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Sexuality in older age

By Abi Taylor

Royal Berkshire Hospital
Elderly Care Medicine

Old people having sex…funny? embarrassing? disgusting? Or a normal part of healthy ageing?

Most people don’t tend to think about the sexuality of older people. There are general assumptions that older people aren’t having sex, aren’t interested in sex, and couldn’t do it even if they wanted to. And, if they were interested in sex they may be viewed as perverted or abnormal.  However, research shows that sex can be important to many older people, and that people continue to be sexually active often into old age. Our general discomfort with the topic could be related to subconscious fears of one’s own aging, the media’s portrayal of sex as the sole preserve of young attractive people, thoughts of sex being mainly for the purpose of procreation or deeply buried feelings related to one’s own parents or grandparent s having sex.

The review paper “Sexuality in older age: essential considerations for healthcare professionals” was inspired by several patients on my ward whilst working as a junior doctor (FY1) in geriatric medicine.  Discussions amongst the juniors on my team demonstrated our ignorance surrounding the issue of sex, and also ignited our curiosity. Did the elderly demented patients who commented on the size of our breasts actually think of sex anymore, or was it some kind of disinhibited reflexive comment from deeply buried memories of a long gone sexuality? Did the patients celebrating their 75th wedding anniversary still sleep together? Was sex important to any of them? Did they care if the medication we prescribed made them impotent? I wanted to understand more about how older people feel about sex and whether the general perceptions of an asexual old age were true.

Reactions from both medical and non-medical friends on hearing the subject of my research were interesting and varied – some were simply surprised that there was any literature on the subject, some laughed and said it was disgusting and yet others were somewhat voyeuristically interested (indeed the most common question I was asked by friends is related to how many old people have sex and how often). These reactions highlighted the preconceptions that people tend to have about sex in old people and I wanted to understand more about the reality.

Research into sexuality has many difficulties but it is clear that older people do indeed think about sex, and many are still sexually active. Good general physical (and mental) health and availability of a partner are associated with maintaining sexual interest and function. Older people can suffer from various sexual problems which unfortunately do not get routinely discussed with healthcare professionals for a variety of reasons – one purpose of the research was to remind clinicians to enquire about sexual problems where appropriate and offer advice and treatment.

Abi Taylor is a junior doctor working at the Royal Berkshire Hospital, with interests in old age psychiatry and geriatric medicine. Her review paper, “Sexuality in older age” written with Margot A Gosney, has been made publicly available by Age and Ageing. You can read it free online here.

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