Many things get better with age: You likely become more financially stable, check goals off your bucket list and get to apply for senior discounts at movie theaters. Your sex life? It can become a little rocky at times. Throughout the years, it might become harder — both physically and mentally — to be as secure in bed as you used to in your 20s and 30s. But there’s no reason why you can’t have a happy and healthy sex life as you age. What can you expect in the bedroom as each year's birthday cake becomes increasingly a fire hazard? Here is what the experts have to say.
1. Low Libido
Due to a decrease in the sex hormones testosterone and estrogen, your sex drive might drop as you age. “For aging women, libido decreases when hormones drop during perimenopause and menopause,” explains Dr. Holly Richmond, Ph.D., licensed marriage and family therapist and AASECT certified sex therapist. “There’s an overall malaise or ambiguity — sometimes outright non-interest — in sex,” she says. And for aging men, anxieties encountered due to performance troubles might lower libido and lead to a drop in testosterone, according to a 2015 study published in The Endocrine Society.
To boost your libido, “eat a healthy, low-inflammatory diet that’s high in omega-3 fatty acids like salmon, nuts and avocado, get regular cardio in, do weight-bearing exercise three to four times a week and masturbate three to four times a week,” she says. Zinc supplementation might also help, as explained in the Journal of Human Reproductive Sciences.
2. Erectile Dysfunction
As men age, performance — or lack thereof — might become an issue. “Older men will most likely notice a change in the strength of their erections and decrease in libido, but it’s certainly not a given and is different for every person,” says Richmond. “There is not a physiological problem — there’s nothing wrong with them — it’s just a matter of aging and reduced blood flow,” she says. The ease with which one can achieve erections declines naturally with age, albeit at varying speeds and based on genetics and overall health and lifestyle choices.
Fortunately, there are ways to tackle erectile dysfunction.“We may prescribe meds like sildenafil, which inhibit an enzyme responsible for degrading nitric oxide gas, which then allows the penile tissue to relax and fill with blood to create an erection,” says sexologist Dr. Damian Jacob Sendler, M.D., Sc.D., Ph.D. Research shows that these methods can help older men build and maintain an erection, as shown in a 2014 study published in Asian Journal of Andrology.
3. Painful Joints
As you age, stamina naturally decreases and joint pain increases — and certain conditions, such as arthritis or osteoporosis, can make the body more fragile. “Being overweight or having arthritis can affect sexual health, limiting positions and stamina,” explains Richmond.
Joint and rheumatic problems can be addressed with anti-inflammatory medications, such as ibuprofen, Sendler says. Keeping your joints limber through fitness will also enhance your abilities in the bedroom, with a focus on musculoskeletal, light-intensity training and proper diet. “One of the easiest exercises to do is to walk a lot, since it increases our oxygenation level and improves circulation.” (And research shows good circulation leads to an erection too!) You can also try yoga, barre and stretching, as these types of exercise have been shown to improve pelvic floor strength, core stability and flexibility, says Richmond. Working the pelvic floor muscles will increase sexual function, according to a 2018 study in the Journal of Sexual Medicine.
4. Decreased Penile Sensitivity
With age, men may develop decreased penile sensitivity, says Dr. Robert Glatter, M.D., an assistant professor of emergency medicine at Northwell Health and attending emergency physician at Lenox Hill Hospital. Furthermore, the penis becomes less rigid in most men by age 60 — and conditions like diabetes can make sex especially challenging, as explained in Erectile Dysfunction as a Cardiovascular Impairment.
How can this challenge be overcome? “A more relaxed environment is required to optimize blood flow and increase sensitivity,” he says, so try to ease anxieties when feeling under pressure to perform. You can implement mindfulness through diaphragmatic breathing, which has been shown to reduce stress, based on a 2017 study in Frontiers in Psychology. You should also get more in tune with your body to figure out what works for you. “The number-one thing to do in order to get ready is to figure out in what situation we get sexually aroused the most. So we need to know how our body responds to the process of aging and modulate sexual performance accordingly,” says Sendler. If you know what triggers your arousal (a position, a visual or a phrase), play those up.
