Sexual Health Q&A

What are some of the physical changes that may affect sexual health as people age?

Good sex can be enjoyed well into later life, but aging brings about some physical changes that may call for some adjustments.

Issues for Men

  • Erectile dysfunction (ED). ED becomes more common as men get older and may be caused by other medical conditions such as diabetes, cardiovascular disease, and prostate cancer treatment. Fortunately, ED can often be treated with medication, injections, vacuum devices, or penile implants.
  • Low testosterone. As men age, their testosterone levels decrease, which may interfere with libido and erectile function. Testosterone replacement therapy may help.

Issues for Women

  • Vaginal changes. Many women experience sexual discomfort because of vaginal changes during menopause. When a woman’s ovaries stop producing eggs, they also produce less estrogen, a hormone that helps keep the vagina flexible and lubricated. As a result, vaginal walls may become thinner, dryer, shorter, and narrower. Some women develop an inflammatory condition called atrophic vaginitis.

To make sex more comfortable, some women use a water-based lubricant or prescription estrogen that can be applied inside the vagina. Others decide to go on hormone replacement therapy, which may help alleviate other menopausal symptoms as well.

Issues for Both Men and Women

For both men and women, pain from surgery, arthritis, or other medical conditions can make sex more challenging. Some couples may need to try different positions, use props like pillows, or experiment with other sexual activities. For example, if vaginal intercourse is painful, oral sex may be a satisfying alternative. Or, couples may choose to have sex at a particular time of day, when pain is less severe.