Skip to main content
SpringerLink
Log in

Sexual Activity and Psychosocial Benefits in Older Adults: Challenges and Ways Forward

  • Chapter
  • First Online:
Sexual Behaviour and Health in Older Adults

Part of the book series: Practical Issues in Geriatrics ((PIG))

  • 540 Accesses

Abstract

Sexuality plays an important role in the lives of individuals throughout their lifespan, as it can be expressed and experienced in different ways. There is a common worldwide misconception that individuals become asexual as they get older, but an emerging body of evidence confirms that this is not true, and that their sexuality is likely to be misunderstood.

Perceptions of sexuality, sexual desire as well as forms of sexual behaviour differ among older adults and are influenced by many factors, such as their state of health or existing illnesses as well as their social, cultural, and structural contexts. The definition of sexuality in older adults is much broader than that of the younger population and is not just limited to sexual intercourse. On the contrary, many older adults relate the positive emotions and close companionship associated with joy, love, happiness, cuddling, touching, and hugging to sexuality in older age.

Many reports and empirical studies confirm that sexual intercourse and other types of sexual behaviours happen among the elderly, and that sexual experience is often seen as an important factor in their mental and physical health. Furthermore, irrespective of its form, positive sexual activity in older adults leads to greater enjoyment in life, higher levels of psychosocial satisfaction, increased physical activity, better health, and higher relationship satisfaction.

However, for many older adults, their sexual needs and well-being are often ignored or met with disdain for various reasons. Apart from an increasing number of health issues, chronic diseases, and medication use in older adults, other factors that inevitably affect sexuality are related to their social, cultural, and structural contexts. A lack of interest or commitment in relationships, cultural differences as well as a lack of privacy in institutionalized contexts also determine how old-aged people express and experience sexuality. If these health and social contexts are not adequately addressed, their sexual perception and behaviours are likely to be negatively shaped.

For this reason, healthcare practitioners and those who are in close interaction with the elderly should be aware of these barriers and be able to engage with them in discussions about sexuality. In order to better understand sexuality in older adults more cultural, ethnic, and religious sensitivity is needed. Further, education on older age sexuality as well as engaging in open discussions on sexuality with older adults is desirable.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Association for Sexual Health. Declaration of sexual rights. 2014. https://worldsexualhealth.net/resources/declaration-of-sexual-rights/. Accessed 31 Aug 2020.

  2. World Health Organization. Sexual and reproductive health—defining sexual health. 2006. https://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/. Accessed 31 Aug 2020.

  3. Kolodziejczak K, et al. Sexual activity, sexual thoughts, and intimacy among older adults: links with physical health and psychosocial resources for successful aging. Psychol Aging. 2019;34(3):389.

    Article  Google Scholar 

  4. World Health Organization. World report on ageing and health. 2015. https://www.who.int/ageing/events/world-report-2015-launch/en/. Accessed 31 Aug 2020.

  5. Freak-Poli R. It’s not age that prevents sexual activity later in life. Aust J Ageing. 2020;39(Suppl 1):22–9.

    Article  Google Scholar 

  6. Graf AS, Patrick JH. The influence of sexual attitudes on mid- to late-life sexual well-being: age, not gender, as a salient factor. Int J Aging Hum Dev. 2014;79(1):55–79.

    Article  Google Scholar 

  7. Hinchliff S, et al. Older adults’ experiences of sexual difficulties: qualitative findings from the English longitudinal study on ageing (ELSA). J Sex Res. 2018;55(2):152–63.

    Article  Google Scholar 

  8. Verschuren JE, et al. Chronic disease and sexuality: a generic conceptual framework. J Sex Res. 2010;47(2):153–70.

    Article  Google Scholar 

  9. McNicoll L. Issues of sexuality in the elderly. Med Health R I. 2008;91(10):321–2.

    Google Scholar 

  10. Papaharitou S, et al. Factors associated with sexuality in later life: an exploratory study in a group of Greek married older adults. Arch Gerontol Geriatr. 2008;46(2):191–201.

    Article  CAS  Google Scholar 

  11. DeLamater J. Sexual expression in later life: a review and synthesis. J Sex Res. 2012;49(2–3):125–41.

    Article  Google Scholar 

  12. Freak-Poli R, et al. Sexual activity and physical tenderness in older adults: cross-sectional prevalence and associated characteristics. J Sex Med. 2017;14(7):918–27.

