13.11: Frequency and Enjoyment of Sexual Activity
- Page ID
- 84102
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A brief examination of age-related alterations in the frequency and enjoyment (subjective quality) of sexual activity follows. Except where specific differences are noted, this discussion describes both men and women.
On the average, the frequency of sexual activity decreases with age. This decrease accompanies average declines in desire for, interest in, and enjoyment of sexual activity. However, the degree of change in these three parameters is highly variable among individuals, and some people experience increases rather than decreases in one or more parameters.
Contributing Factors
Among the most important biological factors that reduce the frequency and enjoyment of sexual activity is declining health of one of the partners, especially the man. Furthermore, the influence of declining health is often amplified by treatments that affect sexual functioning (e.g., medications, radiation therapy, surgery on reproductive or other organs). Other biological factors that tend to reduce the frequency and enjoyment of sexual activity include age changes in the reproductive, nervous, and circulatory systems; faster onset of fatigue; overeating; and excessive consumption of alcohol.
Menopause leads to an average reduction in sexual activity. However, it results in increased sexual activity for some women because they no longer fear pregnancy or because sexual activity helps prevent or reverse negative self-images resulting from menopause.
Male sexual activity is not affected by ordinary changes in testosterone levels until after approximately age 80. However, abnormally severe decreases in testosterone reduce the desire for sexual activity and adversely affect the functioning of the reproductive system.
The frequency and enjoyment of sexual activity are usually reduced by age-related social changes (e.g., loss of spouse, change in household) and psychological factors. Relevant psychological factors include fear of aggravating a heart condition, boredom from lack of variation in sexual expression, diminished self-image, perceptions of altered physical appearance, depression, stereotyping, and fear of failure. Conversely, especially for men, novelty in sexual activity (e.g., new spouse, modified types of sexual expression) may result in temporary increases in the frequency of sexual activity.
The consequences of economic changes may also diminish the frequency and enjoyment of sexual activity. For example, a reduced income may cause altered living arrangements (e.g., living with relatives) and an accompanying loss of privacy. Finally, institutionalization can create or amplify adverse effects in all these categories (biological, social, psychological, economic).
Making Adjustments
The physical, social, psychological, and emotional benefits of sexual activity continue to be important for many older people. Therefore, actions that prevent or ameliorate factors that adversely affect sexual activity can help maintain a high quality of life. Such actions include maintaining good health; accepting age changes (e.g., cosmetic changes, slowed responsiveness); and using compensatory strategies (e.g., lubricants, modified sexual techniques). When the frequency or enjoyment of sexual activity becomes unsatisfactory, medical and psychological evaluation and therapy can help identify and resolve problems.