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Promotion of Sex in Older Adults

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Sexual Behaviour and Health in Older Adults

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

Abstract

Sexuality remains an essential aspect of life in older adults and substantially contributes to health outcomes. It is important for healthcare workers to be aware of challenges older adults face in the context of sexuality, to consider possible barriers, and to adequately address issues concerning sexuality when working with older adults. This chapter addresses some of the issues that healthcare workers face in the context of sexuality in older adults and to provide guidance on how to approach them. Barriers to communication often include common misconceptions, such as “older adults do not engage in sex”, “sex is defined as penile-vaginal intercourse”, “orgasm is the only goal of sex”, and “risk of sexually transmitted infections and HIV among older populations is low” and healthcare workers’ awareness of their own knowledge and experience with the subject are discussed. Tools including an evaluation of sexual health services, practical communication tools, and ways to initiate a conversation on sexuality are provided. Guidelines on sexual history taking, an important part of an exam for the patient’s health including sexual orientation, gender identity, sexual activities, potential risk behavior, romantic and sexual partner(s), and signs or symptoms of sexual problems or dysfunctions, are presented.

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References

  1. World Health Organization. Aging and health. 2018. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health#:~:text=By%202050%2C%20the%20world's%20population,in%20this%20age%20group%20worldwide.

  2. World Health Organization. Defining sexual health: report of a technical consultation of sexual health, 28–31 January 2002. Geneva: Sexual health document series; 2006. http://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf.

    Google Scholar 

  3. Hyde Z, Flicker L, Hankey GJ, Almeida OP, McCaul KA, Chubb SA, Yeap BB. Prevalence of sexual activity and associated factors in men aged 75 to 95 years: a cohort study. Ann Intern Med. 2010;153(11):693–702. https://doi.org/10.7326/0003-4819-153-11-201012070-00002.

    Article  Google Scholar 

  4. Grabovac I, Smith L, McDermott DT, Stefanac S, Yang L, Veronese N, Jackson SE. Well-being among older gay and bisexual men and women in England: a cross-sectional population study. J Am Med Dir Assoc. 2019;20(9):1080–1085.e1081. https://doi.org/10.1016/j.jamda.2019.01.119.

    Article  Google Scholar 

  5. Knochel KA, Croghan CF, Moone RP, Quam JK. Training, geography, and provision of aging services to lesbian, gay, bisexual, and transgender older adults. J Gerontol Soc Work. 2012;55(5):426–43. https://doi.org/10.1080/01634372.2012.665158.

    Article  Google Scholar 

  6. World Health Organization. WHO meeting on ethical, legal, human rights and social accountability implications of self-care interventions for sexual and reproductive health: 12–14 March 2018, Brocher Foundation, Hermance, Switzerland: summary report. Geneva: World Health Organization; 2018.

    Google Scholar 

  7. Matthias RE, Lubben JE, Atchison KA, Schweitzer SO. Sexual activity and satisfaction among very old adults: results from a community-dwelling Medicare population survey. Gerontologist. 1997;37(1):6–14. https://doi.org/10.1093/geront/37.1.6.

    Article  CAS  Google Scholar 

  8. Smith LJ, Mulhall JP, Deveci S, Monaghan N, Reid MC. Sex after seventy: a pilot study of sexual function in older persons. J Sex Med. 2007;4(5):1247–53. https://doi.org/10.1111/j.1743-6109.2007.00568.x.

    Article  Google Scholar 

  9. Ambler DR, Bieber EJ, Diamond MP. Sexual function in elderly women: a review of current literature. Rev Obstet Gynecol. 2012;5(1):16–27. https://www.ncbi.nlm.nih.gov/pubmed/22582123.

    Google Scholar 

  10. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80y: prevalence and correlates identified in the global study of sexual attitudes and behaviors. Int J Impot Res. 2005;17:39–57. https://doi.org/10.1038/sj.ijir.3901250.

    Article  CAS  Google Scholar 

  11. Mulhall JP, Luo X, Zou KH, Stecher V, Galaznik A. Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA. Int J Clin Pract. 2016;70(12):1012–8. https://doi.org/10.1111/ijcp.12908.

    Article  CAS  Google Scholar 

  12. Camacho ME, Reyes-Ortiz CA. Sexual dysfunction in the elderly: age or disease? Int J Impot Res. 2005;17:S52–6. https://doi.org/10.1038/sj.ijir.3901429.

    Article  Google Scholar 

  13. Ni Lochlainn M, Kenny RA. Sexual activity and aging. J Am Med Dir Assoc. 2013;14(8):565–72. https://doi.org/10.1016/j.jamda.2013.01.022.

