Sexuality in the Aging Couple, Part I: The Aging Woman

Irwin W. Kuzmarov, MD, FRCSC; Jerald Bain, BScPhm, MD, MSc, FRCPC, CertEndo, BA

Disclosures

Geriatrics and Aging. 2008;11(10):589-594. 

In This Article

Abstract and Introduction

Abstract

Sexuality and sexual activity do not end when a person reaches a certain age. Sexual desire and activity continue well into later life, and age is not a deterrent to a happy and healthy sex life. However, clinicians should be aware that the normal sexual response of men and women may change with aging. When sexual dysfunction occurs, studies show that men and women tend to view sexual dysfunction differently. Part I of this article addresses sexuality and sexual dysfunction in aging women; Part II (to appear in a forthcoming issue of Geriatrics & Aging) will address the male side of the picture. It is crucial that family doctors be aware of sexuality in the aging couple, and be able to evaluate and manage problems that may arise.

Introduction

Sexuality and sexual activity do not come to an end as a normal part of aging. Sexual desire and activity continue well into later life, and age is not a deterrent to a happy and healthy sex life.[1] Although there is a decrease in sexual activity with age, particularly in women, sexual activity persists well into the senior years.[2,3,4,5] Marsiglio et al. showed that 24% of people over 76 were having sexual relations more than twice per month ( Table 1 ).[6] Sexual interaction does not necessarily mean sexual intercourse; further, studies show that older women often initiate and influence or direct the interaction.

The introduction of PDE-5 inhibitors has changed the profile of sexual functioning in aging men and has led to a broadening of our understanding of the sexual function and dysfunction of couples, with a focus on the erectile process. In women a more precise classification of sexual function and dysfunction has allowed the development of treatment options with more specific goals.[7]

The ability of couples to adapt to the changes of aging, and to understand them, is essential to maintaining a healthy lifestyle. This implies an understanding of the changes, an openness between the partners, and an ability to communicate feelings, desires, and weaknesses too. It implies, as well, a need by the medical community to become familiar with the normal sexual changes associated with aging, as well as the sexual dysfunctional problems that exist in women as well as in men.

In Part I of this two-part series, we will attempt to present an overview of the sexual changes in women and a profile of sexual interaction between men and women. We will deal with female sexual function and dysfunction, and the role of primary care physicians in the management of these issues. Part II, focused on the aging male, will appear in the next issue of Geriatrics & Aging.

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