    Article  Google Scholar 

  13. Deacon S, Minichiello V, Plummer D. Sexuality and older people: revisiting the assumptions. Educ Gerontol. 1995;21(5):497–513.

    Article  Google Scholar 

  14. Waite LJ, et al. Sexuality: measures of partnerships, practices, attitudes, and problems in the National Social Life, health, and Aging study. J Gerontol B Psychol Sci Soc Sci. 2009;64(Suppl 1):i56–66.

    Article  Google Scholar 

  15. Hinchliff S, Gott M. Perceptions of well-being in sexual ill health: what role does age play? J Health Psychol. 2004;9(5):649–60.

    Article  Google Scholar 

  16. Bouman WP. The Oxford textbook of old age psychiatry. In: Dening T, Thomas A, editors. Sexuality in later life. Oxford: Oxford University Press; 2013. p. 703–23.

    Chapter  Google Scholar 

  17. Heidari S. Sexuality and older people: a neglected issue. Reprod Health Matters. 2016;24(48):1–5.

    Article  Google Scholar 

  18. Lindau ST, et al. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762–74.

    Article  CAS  Google Scholar 

  19. Beckman N, et al. Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001. BMJ. 2008;337:a279.

    Article  Google Scholar 

  20. Træen B, et al. Sexuality in older adults (65+)—an overview of the recent literature, part 2: body Image and sexual satisfaction. Int J Sex Health. 2017;29(1):11–21.

    Article  Google Scholar 

  21. Muller B, et al. Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study. PLoS One. 2014;9(11):e111404.

    Article  Google Scholar 

  22. Ferris JA, et al. Self reported sexual activity in Australian sexagenarians. BMJ. 2008;337:a1250.

    Article  Google Scholar 

  23. Fileborn B, et al. Sex, desire and pleasure: considering the experiences of older Australian women. Sex Relat Ther. 2015;30(1):117–30.

    Article  Google Scholar 

  24. Lee DM, et al. Sexual health and well-being among older men and women in England: findings from the English longitudinal study of ageing. Arch Sex Behav. 2016;45(1):133–44.

    Article  Google Scholar 

  25. Lee DM, et al. Sexual health and positive subjective well-being in partnered older men and Women. J Gerontol B Psychol Sci Soc Sci. 2016;71(4):698–710.

    Article  Google Scholar 

  26. Sandberg L. In lust we trust? Masculinity and sexual desire in later life. Men Masculinities. 2016;19(2):192–208.

    Article  Google Scholar 

  27. Schlesinger B. The sexless years or sex rediscovered. In: Neugebauer-Visano R, editor. Seniors and sexuality: experiencing intimacy in later life. Toronto: Canadian Scholars’ Press; 1995. p. 5–16.

    Google Scholar 

  28. Ussher JM, et al. Renegotiating sex and intimacy after cancer: resisting the coital imperative. Cancer Nurs. 2013;36(6):454–62.

    Article  Google Scholar 

  29. Bush E. The use of human touch to improve the Well-being of older adults. A holistic nursing intervention. J Holist Nurs. 2001;19(3):256–70.

    Article  CAS  Google Scholar 

  30. Vieira AI, et al. Hand tactile discrimination, social touch and frailty criteria in elderly people: a cross sectional observational study. Arch Gerontol Geriatr. 2016;66:73–81.

    Article  Google Scholar 

  31. Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51(Suppl):S54–66.

    Article  Google Scholar 

  32. Flett GL, Heisel MJ. Aging and feeling valued versus expendable during the COVID-19 pandemic and beyond: a review and commentary of why mattering is fundamental to the health and well-being of older adults. Int J Ment Heal Addict. 2021;19:2443–69.

    Article  Google Scholar 

  33. Johnson BK. A correlational framework for understanding sexuality in women age 50 and older. Health Care Women Int. 1998;19(6):553–64.

    Article  CAS  Google Scholar 

  34. Amin SH, Kuhle CL, Fitzpatrick LA. Comprehensive evaluation of the older woman. Mayo Clin Proc. 2003;78(9):1157–85.

    Article  Google Scholar 

  35. Lagana L, Maciel M. Sexual desire among Mexican-American older women: a qualitative study. Cult Health Sex. 2010;12(6):705–19.

    Article  Google Scholar 

  36. Seguin RA, et al. Strength training improves body image and physical activity behaviors among midlife and older rural women. J Ext. 2013;51(4):4FEA2.