    Article  Google Scholar 

  14. Dorner TE, Berner C, Haider S, Grabovac I, Lamprecht T, Fenzl KH, Erlacher L. Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study. Rheumatol Int. 2018;38(6):1103–14. https://doi.org/10.1007/s00296-018-4023-3.

    Article  Google Scholar 

  15. Grabovac I, Dorner TE. Association between low back pain and various everyday performances: activities of daily living, ability to work and sexual function. Wien Klin Wochenschr. 2019;131(21–22):541–9. https://doi.org/10.1007/s00508-019-01542-7.

    Article  Google Scholar 

  16. Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes. 2014;7:95–105. https://doi.org/10.2147/DMSO.S36455.

    Article  Google Scholar 

  17. Palacios S, Castaño R, Grazziotin A. Epidemiology of female sexual dysfunction. Maturitas. 2009;63(2):119–23. https://doi.org/10.1016/j.maturitas.2009.04.002.

    Article  Google Scholar 

  18. Tiefer L. Medicalizations and demedicalizations of sexuality therapies. J Sex Res. 2012;49(4):311–8. https://doi.org/10.1080/00224499.2012.678948.

    Article  Google Scholar 

  19. Marshall BL. Medicalization and the refashioning of age-related limits on sexuality. J Sex Res. 2012;49(4):337–43. https://doi.org/10.1080/00224499.2011.644597.

    Article  Google Scholar 

  20. Goldstein I, Fisher WA, Sand M, Rosen RC, Mollen M, Brock G, et al. Women’s sexual function improves when partners are administered vardenafil for erectile dysfunction: a prospective, randomized, double-blind, placebo-controlled trial. J Sex Med. 2005;2(6):819–32. https://doi.org/10.1111/j.1743-6109.2005.00147.x.

    Article  CAS  Google Scholar 

  21. Skałacka K, Gerymski R. Sexual activity and life satisfaction in older adults. Psychogeriatrics. 2019;19(3):195–201. https://doi.org/10.1111/psyg.12381.

    Article  Google Scholar 

  22. Nicolosi A, Laumann EO, Glasser DB, Moreira ED, Paik A, Gingell C, Global Study of Sexual Attitudes and Behaviors Investigators' Group. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 2004;64(5):991–7. https://doi.org/10.1016/j.urology.2004.06.055.

    Article  Google Scholar 

  23. 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. https://doi.org/10.1136/bmj.c810.

    Article  Google Scholar 

  24. Bosland MC. The etiopathogenesis of prostatic cancer with special reference to environmental factors. Adv Cancer Res. 1988;51:1–106. https://doi.org/10.1016/s0065-230x(08)60220-1.

    Article  CAS  Google Scholar 

  25. Brody S. The relative health benefits of different sexual activities. J Sex Med. 2010;7(4 Pt 1):1336–61. https://doi.org/10.1111/j.1743-6109.2009.01677.x.

    Article  Google Scholar 

  26. Brody S, Costa RM. Satisfaction (sexual, life, relationship, and mental health) is associated directly with penile-vaginal intercourse, but inversely with other sexual behavior frequencies. J Sex Med. 2009;6(7):1947–54. https://doi.org/10.1111/j.1743-6109.2009.01303.x.

    Article  Google Scholar 

  27. Brody S, Preut R. Vaginal intercourse frequency and heart rate variability. J Sex Marital Ther. 2003;29(5):371–80. https://doi.org/10.1080/00926230390224747.

    Article  Google Scholar 

  28. Ebrahim S, May M, Ben Shlomo Y, McCarron P, Frankel S, Yarnell J, Davey Smith G. Sexual intercourse and risk of ischaemic stroke and coronary heart disease: the Caerphilly study. J Epidemiol Community Health. 2002;56(2):99–102. https://doi.org/10.1136/jech.56.2.99.

    Article  CAS  Google Scholar 

  29. Flynn TJ, Gow AJ. Examining associations between sexual behaviours and quality of life in older adults. Age Ageing. 2015;44(5):823–8. https://doi.org/10.1093/ageing/afv083.

    Article  Google Scholar 

  30. Lê MG, Bachelot A, Hill C. Characteristics of reproductive life and risk of breast cancer in a case-control study of young nulliparous women. J Clin Epidemiol. 1989;42(12):1227–33. https://doi.org/10.1016/0895-4356(89)90121-2.

    Article  Google Scholar 

  31. Palmore EB. Predictors of the longevity difference: a 25-year follow-up. Gerontologist. 1982;22(6):513–8. https://doi.org/10.1093/geront/22.6.513.

    Article  CAS  Google Scholar 

  32. Lemieux L, Kaiser S, Pereira J, Meadows LM. Sexuality in palliative care: patient perspectives. Palliat Med. 2004;18(7):630–7. https://doi.org/10.1191/0269216304pm941oa.

