Sexuality and Chronic Illness

What about sexuality and aging?

According to the American Association of Retired Persons (AARP), there are currently more than 33 million Americans over the age of 65. By the year 2011 (just around the corner), the first wave of the young American baby boomers (total of approximately 76 million people) will celebrate their 65th birthday! By 2030, one in five, or 20%, of Americans will be age 65 or older.

Typically, the Centers for Disease Control and Prevention and AARP have in the past focused their efforts and research toward disease management and prevention, health promotion, immunization, and healthy lifestyle management. Little if any effort is directed to maintaining active sexual intimacy as people age.

Although sexual behavior and desires change with aging, the need for intimacy and physical closeness does not dissipate. Chronic medical illnesses such as high blood pressure, diabetes, cancer, and orthopedic conditions can impair and have significant impact on sexual function and your sexual response cycle. Sometimes all it requires to resolve some issues is some creative thinking, such as adding pillows for comfort, planning sexual activity when you are well rested, or modifying sexual positioning to accommodate minor disabilities.

Although sexual behavior and desires change with aging, the need for intimacy and physical closeness does not dissipate.

Many elderly people are on multiple medications, which can affect erectile functioning, orgasm, arousal, and desire in both men and women. These types of issues, too, may sometimes be solved quite easily. The North American Menopause Society conducted a survey of 752 postmenopausal women that showed that half of the women felt happier and more fulfilled between the ages of 50 and 65 years than they did in their 20s, 30s, and 40s. Many women stated that their sexual relationship made it through the menopausal transition unchanged. If their sexual life was satisfying before, then it remained as such after; if it was forced and unpleasurable before, then, unfortunately, it remained the same after menstruation[1] stopped.

The primary key to successful sexuality as you age is to keep the lines of communication open: ask questions, talk, and listen. Although we all want our healthcare providers to be psychic and know exactly what's ailing us, many doctors and nurses are sexually naive—they lack the time, education, and diagnostic skills to identify sexually based disorders. Speak up and be heard. Let your healthcare providers know that sexuality is an important part of your quality of life even if they think that sex is unimportant.

As a patient, you should demand answers and evaluations from your healthcare providers because sexuality, sexual functioning, intimacy, and connectedness are important issues in your quality of life and the human experience. There is no need to continue to suffer. A sexual problem should never be ignored.

For their part, healthcare providers must begin to routinely ask you about your sexual functioning because they cannot treat a problem if they are not aware of it. They must not be afraid to open Pandora's box. They must know of resources in your community and refer you when they are uncomfortable or ill-equipped to deal with issues; ignoring a problem will not make it disappear.

A recent article in the July 2007 issue of Ob. Gyn. News titled "One Third of Seniors Have Sex Once a Week" discussed the fact that sex remains an important part of their life for people in the age group of 65 to 74 years. The survey of more than 3,000 seniors found that 73% of those interviewed had a spouse or significant other and that of those 73% were sexually active, which was defined as having had at least one sex partner in the previous 12 months. In the oldest group, those aged 75 to 85 years, 23% of men and 24% of women reported having sex once a week or more, and 47% of men and 46% of women reported having less than one sexual episode per month. Dr. Lindau of the Geriatric Section of the Department of Medicine at the University of Chicago stated that the responses of this age group were similar to those reported for participants aged 18 to 59 years. Sexual problems were also common: 62% of men and 70% of women reported one or more sexual complaints, and as a result many avoided sexual intimacy. Forty-eight percent of men and 34% of women had discussed their concerns with their physicians. Self-stimulation, oral sex, and intercourse all occurred as men and women age.

Unfortunately, as a society we tend to shun aging. As we age, many feel pressured to change their appearances to recapture youthfulness and vitality. Cosmetic surgery, hair coloring, and other physical changes occur with increasing frequency in both sexes as people try to recapture the sensual and sexual fountain of youth. Aging and sexual dynamism should not be diametrically opposed—sex with your longstanding partner changes with time, and intimacy and connectedness may often supersede intercourse when medical and or physical barriers prevail. The human spirit, regardless of age, needs and yearns for companionship, touch, and closeness. Close intimate sexual connections are part of humanness and can be experienced and enjoyed until death. There is definitely no age limit to sex and neither should older people be discouraged from making intimate connections.

Many women with underlying heart disease or stroke continue to engage in sexual activity well into later life.

  • [1] Vaginal bleeding resulting from endometrial shedding following ovulation when the egg is not fertilized.
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