Skip to main content

Sexuality and Aging

  • Living reference work entry
  • First Online:
Geriatric Medicine

Abstract

Sexuality is a complex interplay of the needs for intimacy, affection, connection, pleasure, self-image, and context related to gender, ethnicity, and community. It is affected by multiple factors, including psychological, social, physiological, cultural, religious, and hormonal age-related changes, and comorbidities can also affect sexual function. Consideration of the unique needs surrounding sexuality in the geriatric population offers insight into the diagnosis and treatment of sexual dysfunction as well as the underlying biopsychosocial and physiological components of geriatric sexuality.

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

Access this chapter

Institutional subscriptions

Similar content being viewed by others

References

  1. Crooks RL, Baur K, Widman L. Our sexuality. Cengage Learning; 2020.

    Google Scholar 

  2. Dunn ME, Cutler N. Sexual issues in older adults. AIDS Patient Care STDs. 2000;14(2):67–9.

    Article  CAS  PubMed  Google Scholar 

  3. Hillman J. Sexuality and aging. Springer; 2012.

    Book  Google Scholar 

  4. Dhingra I, De Sousa A, Sonavane S. Sexuality in older adults: clinical and psychosocial dilemmas. J Geriatric Ment Health. 2016;3(2):131–9.

    Article  Google Scholar 

  5. Gledhill S, Schweitzer RD. Sexual desire, erectile dysfunction and the biomedicalization of sex in older heterosexual men. J Adv Nurs. 2014;70(4):894–903.

    Article  PubMed  Google Scholar 

  6. Gewirtz-Meydan A. Sex for seniors: how physicians discuss older adult’s sexuality. Isr J Health Policy Res. 2020;9:8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. He MS, Velkoff AD. 65+ in the United States: 2005. U.S. Government Printing Office: U.S. Census Bureau; 2005.

    Google Scholar 

  8. Stepler R. Led by Baby Boomers, divorce rates climb for America’s 50+ population. 2017. Available from: https://www.pewresearch.org/fact-tank/2017/03/09/led-by-baby-boomers-divorce-rates-climb-for-americas-50-population/

  9. Bretschneider JG, McCoy NL. Sexual interest and behavior in healthy 80-year-olds to 102-year-olds. Arch Sex Behav. 1988;17(2):109–29.

    Article  CAS  PubMed  Google Scholar 

  10. Waite LJ, et al. Sexuality: measures of partnerships, practices, attitudes, and problems in the national social life, health, and aging study. J Gerontol Ser B: Psychol Sci Soc Sci. 2009;64B(Suppl 1):i56–66.

    Article  Google Scholar 

  11. 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  PubMed  PubMed Central  Google Scholar 

  12. Rowland DL, Gutierrez BR. Human sexual response, phases of. In: Wetzel A, editor. The Sage encyclopedia of abnormal and clinical psychology. Sage; 2017. p. 1705–6.

    Google Scholar 

  13. Sharpe TH. Introduction to sexuality in late life. Fam J (Alexandria, VA). 2004;12(2):199–205.

    Article  Google Scholar 

  14. Matsumoto AM. Andropause: clinical implications of the decline in serum testosterone levels with aging in men. J Gerontol Ser A Biol Med Sci. 2002;57(2):M76–99.

    Article  Google Scholar 

  15. Nagaratnam N, Nagaratnam K, Cheuk G. Male sexual dysfunction: erectile dysfunction (ED). Springer International Publishing; 2018. p. 309–14.

    Google Scholar 

  16. Khan AH, Rasaily D. Tramadol use in premature ejaculation: daily versus sporadic treatment. Indian J Psychol Med. 2013;35(3):256–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ciocanel O, Power K, Eriksen A. Interventions to treat erectile dysfunction and premature ejaculation: an overview of systematic reviews. Sex Med. 2019;7(3):251–69.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Morley J. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009;5:427.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Andersson KE. PDE5 inhibitors – pharmacology and clinical applications 20 years after sildenafil discovery. Br J Pharmacol. 2018;175(13):2554–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Khera M, et al. Testosterone therapy and cardiovascular risk: a critical analysis of studies reporting increased risk. J Sex Med. 2021;18(1):83–98.