    Article  Google Scholar 

  33. Rouanne M, Massard C, Hollebecque A, Rousseau V, Varga A, Gazzah A, et al. Evaluation of sexuality, health-related quality-of-life and depression in advanced cancer patients: a prospective study in a phase I clinical trial unit of predominantly targeted anticancer drugs. Eur J Cancer. 2013;49(2):431–8. https://doi.org/10.1016/j.ejca.2012.08.008.

    Article  CAS  Google Scholar 

  34. Vitrano V, Catania V, Mercadante S. Sexuality in patients with advanced cancer: a prospective study in a population admitted to an acute pain relief and palliative care unit. Am J Hosp Palliat Med. 2011;28(3):198–202. https://doi.org/10.1177/1049909110386044.

    Article  Google Scholar 

  35. Tristano AG. Impact of rheumatoid arthritis on sexual function. World J Orthop. 2014;5(2):107–11. https://doi.org/10.5312/wjo.v5.i2.107.

    Article  Google Scholar 

  36. Zhao S, Li E, Wang J, Luo L, Luo J, Zhao Z. Rheumatoid arthritis and risk of sexual dysfunction: a systematic review and Metaanalysis. J Rheumatol. 2018;45(10):1375–82. https://doi.org/10.3899/jrheum.170956.

    Article  Google Scholar 

  37. Kelemen A, Cagle J, Chung J, Groninger H. Assessing the impact of serious illness on patient intimacy and sexuality in palliative care. J Pain Symptom Manag. 2019;58(2):282–8. https://doi.org/10.1016/j.jpainsymman.2019.04.015.

    Article  Google Scholar 

  38. Chung E. Sexuality in ageing male: review of pathophysiology and treatment strategies for various male sexual dysfunctions. Med Sci (Basel). 2019;7(10):98. https://doi.org/10.3390/medsci7100098.

    Article  Google Scholar 

  39. Moreira ED, Glasser DB, Gingell C, GSSAB Investigators’ Group. Sexual activity, sexual dysfunction and associated help-seeking behaviours in middle-aged and older adults in Spain: a population survey. World J Urol. 2005;23(6):422–9. https://doi.org/10.1007/s00345-005-0035-1.

    Article  Google Scholar 

  40. Smith L, Yang L, Forwood S, Lopez-Sanchez G, Koyanagi A, Veronese N, et al. Associations between sexual activity and weight status: findings from the English longitudinal study of ageing. PLoS One. 2019;14(9):e0221979. https://doi.org/10.1371/journal.pone.0221979.

    Article  CAS  Google Scholar 

  41. Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762–74. https://doi.org/10.1056/NEJMoa067423.

    Article  CAS  Google Scholar 

  42. Træen B, Štulhofer A, Janssen E, Carvalheira AA, Hald GM, Lange T, Graham C. Sexual activity and sexual satisfaction among older adults in four European countries. Arch Sex Behav. 2019;48(3):815–29. https://doi.org/10.1007/s10508-018-1256-x.

    Article  Google Scholar 

  43. Owen BN, Brock PM, Butler AR, Pickles M, Brisson M, Baggaley RF, Boily MC. Prevalence and frequency of heterosexual anal intercourse among young people: a systematic review and meta-analysis. AIDS Behav. 2015;19(7):1338–60. https://doi.org/10.1007/s10461-015-0997-y.

    Article  Google Scholar 

  44. Meston CM, Buss DM. Why humans have sex. Arch Sex Behav. 2007;36(4):477–507. https://doi.org/10.1007/s10508-007-9175-2.

    Article  Google Scholar 

  45. Mark K, Herbenick D, Fortenberry D, Sanders S, Reece M. The object of sexual desire: examining the "what" in "what do you desire?". J Sex Med. 2014;11(11):2709–19. https://doi.org/10.1111/jsm.12683.

    Article  Google Scholar 

  46. Kalra G, Subramanyam A, Pinto C. Sexuality: desire, activity and intimacy in the elderly. Indian J Psychiatry. 2011;53(4):300–6. https://doi.org/10.4103/0019-5545.91902.

    Article  Google Scholar 

  47. Helgason AR, Adolfsson J, Dickman P, Arver S, Fredrikson M, Göthberg M, Steineck G. Sexual desire, erection, orgasm and ejaculatory functions and their importance to elderly Swedish men: a population-based study. Age Ageing. 1996;25(4):285–91. https://doi.org/10.1093/ageing/25.4.285.

    Article  CAS  Google Scholar 

  48. Sandberg L. Just feeling a naked body close to you: men, sexuality and intimacy in later life. Sexualities. 2013;16(3/4):261–82. https://doi.org/10.1177/1363460713481726.

    Article  Google Scholar 

  49. Blumenstock SM, Quinn-Nilas C, Milhausen RR, McKay A. 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. https://doi.org/10.1007/s10508-019-01498-9.

