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Senior Citizens & Sex
Sex Declines Only Slightly for Active Senior
Citizens from Age 50 into 70s
Many senior citizens have active sex lives into
their 80s
 Aug. 23, 2007 - The first comprehensive national
survey of sexual attitudes, behaviors and problems among older adults in
the United States has found that most people ages 57 to 85 think of
sexuality as an important part of life and that the frequency of sexual
activity, for those who are active, declines only slightly from the 50s
to the early 70s.
Data from the University of Chicago's National
Social Life, Health and Aging Project (NSHAP), presented in the August
23, 2007, issue of the New England Journal of Medicine, showed that many
men and women remain sexually active—participating in vaginal
intercourse, oral sex and masturbation—well into their 70s and 80s.
The survey also found that sexual activity was
closely tied to overall health, which was even more important than age.
As health declined steadily after the early 70s, so did the prevalence
of sexual activity, particularly for women. Among those who remained
sexually active, nearly half reported at least one sexual problem, such
as lack of desire (43% of women), vaginal dryness (39% of women) or
erectile dysfunction (37% of men).
"We found that older adults remain interested and
engage in sex, yet many experience bothersome sexual problems that can
compromise both health and relationships," said Stacy Tesser Lindau, MD,
assistant professor of obstetrics and gynecology and of
medicine-geriatrics at the University of Chicago and lead author of the
study.
With the first baby boomers turning 60, older
adults make up the fastest growing segment of the US population. Yet the
"lack of reliable information about how sexual activity and function
might change with age and illness, combined with taboos around
discussing sex in later life, contributes to worry or even shame for
many older adults," she added.
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Highlights
● The prevalence of sexual activity declined with
age
> 73% among respondents who were 57 to 64 years of age,
> 53% among respondents who were 65 to 74 years of age, and
> 26% among respondents who were 75 to 85 years of age.
● Women were significantly less likely than men
at all ages to report sexual activity.
● Among respondents who were sexually active,
about half of both men and women reported at least one bothersome sexual
problem.
● The most prevalent sexual problems among women
were low desire (43%), difficulty with vaginal lubrication (39%), and
inability to climax (34%).
● Among men, the most prevalent sexual problems
were erectile difficulties (37%). Fourteen percent of all men reported
using medication or supplements to improve sexual function.
● Men and women who rated their health as being
poor were less likely to be sexually active and, among respondents who
were sexually active, were more likely to report sexual problems.
● A total of 38% of men and 22% of women reported
having discussed sex with a physician since the age of 50 years.
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"I am especially happy that we now have in hand
reliable and comprehensive information on sexual function and activity
among older adults based on a scientifically drawn representative sample
of Americans 57 years of age and older," said co-author Edward Laumann,
PhD, the George Herbert Mead Distinguished Service Professor in
Sociology and co-director of the 1992 National Health and Social Life
Survey, which surveyed persons aged 18 to 59.
"Social relationships are known to contribute to
health and well-being in older men and women," says Richard Suzman, PhD,
director of the Social and Behavioral Research Program at the National
Institute on Aging, which primarily funded the study. "This pioneering
research gives us valuable insight into intimate social relationships,
providing data clinicians may now draw upon to open better informed
conversations with patients about sexuality and health."
Many medical conditions and treatments can
interfere with sexuality. American men spend more than a billion dollars
each year on medications to improve sexual function. Despite such
frequent problems, few older men (38%) and even fewer women (22%) had
discussed sex with a physician since age 50, the researchers found. Men
were more likely to do so, perhaps because effective drugs are
available. Nearly 1 in 7 men (14%) reported taking medication to improve
sexual function.
The survey documented another significant gender
difference. While 78 percent of men ages 75 to 85 have a spouse or other
intimate relationship, only 40 percent of women that age do, a
consequence of the age disparity of relationships coupled with women's
greater longevity.
"Sexuality is an important part of a healthy and
engaged life at older ages for both women and men," said co-author Linda
Waite, PhD, the Lucy Flower Professor in Urban Sociology at the
University of Chicago and Director of the Center for Aging at NORC. For
the vast majority of men, aging is a partnered experience, "but women's
sexuality," Waite said, "is more often affected by the death or poor
health of their spouse."
NSHAP, funded by the National Institutes of Health,
was created to discover how social relationships, especially intimate
relationships, influence health as people age. Between July 2005 and
March 2006, the researchers interviewed 3,005 people ages 57 to 85 in
their homes. They asked about social and marital history, sexual
activity and function, and physical and mental health.
While there have been other surveys focused on the
older population, "they have typically been based on convenience samples
with low completion rates or clinical samples with unknown biases in
representing the population at large," Laumann said. Such surveys
typically over- or under-estimate the prevalence of sexual problems.
"NSHAP provides us with a much more reliable guide to strengths and
weaknesses of sexual health in the older population of the United
States."
Another new element of NSHAP is the collection of
physiological specimens such as spots of blood, saliva and vaginal
swabs. In follow-up studies, the researchers will use these specimens to
extract various "biomarkers." These will provide evidence about hormone
levels, prevalence of diseases such as heart disease or diabetes, and
the frequency of human papillomavirus, a sexually transmitted disease.
The NSHAP team also gathered data on how older
adults perceive the world of social relationships, assessing
participants’ sense of touch, taste and smell as well as vision and
hearing.
Despite the personal nature of many of the
questions, study participants were very forthcoming, as expected from
prior clinical and research experience with older adults. Seventy-five
percent of those approached agreed to participate. Overall, only 2 to 7
percent declined to answer direct questions about sexual activities or
problems. (Fourteen percent did not answer questions about masturbation
on a self-administered questionnaire.) “Participants were more likely to
refuse questions about income than they were about sex,” Lindau said.
Many of those who were sexually active found ways to remain active,
despite worsening health. The proportion of sexually active couples that
engage in oral sex, for example, hovered at around 50 percent for those
under 75. More than half of men and a quarter of women, whether they had
a sexual partner or not, acknowledged masturbating.
"Although sexuality has long been thought to
deteriorate inevitably with age, we found that health is a more
important indicator for many aspects of sexuality than is age alone,"
Lindau said. "This suggests that older adults with medical problems, or
those considering treatment that might affect sexuality, should be
counseled based on health status rather than just their age."
The most common reported reason for sexual
inactivity among individuals with a spousal or other intimate
relationship for men (55%) and women (64%) was the male partner's
physical health. Women, especially those who were not in a current
relationship, were more likely than men to report lack of interest in
sex.
Despite the unprecedented shift in the age of the
population, the public, physicians and policymakers lack information on
sexual behavior at older ages and on how sexual activities and problems
change with age and illness.
"We hope our findings improve public health by
countering harmful stereotypes and allowing older individuals to view
their experience relative to others," Lindau said. "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."
This report, according to the authors, provides the
first such reference for clinical decision making. It "should improve
patient education and counseling," they conclude, and help identify
"health related and potentially treatable sexual problems."
Editor’s Notes:
The National Health, Social Life and Aging Project
is supported by the National Institutes of Health, including the
National Institute on Aging, the Office of Research on Women's Health,
the Office of AIDS Research, and the Office of Behavioral and Social
Sciences Research. NSHAP is also supported by the National Opinion
Research Center, whose staff was responsible for the data collection.
Additional authors of the study include Philip
Schumm and Colm A. O’Muircheartaigh of the University of Chicago and
Wendy Levinson of the University of Toronto.
Reference: Lindau, S.T., et al. A national study of
sexuality and health among older adults in the U.S. New England Journal
of Medicine (2007), 357(8): 762-774.
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