    Google Scholar 

  37. World Health Organization. Constitution of the World Health Organization. 2006. https://www.who.int/about/who-we-are/constitution. Accessed 17 Sep 2020.

  38. Syme ML. The evolving concept of older adult sexual behavior and its benefits. Generations. 2014;38:35–41.

    Google Scholar 

  39. Flynn T-J, Gow AJ. Examining associations between sexual behaviours and quality of life in older adults. Age Ageing. 2015;44(5):823–8.

    Article  Google Scholar 

  40. Smith L, et al. Sexual activity is associated with greater enjoyment of life in older adults. Sex Med. 2019;7(1):11–8.

    Article  Google Scholar 

  41. Blumenstock SM, et al. High emotional and sexual satisfaction among partnered Midlife Canadians: associations with relationship characteristics, sexual activity and communication, and health. Arch Sex Behav. 2020;49(3):953–67.

    Article  Google Scholar 

  42. Kim ES, Ong A. Characterizing the pathways underlying the association between psychological well-being and health. Innov Aging. 2019;3(Supplement_1):S813.

    Google Scholar 

  43. Lindau ST, Gavrilova N. Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ. 2010;340:c810.

    Article  Google Scholar 

  44. Kontula O, Haavio-Mannila E. The impact of aging on human sexual activity and sexual desire. J Sex Res. 2009;46(1):46–56.

    Article  Google Scholar 

  45. Brody S. The relative health benefits of different sexual activities. J Sex Med. 2010;7(4 Pt 1):1336–61.

    Article  Google Scholar 

  46. Heiman JR, et al. Sexual satisfaction and relationship happiness in midlife and older couples in five countries. Arch Sex Behav. 2011;40(4):741–53.

    Article  Google Scholar 

  47. Jannini EA, et al. Is sex just fun? How sexual activity improves health. J Sex Med. 2009;6(10):2640–8.

    Article  Google Scholar 

  48. Merghati Khoei E, et al. Development, validity and reliability of sexual health measures for spinal cord injured patients in Iran. Int J Fertil Steril. 2013;7(2):82–7.

    Google Scholar 

  49. Nusbaum MR, Hamilton C, Lenahan P. Chronic illness and sexual functioning. Am Fam Physician. 2003;67(2):347–54.

    Google Scholar 

  50. Ziaei T, et al. Psychometric properties of the Farsi version of modified multidimensional sexual self-concept questionnaire. Iran J Nurs Midwifery Res. 2013;18(6):439–45.

    Google Scholar 

  51. DeLamater JD, Sill M. Sexual desire in later life. J Sex Res. 2005;42(2):138–49.

    Article  Google Scholar 

  52. Byers ES. Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. J Sex Res. 2005;42(2):113–8.

    Article  Google Scholar 

  53. Rosen RC, et al. Men with sexual problems and their partners: findings from the international survey of relationships. Arch Sex Behav. 2016;45(1):159–73.

    Article  Google Scholar 

  54. Merghati-Khoei E, et al. Sexuality and elderly with chronic diseases: a review of the existing literature. J Res Med Sci. 2016;21:136.

    Article  Google Scholar 

  55. DeLamater J, Karraker A. Sexual functioning in older adults. Curr Psychiatry Rep. 2009;11(1):6–11.

    Article  Google Scholar 

  56. Noroozi M, et al. How does a group of Iranian youth conceptualize their risky sexual experiences? Iran Red Crescent Med J. 2015;17(2):e18301.

    Article  Google Scholar 

  57. Beckman N, et al. Determinants of sexual activity in four birth cohorts of Swedish 70-year-olds examined 1971–2001. J Sex Med. 2014;11(2):401–10.

    Article  Google Scholar 

  58. Jeong HC, et al. Sexual behavior of the elderly in urban areas. World J Mens Health. 2012;30(3):166–71.

    Article  Google Scholar 

  59. Træen B, et al. Sexuality in older adults (65+)—an overview of the literature, part 1: sexual function and its difficulties. Int J Sex Health. 2017;29(1):1–10.

    Article  Google Scholar 

  60. Karraker A, Delamater J, Schwartz CR. Sexual frequency decline from midlife to later life. J Gerontol B Psychol Sci Soc Sci. 2011;66(4):502–12.

    Article  Google Scholar 

  61. George LK, Weiler SJ. Sexuality in middle and late life. The effects of age, cohort, and gender. Arch Gen Psychiatry. 1981;38(8):919–23.