5. Greater Stress
As you age, stressful life events will likely creep up. Whether they’re health-related, familial or financial, these challenges will further exacerbate the stress you might be feeling within the bedroom. The mental strain might not only lower libido, but could also make sexual performance physically unattainable. Arousal can become more difficult, and it might take longer for lubrication, says Glatter. And if sex seems painful, whether from joint pain or dryness, he says, that anticipation of discomfort during sex will worsen the anxiety.
In fact, a recent study at North Carolina State University found that older people have more difficulty reducing the impact of stressful situations than they did in their youth. When it comes to something as personal as sex, it can be even harder. One way to move forward is to communicate with your partner, work together and reassure each other that lack of sexual function is treatable and nothing to be embarrassed about, says Richmond. Also try mindfulness-based practices like sensate focus, which take the focus off performance and puts it on pleasure, she says. “I pull from tantric exercises and also use grounding practices to keep the client in the moment, in his body and not in his head,” she explains.
6. Lower Levels of Testosterone
As you age, testosterone levels drop, which can affect both physical and psychological aspects of sexuality. “Decreased testosterone levels affect performance, libido and physical characteristics like dryness, erectile dysfunction and even joint pain,” says Dr. Jennifer Landa, M.D., a gynecologist and chief medical officer at BodyLogicMD. And it’s not only men who suffer from less testosterone. “Decreased testosterone with aging affects every facet of sexuality, including performance in both men and women,” she says. It can lead to something called “male menopause,” as explained in The Aging Male. Men, generally over 50, might experience thinning hair and difficulties getting erections as well as depression and high anxiety, says sexologist Sendler.
What could help? “The little blue pill, Viagra, and other medications like Levitra and Cialis are in a class called PDE-5 inhibitors. These little miracle cures not only temporarily increase blood flow to the penis, they also improve the health of the endothelium and are actually helping to heal blood vessels that are impaired in erectile dysfunction,” says Landa. And women can benefit from these medications as well. “I’m a huge fan of these medications, even for women. Women will also experience decreased blood flow due to endothelial dysfunction as they age, and that can affect their sexual function in terms of engorgement and lubrication,” she says.
As they age, women can encounter dryness. Because of a dip in estrogen, it becomes harder to get lubricated and have sex without friction or discomfort, explains Sendler. “Due to that, sex may become irritable, [and] even cause inflammation and abrasions,” he says.
What to do? “Women can take estrogen supplements or use topical creams, though these may carry other risks like increased chance of heart problems due to increased stimulation of hormonal receptors,” he says. Always be sure to get a doctor’s approval before trying out a new product. A safe and effective option is lube. “I always recommend water-based because they maintain an alkaline environment, causing less irritation, and these lubes also create less heat during rubbing,” says Sendler. And while oil-based lubes do ensure more lubrication, as oil is naturally slippery, “the problem with these [oil-based] lubes is that they tend to smell, might damage our clothes and are more difficult to clean up,” he says.
Another thing you might notice as you age is leakage spills. While these are perfectly normal and no reason to be ashamed, they can kill the mood if they happen during bedroom time. Both sexes can experience this, but for women it often happens as a result of childbirth and the onset of muscular weakness that comes with age, says Sendler. “With age, our muscles of the pelvic floor get fatigued. This is why elderly men and women tend to run when they need to use the restroom,” he explains.
One way you can strengthen those pelvic floor muscles is through Kegel exercises, he says. “There are also medications that improve continence, but these have other side effects like eye dryness,” he adds, so you’ll want to discuss your safest approach first with your primary physician.
There's no way of sugarcoating it — as you age, multiple factors are bound to make sex more challenging. The good news is, every roadblock comes with a solution. Now go out and enjoy your partner's company, stress-free!