<697::aid-jclp2270320345>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
- Gupta K. Sexual dysfunction in elderly women. Clin Geriatr Med. 1990 Feb;6(1):197–203. [PubMed] [Google Scholar]
- Hilton P. Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol. 1988 Apr;95(4):377–381. doi: 10.1111/j.1471-0528.1988.tb06609.x. [DOI] [PubMed] [Google Scholar]
- Kaiser F. E. Sexuality in the elderly. Urol Clin North Am. 1996 Feb;23(1):99–109. doi: 10.1016/s0094-0143(05)70296-2. [DOI] [PubMed] [Google Scholar]
- Køster A. Change-of-life anticipations, attitudes, and experiences among middle-aged Danish women. Health Care Women Int. 1991 Jan-Mar;12(1):1–13. doi: 10.1080/07399339109515922. [DOI] [PubMed] [Google Scholar]
- Ludeman K. The sexuality of the older person: review of the literature. Gerontologist. 1981 Apr;21(2):203–208. doi: 10.1093/geront/21.2.203. [DOI] [PubMed] [Google Scholar]
- Meston C. M., Gorzalka B. B. Psychoactive drugs and human sexual behavior: the role of serotonergic activity. J Psychoactive Drugs. 1992 Jan-Mar;24(1):1–40. doi: 10.1080/02791072.1992.10471616. [DOI] [PubMed] [Google Scholar]
- Meston C. M., Gorzalka B. B., Wright J. M. Inhibition of subjective and physiological sexual arousal in women by clonidine. Psychosom Med. 1997 Jul-Aug;59(4):399–407. doi: 10.1097/00006842-199707000-00010. [DOI] [PubMed] [Google Scholar]
- Meston C. M., Trapnell P. D., Gorzalka B. B. Ethnic and gender differences in sexuality: variations in sexual behavior between Asian and non-Asian university students. Arch Sex Behav. 1996 Feb;25(1):33–72. doi: 10.1007/BF02437906. [DOI] [PubMed] [Google Scholar]
- Morales A. J., Nolan J. J., Nelson J. C., Yen S. S. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab. 1994 Jun;78(6):1360–1367. doi: 10.1210/jcem.78.6.7515387. [DOI] [PubMed] [Google Scholar]
- Pfeiffer E., Verwoerdt A., Wang H. S. Sexual behavior in aged men and women. I. Observations on 254 community volunteers. Arch Gen Psychiatry. 1968 Dec;19(6):753–758. doi: 10.1001/archpsyc.1968.01740120113016. [DOI] [PubMed] [Google Scholar]
- Roughan P. A., Kaiser F. E., Morley J. E. Sexuality and the older woman. Clin Geriatr Med. 1993 Feb;9(1):87–106. [PubMed] [Google Scholar]
- Schiavi R. C., Rehman J. Sexuality and aging. Urol Clin North Am. 1995 Nov;22(4):711–726. [PubMed] [Google Scholar]
- Schreiner-Engel P., Schiavi R. C., Vietorisz D., Smith H. The differential impact of diabetes type on female sexuality. J Psychosom Res. 1987;31(1):23–33. doi: 10.1016/0022-3999(87)90094-8. [DOI] [PubMed] [Google Scholar]
- WOESSNER J. F., Jr AGE-RELATED CHANGES OF THE HUMAN UTERUS AND ITS CONNECTIVE TISSUE FRAMEWORK. J Gerontol. 1963 Jul;18:220–226. doi: 10.1093/geronj/18.3.220. [DOI] [PubMed] [Google Scholar]