Skip to main content

Sexual Health and Well-being Among Older Men and Women in England: Findings from the English Longitudinal Study of Ageing

Abstract

We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples’ sexual health should be managed, not just in the context of their age, gender, and general health, but also within their existing sexual relationship.

This is a preview of subscription content, access via your institution.

References

  • Bacon, C. G., Mittleman, M. A., Kawachi, I., Giovannucci, E., Glasser, D. B., & Rimm, E. B. (2003). Sexual function in men older than 50 years of age: Results from the health professionals follow-up study. Annals of Internal Medicine, 139(3), 161–168.

    PubMed  Article  Google Scholar 

  • Bancroft, J., Loftus, J., & Long, J. S. (2003). Distress about sex: A national survey of women in heterosexual relationships. Archives of Sexual Behavior, 32(3), 193–208.

    PubMed  Article  Google Scholar 

  • Baumeister, R. F., Catanese, K. R., & Vohs, K. D. (2001). Is there a gender difference in strength of sex drive? Theoretical views, conceptual distinctions, and a review of relevant evidence. Personality and Social Psychology Review, 5(3), 242–273.

    Article  Google Scholar 

  • Blanker, M. H., Bosch, J. L. H. R., Groeneveld, F. P. M. J., Bohnen, A. M., Prins, A., Thomas, S., & Hop, W. C. J. (2001). Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: Prevalence, concern, and relation to sexual activity. Urology, 57(4), 763–768. doi:10.1016/S0090-4295(00)01091-8.

    PubMed  Article  Google Scholar 

  • Christopher, F. S., & Sprecher, S. (2000). Sexuality in marriage, dating, and other relationships: A decade review. Journal of Marriage and the Family, 62(4), 999–1017. doi:10.1111/j.1741-3737.2000.00999.x.

    Article  Google Scholar 

  • Corona, G., Lee, D. M., Forti, G., O’Connor, D. B., Maggi, M., O’Neill, T. W., … Group, E. S. (2010). Age-related changes in general and sexual health in middle-aged and older men: Results from the European Male Ageing Study (EMAS). Journal of Sexual Medicine, 7(4 Pt 1), 1362–1380. doi:10.1111/j.1743-6109.2009.01601.x.

  • DeLamater, J. (2012). Sexual expression in later life: A review and synthesis. Journal of Sex Research, 49(2–3), 125–141. doi:10.1080/00224499.2011.603168.

    PubMed  Article  Google Scholar 

  • Fenton, K. A., Johnson, A. M., McManus, S., & Erens, B. (2001). Measuring sexual behaviour: Methodological challenges in survey research. Sexually Transmitted Infections, 77(2), 84–92.

    PubMed  PubMed Central  Article  Google Scholar 

  • Field, N., Mercer, C. H., Sonnenberg, P., Tanton, C., Clifton, S., Mitchell, K. R., … Johnson, A. M. (2013). Associations between health and sexual lifestyles in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 382(9907), 1830–1844. doi:10.1016/S0140-6736(13)62222-9.

  • Hill, J., Bird, H., & Thorpe, R. (2003). Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology (Oxford), 42(2), 280–286.

    Article  Google Scholar 

  • Impett, E. A., & Peplau, L. A. (2002). Why some women consent to unwanted sex with a dating partner: Insights from attachment theory. Psychology of Women Quarterly, 26(4), 360–370. doi:10.1111/1471-6402.T01-1-00075.

    Article  Google Scholar 

  • Karraker, A., DeLamater, J., & Schwartz, C. R. (2011). Sexual frequency decline from midlife to later life. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66(4), 502–512. doi:10.1093/geronb/gbr058.

    Article  Google Scholar 

  • Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., … GSSAB Investigators’ Group. (2005). Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. International Journal of Impotence Research, 17(1), 39–57.

  • Laumann, E. O., Paik, A., Glasser, D. B., Kang, J. H., Wang, T., Levinson, B., … Gingell, C. (2006). A cross-national study of subjective sexual well-being among older women and men: Findings from the Global Study of Sexual Attitudes and Behaviors. Archives of Sexual Behavior, 35(2), 145–161. doi:10.1007/s10508-005-9005-3.

  • Lindau, S. T., & Gavrilova, N. (2010). Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. British Medical Journal, 340, c810. doi:10.1136/bmj.c810.

    PubMed  PubMed Central  Article  Google Scholar 

  • Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O’Muircheartaigh, C. A., & Waite, L. J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357(8), 762–774. doi:10.1056/NEJMoa067423.

    PubMed  PubMed Central  Article  Google Scholar 

  • Mak, R., De Backer, G., Kornitzer, M., & De Meyer, J. M. (2002). Prevalence and correlates of erectile dysfunction in a population-based study in Belgium. European Urology, 41(2), 132–138.

    PubMed  Article  Google Scholar 

  • McKinlay, J. B. (2000). The worldwide prevalence and epidemiology of erectile dysfunction. International Journal of Impotence Research, 12(Suppl 4), S6–S11.

    PubMed  Article  Google Scholar 

  • Mercer, C. H., Tanton, C., Prah, P., Erens, B., Sonnenberg, P., Clifton, S., … Johnson, A. M. (2013). 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, 382(9907), 1781–1794. doi:10.1016/S0140-6736(13)62035-8.

  • Mercer, C. H., Wellings, K., & Johnson, A. M. (2013b). What’s new about Natsal-3? Sexually Transmitted Infections. doi:10.1136/sextrans-2013-051292.