    Article  CAS  PubMed  Google Scholar 

  21. Morgentaler A, et al. Testosterone therapy and cardiovascular risk: advances and controversies. Mayo Clin Proc. 2015;90(2):224–51.

    Article  CAS  PubMed  Google Scholar 

  22. Barnard JT, et al. Technological advances in penile implant surgery. J Sex Med. 2021;18(7):1158–66.

    Article  PubMed  Google Scholar 

  23. Arthur SS, et al. Managing female sexual dysfunction. Urologic oncology: seminars and original investigations. 2021.

    Google Scholar 

  24. March AL. Sexuality and intimacy in the older adult woman. Nurs Clin North Am. 2018;53(2):279–87.

    Article  PubMed  Google Scholar 

  25. Coelho G, et al. Depression and obesity, but not mild obstructive sleep apnea, are associated factors for female sexual dysfunction. Sleep Breath. 2021. https://doi.org/10.1007/s11325-021-02433-w. Epub ahead of print. PMID: 34318402.

  26. Morton L. Sexuality in the older adult. Primary Care. 2017;44(3):429−+.

    Google Scholar 

  27. Kammerer-Doak D, Rogers R. Female sexual dysfunction. Springer International Publishing; 2021. p. 909–21.

    Google Scholar 

  28. Davis SR, et al. Testosterone for low libido in postmenopausal women not taking estrogen. N Engl J Med. 2008;359(19):2005–17.

    Article  CAS  PubMed  Google Scholar 

  29. Gao L, et al. Systematic review and meta-analysis of phosphodiesterase type 5 inhibitors for the treatment of female sexual dysfunction. Int J Gynecol Obstet. 2016;133(2):139–45.

    Article  CAS  Google Scholar 

  30. Walsh KE, Berman JR. Sexual dysfunction in the older woman. Drugs Aging. 2004;21(10):655–75.

    Article  CAS  PubMed  Google Scholar 

  31. Boswell EN, Dizon DS. Breast cancer and sexual function. Transl Androl Urol. 2015;4(2):160–8.

    PubMed  PubMed Central  Google Scholar 

  32. Santoro N, et al. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metabol. 2021;106(1):1–15.

    Article  Google Scholar 

  33. Stute P. Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief? Arch Gynecol Obstet. 2013;288(6):1199–201.

    Article  PubMed  Google Scholar 

  34. Rubin ES, et al. A clinical reference guide on sexual devices for obstetrician–gynecologists. Obstet Gynecol. 2019;133(6):1259–68.

    Article  PubMed  Google Scholar 

  35. AAFP. Treating sexual difficulties in menopause. Am Fam Physician. 2007;76(11):1717.

    Google Scholar 

  36. Polo-Kantola P, Rantala MJ. Menopause, a curse or an opportunity? An evolutionary biological view. Acta Obstet Gynecol Scand. 2019;98(6):687–8.

    Article  PubMed  Google Scholar 

  37. Peacock K, Kari K. Menopause. Treasure Island: StatPearls Publishing LLC; 2021.

    Google Scholar 

  38. USPSTF. Osteoporosis to prevent fractures: screening. 2021.

    Google Scholar 

  39. Bansal R, Aggarwal N. Menopausal hot flashes: a concise review. J Midlife Health. 2019;10(1):6–13.

    PubMed  PubMed Central  Google Scholar 

  40. Prentice R. Postmenopausal hormone therapy and the risks of coronary heart disease, breast cancer, and stroke. Semin Reprod Med. 2014;32(06):419–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Manson JE, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the women’s health initiative randomized trials. JAMA. 2013;310(13):1353.

    Article  CAS  PubMed  Google Scholar 

  42. Marcus E-L, Tur-Kaspa R. Viral hepatitis in older adults. J Am Geriatr Soc. 1997;45(6):755–63.

    Article  CAS  PubMed  Google Scholar 

  43. Forward KR. Risk of coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia. Can J Infect Dis Med Microbiol. 2010;21(2):e84–6. https://doi.org/10.1155/2010/760218. PMID: 21629610; PMCID: PMC2912101.

