Today men and women are living longer, healthier lives. As a result of this improvement in health many older couples now still continue to enjoy intimacy and sexuaily fulfilling lives. This fact-sheet will help you with some queries that you may have.

Does sex change as you get older?

The issues surrounding mature sexuality are still not openly discussed. Cultural biases have tended to stereotype older people as asexual, devoid of feelings or emotion. Couples who have been in long-term relationships do not necessarily find it any easier than others when it comes to discussing sexual difficulties. Like many activities in life, sexual expression is highly variable. Sexual function may well be different from that of a younger couple but that doesn't mean that it has to be any less pleasurable.

Will I still be able to have sex as I get older?

The ageing process involves many normal physical changes, some of which naturally affect sexual response, but sexuality is much more than a focus on the genital nature of sex. Often couples can find new ways to stimulate each other, such as erotic reading or videos. Partner communication and frank discussion of sexual desires, fantasies and experimentation are important. Some men may notice that they take longer to become aroused and achieve erection, and that their erections do not seem as hard. Just thinking about sex may no longer be enough. More direct physical stimulation of the penis may be required for a longer time. This may be due to reduced sensitivity. Some men may also find that the length of time between erections becomes longer as they age. The sensation of ejaculation may diminish and the man may find that orgasm doesn't feel as powerful as it did and that the amount of semen is reduced. Ejaculation may also take longer to achieve, and this can be a positive side of getting older as it may give more satisfaction to the partner. Some men may notice that their desire for sex may be reduced, but others may remain sexually active throughout life. If you have found that you are experiencing difficulty obtaining and maintaining your erection, you are not alone. A lot of h.elp is now available. Your doctor may be able to prescribe one of the drugs that now help erectile dysfunction. If, for whatever reason this is not suitable for you, then there are alternatives such as small urethral pellets, penile injections, vacuum aid devices, sex therapy, counselling and surgical implants.

Does illness affect sex?

Yes, it can. As people grow older, they are more likely to experience disabling conditions and illnesses that may affect how they respond sexually. Arthritis, stroke, coronary disease, diabetes, Parkinson's, surgery and the side effects of drugs can all affect how they respond. The psychological effects of illness can also have an impact on sexual function, especially if the diagnosis of a life threatening or life limiting illness has been made, or if the illness affects self-esteem or alters body image drastically. Illness can bring change in the structure of a couple's relationship, as previously independent people become dependent on their partner/carer. One partner may feel it is inappropriate to still have sexual desire if their partner is ill. For many carers the sheer stress and exhaustion of the role may adversely affect desire. Lifestyle can also have an impact how you may see yourself. Retirement and children leaving home is viewed by some as an end of a chapter in their lives, whereas for others it can mean the freeing up of time for each other. Lifestyle factors also have to be taken into consideration, smoking, excessive alcohol, use of recreational drugs, poor diet and lack of exercise can contribute to sexual dysfunction. Talk to your doctor if you find that illness is preventing you from enjoying sex with your partner, they may be able to help and offer solutions or put you in touch with a therapist.

I am a widower: is it wrong to look for love again?

We all need to be loved and wanted. These needs do not diminish over time, but you may find you are seeking other forms of attachment than when you were younger. You may just require companionship and someone to share your favourite TV programs with. If you are looking to rekindle your love life you may feel awkward and embarrassed, not knowing where or how to set off. These are perfectly normal feelings, particularly if your partner had a long illness, and you may have profound feelings of guilt and betrayal. It will help to talk to someone about those feelings. To help you to move forward in a new relationship, you may like to speak to your doctor or contact a therapist. When sexuality is affected, it is often a matter of learning to adapt and adjust rather than accepting an end to all forms of sexual expression.

I am embarrassed to seek help: what can I do?

The only person who will find this embarrassing is your self; you have nothing to be afraid of and everything to gain by seeking help. Discussing sexuality in midlife can sometimes be difficult, but there is no reason to think that because you are older, you cannot use all the services that are available to younger people. Sex is not abnormal after middle age, and for many individuals it does not just cease because procreation is no longer possible. Older age should not prevent you from seeking or receiving help from whatever source is most suitable for you.

About ESHA
The European Sexual Health Alliance (ESHA) is an umbrella organisation for patient support groups across Europe. The main role of this patient focused organization is to assist patients suffering from sexual dysfunction. to inform them about the solutions available as well as to provide awareness and understanding of the condition to their partners, media and other interested parties.

ESHA's purpose is to help every couple affected by sexual dysfunction to communicate openly about their sexual concerns in order to find a solution that improves the patient's sexual function and the couple's quality of life.