    Article  CAS  Google Scholar 

  62. Jowett A, Peel E, Shaw RL. Sex and diabetes: a thematic analysis of gay and bisexual men’s accounts. J Health Psychol. 2012;17(3):409–18.

    Article  Google Scholar 

  63. Potts A, et al. “Viagra stories”: challenging ‘erectile dysfunction’. Soc Sci Med. 2004;59(3):489–99.

    Article  Google Scholar 

  64. Lev EL, et al. Quality of life of men treated with brachytherapies for prostate cancer. Health Qual Life Outcomes. 2004;2:28.

    Article  Google Scholar 

  65. Pirl WF, Mello J. Psychological complications of prostate cancer. Oncology (Williston Park). 2002;16(11):1448–53; discussion 1453–4, 1457–8, 1467.

    Google Scholar 

  66. Visser A, et al. Changes in health-related quality of life of men with prostate cancer 3 months after diagnosis: the role of psychosocial factors and comparisment with benign prostate hyperplasia patients. Patient Educ Couns. 2003;49(3):225–32.

    Article  Google Scholar 

  67. Bokhour BG, et al. Sexuality after treatment for early prostate cancer: exploring the meanings of “erectile dysfunction”. J Gen Intern Med. 2001;16(10):649–55.

    Article  CAS  Google Scholar 

  68. Butler L, et al. Quality of life post radical prostatectomy: a male perspective. Urol Nurs. 2001;21(4):283–8.

    CAS  Google Scholar 

  69. Rosen RC, Bachmann GA. Sexual well-being, happiness, and satisfaction, in women: the case for a new conceptual paradigm. J Sex Marital Ther. 2008;34(4):291–7; discussion 298-307.

    Article  Google Scholar 

  70. Mercer CH, et al. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of sexual attitudes and lifestyles (Natsal). Lancet. 2013;382(9907):1781–94.

    Article  Google Scholar 

  71. Freak-Poli R, et al. Happiness, rather than depression, is associated with sexual behaviour in partnered older adults. Age Ageing. 2017;46(1):101–7.

    Google Scholar 

  72. McFarland MJ, Uecker JE, Regnerus MD. The role of religion in shaping sexual frequency and satisfaction: evidence from married and unmarried older adults. J Sex Res. 2011;48(2–3):297–308.

    Article  Google Scholar 

  73. Le Gall A, Mullet E, Riviere Shafighi S. Age, religious beliefs, and sexual attitudes. J Sex Res. 2002;39(3):207–16.

    Article  Google Scholar 

  74. Lobsenz N. Sex and the senior citizen. New York: Bruner/Mazel; 1974.

    Google Scholar 

  75. Butler R, Lewis M. Aging and mental health, vol. 3. Saint Louis, MO: Mosby; 1988.

    Google Scholar 

  76. Hughes AK, Rostant OS, Pelon S. Sexual problems among older women by age and race. J Womens Health. 2015;24(8):663–9.

    Article  Google Scholar 

  77. Lodge AC, Umberson D. All shook up: sexuality of mid- to later life married couples. J Marriage Fam. 2012;74(3):428–43.

    Article  Google Scholar 

  78. Montemurro B, Gillen MM. Wrinkles and sagging flesh: exploring transformations in women’s sexual body image. J Women Aging. 2013;25(1):3–23.

    Article  Google Scholar 

  79. Calkins M, Cassella C. Exploring the cost and value of private versus shared bedrooms in nursing homes. Gerontologist. 2007;47(2):169–83.

    Article  Google Scholar 

  80. Morgan LA. Balancing safety and privacy: the case of room locks in assisted living. J Hous Elder. 2009;23(3):185–203.

    Article  Google Scholar 

  81. Bauer M. Their only privacy is between their sheets. Privacy and the sexuality of elderly nursing home residents. J Gerontol Nurs. 1999;25(8):37–41.

    Article  CAS  Google Scholar 

  82. Rheaume C, Mitty E. Sexuality and intimacy in older adults. Geriatr Nurs. 2008;29(5):342–9.

    Article  Google Scholar 

  83. McCartney JR, et al. Sexuality and the institutionalized elderly. J Am Geriatr Soc. 1987;35(4):331–3.

    Article  CAS  Google Scholar 

  84. Steinke EE. Sexuality in aging: implications for nursing facility staff. J Contin Educ Nurs. 1997;28(2):59–63.

    Article  CAS  Google Scholar 

  85. Frankowski AC, Clark LJ. Sexuality and intimacy in assisted living: residents’ perspectives and experiences. Sex Res Social Policy. 2009;6(4):25–37.