  44. Forward KR. Risk of coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia. Can J Infect Dis Med Microbiol. 2010;21(2):e84–6.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Negredo E, et al. Aging in HIV-infected subjects: a new scenario and a new view. Biomed Res Int. 2017;2017:1–9.

    Article  Google Scholar 

  46. Aging, B.R.I.o. Sexually transmitted diseases in older adults. [2019 July 18, 2021]. Available from: https://benrose.org/-/resource-library/health-and-wellness-services/sexually-transmitted-diseases-in-older-adults

  47. Smith ML, et al. Sexually transmitted infection knowledge among older adults: psychometrics and test–retest reliability. Int J Environ Res Public Health. 2020;17(7):2462.

    Article  PubMed Central  Google Scholar 

  48. Anupam JB. Sexually transmitted diseases among users of erectile dysfunction drugs. Ann Intern Med. 2010;153(1):1–7.

    Article  Google Scholar 

  49. Gómez Melasio DA, et al. A systematic review of individual, psychological and sociocultural factors associated with safe and risky sexual behavior in older adults. Am J Sex Educ. 2021;16(3):415–34.

    Google Scholar 

  50. Canalichio K, Jaber Y, Wang R. Surgery and hormonal treatment for prostate cancer and sexual function. Transl Androl Urol. 2015;4(2):103–9.

    PubMed  PubMed Central  Google Scholar 

  51. Bazinet A, et al. Favorable preservation of erectile function after prostate brachytherapy for localized prostate cancer. Brachytherapy. 2020;19(2):222–7.

    Article  PubMed  Google Scholar 

  52. Emilee G, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas. 2010;66(4):397–407.

    Article  PubMed  Google Scholar 

  53. Schover LR, et al. Sexual problems during the first 2 years of adjuvant treatment with aromatase inhibitors. J Sex Med. 2014;11(12):3102–11.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Chang YC, Chang SR, Chiu SC. Sexual problems of patients with breast cancer after treatment a systematic review. Cancer Nurs. 2019;42(5):418–25.

    Article  PubMed  Google Scholar 

  55. Vaziri S, Lotfi Kashani F. Sexuality after breast cancer: need for guideline. Iran J Cancer Prev. 2012;5(1):10–5.

    PubMed  PubMed Central  Google Scholar 

  56. Rothenbacher D, et al. Sexual activity patterns before myocardial infarction and risk of subsequent cardiovascular adverse events. J Am Coll Cardiol. 2015;66(13):1516–7.

    Article  PubMed  Google Scholar 

  57. Cohen G, et al. Resumption of sexual activity after acute myocardial infarction and long-term survival. Eur J Prev Cardiol. 2020;29:304.

    Article  Google Scholar 

  58. Arenhall E, et al. The male partners’ experiences of the intimate relationships after a first myocardial infarction. Eur J Cardiovasc Nurs. 2011;10(2):108–14.

    Article  PubMed  Google Scholar 

  59. Calabro RS, Bramanti P. Post-stroke sexual dysfunction: an overlooked and under-addressed problem. Disabil Rehabil. 2014;36(3):263–4.

    Article  PubMed  Google Scholar 

  60. McGrath M, et al. How is sexuality after stroke experienced by stroke survivors and partners of stroke survivors? A systematic review of qualitative studies. Clin Rehabil. 2019;33(2):293–303.

    Article  PubMed  Google Scholar 

  61. Nordentoft T, Schou J, Carstensen J. Changes in sexual behavior after orthopedic replacement of hip or knee in elderly males - a prospective study. Int J Impot Res. 2000;12(3):143–6.

