Many Older Americans Have Active Sex Lives

'Landmark' study finds only modest declines, right up through the 80s

By Amanda Gardner
HealthDay

Many older Americans aren't letting age slow down their sex lives, a new study shows.

The first comprehensive national survey of the sexual attitudes, behaviors and problems of U.S. adults age 57 and older finds many are having sex often. In fact, the frequency of sexual activity dropped only slightly between the late 50s up to the early 70s.

And more than half of those in the oldest age group -- 75 to 85 -- who were sexually active reported having sex at least two to three times per month, and 23 percent reported having sex at least once a week.

"This gives us, for the first time, the most comprehensive and nationally representative data on sexuality for men and women and makes a particular contribution with regard to knowledge of older women's sexuality," study lead author Dr. Stacy Tesser Lindau, assistant professor of obstetrics and gynecology and of medicine-geriatrics at the University of Chicago, said at a Monday teleconference.

Lindau is lead researcher on the study, which is published in the Aug. 23 issue of the New England Journal of Medicine.

"This is of extreme importance and a landmark study that hopefully will get the medical community and society focused on this in a less taboo way. It's a great start," said Dr. Barbara Paris, director of geriatrics at Maimonides Medical Center in New York City. "For most people, it's a shock to hear that people are having sex in their 70s," she said.

"This is a premier study," added Marcia G. Ory, professor of social and behavioral health and director of the Aging and Health Promotion Program at Texas A&M Health Science Center School of Rural Public Health. "It debunks some myths that sex and old age don't go together, and it places this in the context of health and health problems."

According to the study authors, little is known about sexuality among older people in the United States, despite this group being the fastest growing segment of the population.

"I'm a gynecologist, and, for me, there was a tremendous void of information to be able to provide people the information they needed to make health care decisions and to be prepared for changes," Lindau said. "With the right information, people might be able to cope better."

For this study, the University of Chicago's National Social Life, Health and Aging Project (NSHAP) researchers interviewed 3,005 U.S. adults (1,550 women and 1,455 men), aged 57 to 85 in their homes.

Three-quarters of those approached agreed to participate and were remarkably forthcoming about their sex lives.

Researchers found that the prevalence of sexual activity did decline with age, with 73 percent of respondents aged 57 to 64 reporting sexual activity, 53 percent among those aged 65 to 74 and 26 percent among those aged 75 to 85.

Women were less likely to be sexually active than men in age groups. More than three-quarters (78 percent) of men aged 75 to 85 had a spouse or other intimate relationship, only 40 percent of women in that age group had a partner.

Women were also more likely to rate sex as "not at all important" (35 percent versus 13 percent of men).

"There do seem some gender disparities," Lindau said. "Men overall are more likely to have partners in later life and are more likely to be sexually active with their partners."

"Older ages really are different for men and women," added Linda Waite, senior author of the paper and the Lucy Flower Professor in Urban Sociology at the University of Chicago. "Men tend to be married until they die, and women tend to spend their final years as widows." In addition, men tend to have younger partners and women older partners, which translates into fewer opportunities for sexual intimacy for women.

About half of both men and women who were sexually active reported sexual problems. The most prevalent among women were low desire (experienced by 43 percent of respondents), vaginal dryness (39 percent) and inability to climax (34 percent). The most common problem reported by men was erectile dysfunction (37 percent).

Fourteen percent of all men reported using medication or supplements to help improve sexual function. "That was a high number," Lindau said.

Health more than age tended to affect people's sex lives; men and women who said their health was poor were less likely to be sexually active.

"The linkage with sexual health is closer to other health issues and is not so tied directly to aging per se," said Edward Laumann, co-author of the study and the George Herbert Mead Distinguished Service Professor in Sociology at the University of Chicago. "Sexual health, when it begins to deteriorate, may be an important warning sign, because it may be an early warning sign of more profound health problems." Lindau was co-director of the 1992 National Health and Social Life Survey which surveyed persons aged 18 to 59.

Despite difficulties, only 38 percent of men and 22 percent of women reported having discussed sexual health with a doctor since the age of 50.

Many people found ways to stay sexually active, even if their overall health was declining. This included oral sex (the prevalence being about 50 percent among those under 75) and masturbation (more than half of men and 25 percent of women said they masturbated, regardless of whether they had a partner).

That being said, vaginal intercourse was often predominant.

"The vast majority said that vaginal intercourse is always part of sexual behavior; that declines slightly as people age, with more cuddling and kissing and snuggling as the primary activity," Waite said.

The researchers also collected physiological specimens such as saliva and vaginal swabs, the results of which will appear in follow-up studies. The samples will provide information on hormone levels, prevalence of chronic diseases such as diabetes and the frequency of human papillomavirus (HPV), which is sexually transmitted.

While this research will pave the way for far more information in the future, for the present, it may help open the doors of communication.

"For physicians, it really gives us a wake up call that you should be asking about sexual function," said Dr. Laurie Jacobs, chief of geriatric medicine at Montefiore Medical Center in New York City.

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