    Article  Google Scholar 

  86. Eddy DM. Before and after attitudes toward aging in a BSN program. J Gerontol Nurs. 1986;12(5):30–4.

    Article  CAS  Google Scholar 

  87. Luketich GF. Sex and the elderly: what do nurses know? Educ Gerontol. 1991;17(6):573–80.

    Article  Google Scholar 

  88. Roach SM. Sexual behaviour of nursing home residents: staff perceptions and responses. J Adv Nurs. 2004;48(4):371–9.

    Article  Google Scholar 

  89. Hajjar RR, Kamel HK. Sexuality in the nursing home, part 1: attitudes and barriers to sexual expression. J Am Med Dir Assoc. 2004;5(2 Suppl):S42–7.

    Article  Google Scholar 

  90. National Resource Center on LGBT Aging. Outing age 2010: public policy issues affecting lesbian, gay, bisexual and transgender elders. 2010. https://www.lgbtagingcenter.org/resources/resource.cfm?r=30. Accessed 15 Sep 2020.

  91. Office of the High Commissioner for Human Rights. United Nations principles for older persons. 2020. https://www.ohchr.org/en/professionalinterest/pages/olderpersons.aspx. Accessed 17 Sep 2020.

  92. Quinn-Krach P, Van Hoozer H. Sexuality of the aged and the attitudes and knowledge of nursing students. J Nurs Educ. 1988;27(8):359–63.

    Article  CAS  Google Scholar 

  93. Walker BL, Harrington D. Effects of staff training on staff knowledge and attitudes about sexuality. Educ Gerontol. 2002;28(8):639–54.

    Article  Google Scholar 

  94. Agunbiade OM, Togunde D. ‘No sweet in sex’: perceptions of condom usefulness among elderly Yoruba people in Ibadan Nigeria. J Cross Cult Gerontol. 2018;33(3):319–36.

    Article  Google Scholar 

  95. Dalrymple J, et al. Socio-cultural influences upon knowledge of sexually transmitted infections: a qualitative study with heterosexual middle-aged adults in Scotland. Reprod Health Matters. 2016;24(48):34–42.

    Article  Google Scholar 

  96. Fileborn B, et al. Safer sex in later life: qualitative interviews with older Australians on their understandings and practices of safer sex. J Sex Res. 2018;55(2):164–77.

    Article  Google Scholar 

  97. Flynn KE, et al. Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of US adults. J Sex Med. 2016;13(11):1642–50.

    Article  Google Scholar 

  98. Hinchliff S, Gott M. Seeking medical help for sexual concerns in mid- and later life: a review of the literature. J Sex Res. 2011;48(2–3):106–17.

    Article  Google Scholar 

  99. Gleser H. Sex, women and the menopause: are specialist trainee doctors up for it? A survey of views and attitudes of specialist trainee doctors in Community Sexual & Reproductive Health and Obstetrics & Gynaecology around sexuality and sexual healthcare in the (peri)menopause. Post Reprod Health. 2015;21(1):26–33.

    Article  Google Scholar 

  100. Mellor RM, et al. Health care professionals’ views on discussing sexual wellbeing with patients who have had a stroke: a qualitative study. PLoS One. 2013;8(10):e78802.

    Article  CAS  Google Scholar 

  101. World Health Organization. Sexual health, human rights and the law. 2015. https://www.who.int/reproductivehealth/publications/sexual_health/sexual-health-human-rights-law/en/. Accessed 1 Sep 2020.

Download references

Author information

Authors and Affiliations

  1. Institute for Outcomes Research—Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria

    Siniša Grabovac

  2. Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria

    Radhika Seiler-Ramadas

Authors
  1. Siniša Grabovac
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Radhika Seiler-Ramadas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Siniša Grabovac .

Editor information

Editors and Affiliations

  1. Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK

    Lee Smith

  2. Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria

    Igor Grabovac

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Grabovac, S., Seiler-Ramadas, R. (2023). Sexual Activity and Psychosocial Benefits in Older Adults: Challenges and Ways Forward. In: Smith, L., Grabovac, I. (eds) Sexual Behaviour and Health in Older Adults. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-031-21029-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-21029-7_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-21028-0

  • Online ISBN: 978-3-031-21029-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation