Lesson 4: Sex after 50


Let’s start by cutting to the chase

  • Sex will likely be a different experience with a different focus than was sex in your 20’s and 30’s
  • Communication with your partner is key
  • Allow intimacy to be the focus
  • There may be different challenges due to physical changes and conditions
  • There are ways to manage the hurdles that arise


Sex is a healthy activity

            Being sexually active, not specific to the senior years, may have many health benefits. These include:

  • lowering blood pressure
  • burning calories
  • increasing heart health
  • strengthening muscles
  • reducing your risk of heart disease, stroke, and hypertension
  • increasing libido
  • improved sleep, which in turn improves health in numerous ways
  • may strengthen the immune system
  • possible relief from migraines and cluster headaches

In an observational study at a headache clinic of people who remained sexually active during their headaches, significant percentages of people reported partial to complete relief.

Sex specific health improvements have also been observed, including decreased likelihood of diagnosis of prostate cancer before age 70 for men, and improved bladder control and decreased incontinence in women. Importantly, women who continue to be sexually active after menopause are less likely to have significant vaginal atrophy (the thinning of vaginal walls), which can cause pain during intercourse, and urinary symptoms.


The Empty Nest and Privacy

For couples who have raised a family, when they pass their half-century milestone, they may also have regained their privacy as the kids leave the house. During the parenting years, we are preoccupied with our children’s needs, and their care starts early in the morning, and doesn’t end at bedtime. Anyone who has been awakened by the calls of a child with an earache or who has just had a nightmare can attest to this. You are always on call. When a couple does have the time to settle in and pay attention to one another, they may be utterly exhausted, and in dire need of rest before the morning comes again. Further, depending on where you live, proximity to the child(ren)’s bedroom may be close and walls may be thin. While that is great for nighttime parenting, it is not exactly an aphrodisiac, thinking that you may wake the youngins, or worse, that they may be lying awake listening.

This is clearly not everyone’s situation, but it is common enough that once the sadness of having the children grow up and leave passes, the older couple has new opportunities to be intimate and sexual with one another.

Another change that may occur in later midlife is the tapering off of striving in one’s profession. Again, not true for everyone, but for many, the intensity and stress of striving to rise in one’s chosen profession or line of work may have softened, and one’s perspective on life and how to use what remains of it, may open a person up to slow down and smell the proverbial roses.

Common challenges

Why then doesn’t everyone remain chipper and sexually active for the duration? Common causes of decreases in sexual activity in older men include:

  • A lack of desire, often from medications they are taking for other reasons
  • Difficulties achieving and/or maintaining an erection
  • Poor general health

For women, the list includes:

  • Lack of desire, usually resulting from medications
  • Hormonal changes linked to menopause
  • Loss of a partner


What can a person do?

Here are some ideas on how to maintain an active and healthy sex life as you age

  1. Get and stay fit to the extent possible for you

Having sex is a physical activity. Staying fit will decrease concern about hurting yourself, such as pulling a muscle, etc. while in the act. It also boosts mood, and helps you look better, which raises self-confidence. Being fit also reduces the likelihood of erectile dysfunction in men, and can help women with arousal.

  1. Slow down and change it up

There’s no rush. Take your time. Take it out of the bedroom. Relax together in intimate ways such as showering and bathing together, getting massages together, giving one another massages.

  1. Explore sex outside of intercourse. Consider sensual massages, oral sex, sex toys.
  2. Look into your medications. Some of them may be impacting your sex drive. Decreased libido can be a side effect of needed medications. But there may be alternative medications that will have less of an impact on your sexuality. Although it may feel awkward to bring it up, do talk with your physician about it.
  3. Communicate with your partner. Communicate. Communicate!

This cannot be repeated enough. Communication includes listening as well as speaking. Talk about what? Your desires, what you like, what you don’t like. Your physical limitations. Your needs. Your fears.

In this later chapter of life, illnesses, chronic and acute, are a reality to be dealt with at some point. But they do not have to stop you from enjoying a satisfying sexual and intimate relationship.

Physical comfort

As stated in the section on joint freeing movement, 40% of the US adult population has osteoarthritis, and another 1.3 million suffer from rheumatoid arthritis. That’s an awful lot of people with physical discomfort, not to mention those with aching backs. As people age it is not surprising that they may not be able to move with the agility of a 25 year-old, even for old yogis. But that doesn’t mean that there aren’t positions where they can find the physical comfort to be close and intimate with their partner.  In general, some of the best positions for the older and wiser crowd may be those in which the weight is evenly distributed over the joints or the strain on the back is alleviated. Lying side-by-side instead of the missionary position can be helpful. And there are always pillows for support. Some of these positions are described in the links below.


The impact of diabetes

Type II diabetes is alarmingly prevalent in the US. According to the American Diabetes Association, in 2018, 26.8% of Americans age 65 and older had diabetes. Though Type II diabetes has a genetic component, it can be delayed or avoided with diet and lifestyle. However, once a person has it, it may only be managed and cannot be cured. High blood sugar levels in the body negatively affect arousal, and for men, the ability to achieve and maintain an erection. Diabetes impacts blood flow through the small blood vessels in the genitals, and damages nerves. Our sexual parts are bundles of nerves, so to speak. Co-morbidities, i.e. conditions that frequently occur along with diabetes, such as obesity, high blood pressure, sleep apnea, and depression, have their own impacts on sexuality and sexual functioning.

What can help?

            A healthful lifestyle is the best way to improve general health and is essential to managing diabetes. And it can positively impact sexuality. This includes eating a healthful diet, with guidance from a nutrition professional, getting regular exercise, and maintaining a healthy weight. Pelvic floor exercises are important for both women and men. Stress reduction is helpful for everyone, diabetes or not.


Sexually transmitted diseases  (STDs)

            Regardless of age, if both you and your partner are not monogamous, you are at risk for catching an STD.  This means regardless of age, a person who is not having sex exclusively with someone who is not having sex exclusively with them needs to take safe sex precautions.


Communication, again

A critical key to having a healthy and satisfying sex life as you get older is communication – with your partner and with your medical provider.

Sex is a touchy topic for many, no pun intended. Tips to keep communication open and clean with one’s partner and avoid aggravating an already sensitive situation include:

  • Invite discussion, rather than demand it
  • Use “I” statements rather than accusations
  • Save the bedroom for positive, loving interactions
  • Set aside time to share feelings and work towards solutions


Additional reading






































Suggested books to delve further

Dr. Ruth’s Sex After 50      by Dr. Ruth K. Westheimer

Naked at Our Age:  Talking Out Loud About Senior Sex     by Joan Price

Lesson Content

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