    Google Scholar 

  • Mitchell, K. R., Mercer, C. H., Ploubidis, G. B., Jones, K. G., Datta, J., Field, N., … Wellings, K. (2013). Sexual function in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 382(9907), 1817–1829. doi:10.1016/S0140-6736(13)62366-1.

  • Mitchell, K. R., Ploubidis, G. B., Datta, J., & Wellings, K. (2012). The Natsal-SF: A validated measure of sexual function for use in community surveys. European Journal of Epidemiology, 27(6), 409–418. doi:10.1007/s10654-012-9697-3.

    PubMed  PubMed Central  Article  Google Scholar 

  • Morley, J. E., & Tolson, D. T. (2012). Sexuality and ageing. In A. J. Sinclair, J. E. Morley, & B. Vellas (Eds.), Pathy’s principles and practice of geriatric medicine (5th ed., pp. 93–102). New York: Wiley.

    Chapter  Google Scholar 

  • Nehra, A., Jackson, G., Miner, M., Billups, K. L., Burnett, A. L., Buvat, J., … Wu, F. C. (2012). The Princeton III consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clinic Proceedings, 87(8), 766–778. doi:10.1016/j.mayocp.2012.06.015.

  • Nicolosi, A., Laumann, E. O., Glasser, D. B., Moreira, E. D., Paik, A., Gingell, C., & Be, G. S. S. A. (2004). Sexual behavior and sexual dysfunctions after age 40: The Global Study of Sexual Attitudes and Behaviors. Urology, 64(5), 991–997. doi:10.1016/j.urology.2004.06.055.

    PubMed  Article  Google Scholar 

  • O’Connor, D. B., Corona, G., Forti, G., Tajar, A., Lee, D. M., Finn, J. D., … Wu, F. C. (2008). Assessment of sexual health in aging men in Europe: Development and validation of the European Male Ageing Study sexual function questionnaire. Journal of Sexual Medicine, 5(6), 1374–1385. doi:10.1111/j.1743-6109.2008.00781.x.

  • ONS. (2011). Office for National Statistics. Retrieved 5 March, 2014 from http://www.ons.gov.uk/ons/rel/npp/national-population-projections/2010-based-projections/index.html.

  • Sanchez-Cruz, J. J., Cabrera-Leon, A., Martin-Morales, A., Fernandez, A., Burgos, R., & Rejas, J. (2003). Male erectile dysfunction and health-related quality of life. European Urology, 44(2), 245–253.

    PubMed  Article  Google Scholar 

  • Steffick, D. E. (2000). Documentation of affective functioning measures in the health and retirement study. Ann Arbor, MI: HRS Health Working Group.

    Book  Google Scholar 

  • Steptoe, A., Breeze, E., Banks, J., & Nazroo, J. (2013). Cohort Profile: The English Longitudinal Study of Ageing. International Journal of Epidemiology, 42(6), 1640–1648. doi:10.1093/ije/dys168.

    PubMed  PubMed Central  Article  Google Scholar 

  • Suzman, R. (2009). The National Social Life, Health, and Aging Project: An introduction. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(Suppl 1), i5–i11. doi:10.1093/geronb/gbp078.

    Article  Google Scholar 

  • Thompson, I. M., Tangen, C. M., Goodman, P. J., Probstfield, J. L., Moinpour, C. M., & Coltman, C. A. (2005). Erectile dysfunction and subsequent cardiovascular disease. Journal of the American Medical Association, 294(23), 2996–3002. doi:10.1001/jama.294.23.2996.

    PubMed  Article  Google Scholar 

  • Tiefer, L. (2002). Sexual behaviour and its medicalisation. Many (especially economic) forces promote medicalisation. British Medical Journal, 325(7354), 45.

    PubMed  PubMed Central  Article  Google Scholar 

  • Tristano, A. G. (2009). The impact of rheumatic diseases on sexual function. Rheumatology International, 29(8), 853–860. doi:10.1007/s00296-009-0850-6.

    PubMed  Article  Google Scholar 

  • Waite, L. J., Laumann, E. O., Das, A., & Schumm, L. P. (2009). Sexuality: Measures of partnerships, practices, attitudes, and problems in the National Social Life, Health, and Aging Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(Suppl 1), i56–i66. doi:10.1093/geronb/gbp038-&gt.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the study participants. DML is a Research into Ageing Fellow. This study was funded by the National Institute on Aging (Grants 2RO1AG7644-01A1 and 2RO1AG017644) and a consortium of UK Government departments coordinated by the Office for National Statistics. JN and NP were supported by the fRaill project (Grant MRC G1001375/1) as part of the cross-research council Life Long Health and Well-being Programme. The lead author (DML) confirms the independence of all co-authors from funders and sponsors. The ELSA datasets are publicly available from the UK Data Service at www.ukdataservice.ac.uk. ELSA documentation (including questionnaires) is available from the Institute for Fiscal Studies at http://www.elsa-project.ac.uk. Stata® do.files are available from DML at david.m.lee@manchester.ac.uk.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David M. Lee.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lee, D.M., Nazroo, J., O’Connor, D.B. 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 45, 133–144 (2016). https://doi.org/10.1007/s10508-014-0465-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-014-0465-1

Keywords

  • Sexual health
  • Sexual function
  • Population-based
  • Aging
  • Chronic illness
  • ELSA