    Article  Google Scholar 

  50. Roels R, Janssen E. Sexual and relationship satisfaction in young, heterosexual couples: the role of sexual frequency and sexual communication. J Sex Med. 2020;17(9):1643–52. https://doi.org/10.1016/j.jsxm.2020.06.013.

    Article  Google Scholar 

  51. Gillespie BJ. Sexual synchronicity and communication among partnered older adults. J Sex Marital Ther. 2017;43(5):441–55. https://doi.org/10.1080/0092623X.2016.1182826.

    Article  Google Scholar 

  52. Centers for Disease Control and Prevention (2018) Atlas Plus: HIV, hepatitis, STD, TB, social determines of health data. https://www.cdc.gov/nchhstp/atlas/index.htm.

  53. Johnson BK. Sexually transmitted infections and older adults. J Gerontol Nurs. 2013;39(11):53–60. https://doi.org/10.3928/00989134-20130918-01.

    Article  Google Scholar 

  54. Tillman JL, Mark HD. HIV and STI testing in older adults: an integrative review. J Clin Nurs. 2015;24(15–16):2074–95. https://doi.org/10.1111/jocn.12797.

    Article  Google Scholar 

  55. Gott M, Hinchliff S, Galena E. General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med. 2004;58(11):2093–103. https://doi.org/10.1016/j.socscimed.2003.08.025.

    Article  Google Scholar 

  56. Dogan S, Demir B, Eker E, Karim S. Knowledge and attitudes of doctors toward the sexuality of older people in Turkey. Int Psychogeriatr. 2008;20(5):1019–27. https://doi.org/10.1017/S1041610208007229.

    Article  Google Scholar 

  57. Mahieu L, de Casterlé BD, Acke J, Vandermarliere H, Van Elssen K, Fieuws S, Gastmans C. Nurses' knowledge and attitudes toward aged sexuality in Flemish nursing homes. Nurs Ethics. 2016;23(6):605–23. https://doi.org/10.1177/0969733015580813.

    Article  Google Scholar 

  58. Fürst J, Krall H. Sexualität – ein vernachlässigtes Thema in der psychodrama Ausbildung? [sexuality – a neglected topic in psychodrama training?]. Zeitschrift für Psychodrama und Soziometrie. 2012;11:25–39. https://doi.org/10.1007/s11620-012-0141-1.

    Article  Google Scholar 

  59. Roberts M. Balint groups: a tool for personal and professional resilience. Can Fam Physician. 2012;58(3):245–7. https://www.ncbi.nlm.nih.gov/pubmed/22423015.

    Google Scholar 

  60. Barrett C. Auditing organisational capacity to promote the sexual health of older people. Electron J Appl Psychol. 2011;7(1):31–6. https://doi.org/10.7790/ejap.v7i1.233.

    Article  Google Scholar 

  61. Watzlawick P, Beavin Bavelas J, Jackson D. Pragmatics of human communication - a study of interactional patterns, pathologies, and paradoxes. New York: W. W. Norton; 2011.

    Google Scholar 

  62. Lambert MJ, Barley DE. Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy. 2001;38:357–61.

    Article  Google Scholar 

  63. Rogers CR. The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol. 1957;21(2):95–103.

    Article  CAS  Google Scholar 

  64. Rogers CR, Farson RE. Active listening. Chicago: University of Chicago Industrial Relations Center; 1957.

    Google Scholar 

  65. Bachmair S, Faber J, Henning C, Kolb R, Willig W. Beraten will gelernt sein. Ein praktisches Lehrbuch für Anfänger und Fortgeschrittene. 3rd ed. Weinheim: Beltz; 1999.

    Google Scholar 

  66. Dahmer H, Dahmer J. Gesprächsführung. Eine praktische Anleitung. 4th ed. Stuttgart: Thieme; 1999.

    Google Scholar 

  67. Schulz von Thun F. Miteinander reden: Störungen und Klärungen. Allgemeine Psychologie der Kommunikation. Reinbek: Rowohlt; 1981.

    Google Scholar 

  68. Centers for Disease Control and Prevention (2005) A guide to taking a sexual history. https://stacks.cdc.gov/view/cdc/12303.

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Authors and Affiliations

  1. Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria

    Hanna M. Mües

  2. Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria

    Kathrin Kirchheiner

  3. Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria

    Igor Grabovac

Authors
  1. Hanna M. Mües
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  2. Kathrin Kirchheiner
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  3. Igor Grabovac
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Correspondence to Hanna M. Mües .

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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

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Mües, H.M., Kirchheiner, K., Grabovac, I. (2023). Promotion of Sex in Older Adults. 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_12

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  • DOI: https://doi.org/10.1007/978-3-031-21029-7_12

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