    Article  CAS  PubMed  Google Scholar 

  62. CDC. Key statistics from the national survey of family growth. [2015 7/18/2021]. Available from: http://www.cdc.gov/nchs/nsfg/key_statistics/h.htm#hysterectomy

  63. Farrell SA, Kieser K. Sexuality after hysterectomy. Obstet Gynecol. 2000;95(6):1045–51.

    Article  CAS  PubMed  Google Scholar 

  64. Bortolotti A, et al. Cigarette smoking: a risk factor for erectile dysfunction in diabetics. Eur Urol. 2001;40(4):392–6; discussion 397.

    Article  CAS  PubMed  Google Scholar 

  65. Kouidrat Y, et al. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabet Med. 2017;34(9):1185–92.

    Article  CAS  PubMed  Google Scholar 

  66. Rahmanian E, et al. Evaluation of sexual dysfunction and female sexual dysfunction indicators in women with type 2 diabetes: a systematic review and meta-analysis. Diabetol Metab Syndr. 2019;11(1):73.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Barbagallo F, et al. Sexual dysfunction in diabetic women: an update on current knowledge. Diabetology. 2020;1(1):11–21.

    Article  Google Scholar 

  68. Wing RR, et al. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary look AHEAD study. Diabetes Care. 2013;36(10):2937–44.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Rantell A, et al. How does lower urinary tract dysfunction affect sexual function in men and women? ICI-RS 2015-Part 1. Neurourol Urodyn. 2017;36(4):949–52.

    Article  PubMed  Google Scholar 

  70. Shaw C. A systematic review of the literature on the prevalence of sexual impairment in women with urinary incontinence and the prevalence of urinary leakage during sexual activity. Eur Urol. 2002;42(5):432–40.

    Article  PubMed  Google Scholar 

  71. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev. 2017;5(4):470–85.

    Article  PubMed  Google Scholar 

  72. ASHA. 2021 [cited 2021 7/25/2021]. Available from: https://www.ashasexualhealth.org/tips-to-keep-incontinence-from-interfering-with-your-sex-live/

  73. Handa VL, et al. Female sexual function and pelvic floor disorders. Obstet Gynecol. 2008;111(5):1045–52.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Dyer K, Nair RD. Why don’t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom. J Sex Med. 2013;10(11):2658–70.

    Article  PubMed  Google Scholar 

  75. Heidari M, et al. Sexual function and factors affecting menopause: a systematic review. J Menopausal Med. 2019;25(1):15.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Roelofs TSM, Luijkx KG, Embregts P. Intimacy and sexuality of nursing home residents with dementia: a systematic review. Int Psychogeriatr. 2015;27(3):367–84.

    Article  PubMed  Google Scholar 

  77. Tucker I. Management of inappropriate sexual behaviors in dementia: a literature review. Int Psychogeriatr. 2010;22(5):683–92.

    Article  PubMed  Google Scholar 

  78. Mahieu L, Gastmans C. Older residents’ perspectives on aged sexuality in institutionalized elderly care: a systematic literature review. Int J Nurs Stud. 2015;52(12):1891–905.

    Article  PubMed  Google Scholar 

  79. Doll GM. Sexuality in nursing homes: practice and policy. J Gerontol Nurs. 2013;39(7):30–7; quiz 38–9.

    Article  PubMed  Google Scholar 

  80. Di Napoli EA, Breland GL, Allen RS. Staff knowledge and perceptions of sexuality and dementia of older adults in nursing homes. J Aging Health. 2013;25(7):1087–105.

    Article  PubMed  Google Scholar 

  81. Mahieu L, Gastmans C. Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature. Int Psychogeriatr. 2012;24(3):346–57.

    Article  PubMed  Google Scholar 

  82. Lester PE, et al. Sex in nursing homes: a survey of nursing home policies governing resident sexual activity. J Am Med Dir Assoc. 2016;17(1):71–4.

    Article  PubMed  Google Scholar 

  83. AMDA. Capacity for sexual consent in dementia in long-term care. 2016 March 19, 2016 [cited 2021 7/17/2021]. Available from: https://paltc.org/sites/default/files/A16_White%20Paper_Sexuality%20in%20Dementia%20in%20LTC.pdf

  84. Eloniemi-Sulkava U, et al. Spouse caregivers’ perceptions of influence of dementia on marriage. Int Psychogeriatr. 2002;14(1):47–58.

