1. Sexuality and Aging
Class 9
CSL
November 8, 2016

2. Age-Related Changes in Sexual Response in Men
Normal aging is associated with a general decline in physiological sexual response and more variable declines in sexual activity.
As men age, there are gradual declines in sexual function that have variable impacts on sexual activity.
There are no predictable changes in men in sexual desire, although it remains relatively stable in most men
Erections are less reliable and durable and require more stimulation to achieve and sustain

3. Clinical symptoms for men include:
Ejaculation during orgasm involves decreased amounts of seminal fluid, and the refractory period between orgasms can increase by hours to days.
Terms such as andropuase, male climacteric, partial androgen deficiency of the aging male, and late onset hypogonadism have all been coined to refer to a symptom complex that results from age- related declines in testosterone levels.
Clinical symptoms for men include:
Decreased libido and sexual function
Depression
Decreased lean body mass
Body hair
Muscle power
Bone density
Increased visceral fat distribution

4. For men, declines in erectile function can symbolize a threat to their sense of masculinity and lead to excessive worry, anger or even depression.

5. For women, the experience of sexuality in late life is fundamentally shaped by the physiological and psychological changes that occur with menopause.
Menopause leads to important changes in female genital anatomy and function, including:
Atrophy of urogenital tissue
Decreased uterine and vanigal size
Decreases in vaginal lubrication
Vasocongestion
And the erotic sensitivity of nipple, clitoral, and vulvar tissue during sexual activity

6. Up to 85% of menopausal women may also experience symptoms, such as:
Hot flashes
Head and neck aches
Transient disruptions in mood
Sleep disturbances
Excess fatigue

7. Prevalence of Sexuality in Later Life
In general, there is a decline in the frequency of sexual activity after the age of 65…but not as much as might be imagined.
A study of late-life sexuality involved a representative probability sample of 3,005. The definition of being sexually active was not limited to intercourse or orgasm but included any mutual sexual activity.
The percentages of individuals who had been sexually active within the previous 12 months were quite high but declined with age:
Sexual activity from ages from 83.7% of men and 61.6% of women
Sexual activity from ages from 67% of men and 39.5% of women
Sexual activity from ages from 38.5% of men and 16.7% of women

8. Older men were found to be more sexually active than older women
Sexual satisfaction was relatively high in both sexes
The major predictors of sexual activity have included:
Previous level of sexual activity
An individual’s physical and psychological health
Availability , interest level, and health of a partner
Physical health appears to be the most influential factor for older men
Quality of the relationship is most important for older women

9. Homosexuality
There are an estimated 1-3 million gay and lesbian individuals over the age of 60 in the United States, and this number is expected to double in the next 30 years.
Older gay and lesbian individuals feel high levels of satisfaction with both their identities and lifestyles, and high levels of sexual satisfaction
In one study of over 100 older gay men, 86% of respondents 60 years and older were sexually active, with two-thirds of them reporting sexual activity at least once a month.

10. Sexuality in Long-Term-Care Settings
In one study of nursing home residents, less than 10% reported being sexually active in the preceding month
Nearly 20% reported a desire for sexual activity but were limited by the lack of a partner or privacy.
Barriers to sexuality in long-term care include:
Loss of interest
Poor health
Sexually dysfunction
Lack of partners

11. Sexually Transmitted Diseases
Individuals 65 and older account for less than 2% of reported STDs, including:
Chlamydia
Gonorrhea
Syphilis
HIV
Despite low prevalence rates, older people remain at risk for acquiring STDs, especially as they are increasingly sexually active.
A study that looked at nearly 6,000 individuals found that 91% of older men and a majority of older women did not use a condom when having sex with a date or acquaintance, and some didn’t even use one when they knew their partner had and STD.