    Article  PubMed  Google Scholar 

  85. Benbow SM, Beeston D. Sexuality, aging, and dementia. Int Psychogeriatr. 2012;24(7):1026–33.

    Article  PubMed  Google Scholar 

  86. Onishi J, et al. Behavioral, psychological and physical symptoms in group homes for older adults with dementia. Int Psychogeriatr. 2006;18(1):75–86.

    Article  PubMed  Google Scholar 

  87. Tsatali MS, et al. The complex nature of inappropriate sexual behaviors in patients with dementia: can we put it into a frame? Sex Disabil. 2011;29(2):143–56.

    Article  Google Scholar 

  88. Black B, Muralee S, Tampi RR. Inappropriate sexual behaviors in dementia. J Geriatr Psychiatry Neurol. 2005;18(3):155–62.

    Article  PubMed  Google Scholar 

  89. Philo SW, Richie MF, Kaas MJ. Inappropriate sexual behavior. J Gerontol Nurs. 1996;22(11):17–22.

    Article  CAS  PubMed  Google Scholar 

  90. De Giorgi R, Series H. Treatment of inappropriate sexual behavior in dementia. Curr Treat Options Neurol. 2016;18(9):1.

    Article  Google Scholar 

  91. Prakash R, et al. Quetiapine effective in treatment of inappropriate sexual behavior of Lewy body disease with predominant frontal lobe signs. Am J Alzheimer’s Dis Other Dementiasr. 2009;24(2):136–40.

    Article  Google Scholar 

  92. Shilpa Srinivasan M, Weinberg AD. Pharmacologic treatment of sexual inappropriateness in long-term care residents with dementia. Ann Long-Term Care. 2006;14(10):20.

    Google Scholar 

  93. American Geriatrics Society, Talebreza S. Geriatrics evaluation & management tools. In: Talebreza S, editor. Behavioral disturbances in dementia. New York: American Geriatrics Society; 2021.

    Google Scholar 

  94. Fredriksen-Goldsen K. The future of LGBT+ aging: a blueprint for action in services, policies, and research. Generations. 2016;40:6–15.

    PubMed  PubMed Central  Google Scholar 

  95. SAGE. 2017 [8/21/21]. https://www.lgbtmap.org/file/understanding-issues-facing-lgbt-older-adults.pdf

  96. Cahill S, Valadéz R. Growing older with HIV/AIDS: new public health challenges. Am J Public Health. 2013;103(3):e7–e15.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Shane L. VA to offer gender surgery to transgender vets for the first time. Military Times. 2021.

    Google Scholar 

  98. Fredriksen-Goldsen KI, Kim H, Emlet CA, Muraco A, Erosheva EA, Hoy-Ellis CP. The aging and health report: disparities and resilience among lesbian, gay, bisexual, and transgender older adults. Seattle Institute for Multigenerational Health; 2019.

    Google Scholar 

  99. Mirza SAR. Discrimination prevents LGBTQ people from accessing health care, in LGBTQ rights. Center For American Progress; 2018.

    Google Scholar 

  100. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.

    Article  PubMed  PubMed Central  Google Scholar 

  101. SAMHSA. 2019 National survey on drug use and health: lesbian, gay, & bisexual (LGB) adults. 2019 8/22/21.

    Google Scholar 

  102. Morrissey Stahl KA, et al. A Practitioner’s guide to end-of-life intimacy: suggestions for conceptualization and intervention in palliative care. OMEGA – J Death Dying. 2018;77(1):15–35.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul N. Bryman .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Bryman, P.N., Powell, L.A., Ginsberg, T.B. (2022). Sexuality and Aging. In: Wasserman, M., Bakerjian, D., Linnebur, S., Brangman, S., Mims, A., Johnson, J.C. (eds) Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-01782-8_70-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-01782-8_70-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01782-8

  • Online ISBN: 978-3-030-01782-8

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics