We know that sex can be important to older people’s quality of life. Lots of studies tell us about the frequency and types of sex for people aged 60 and older, which I won’t go into here.

What we know less of is older people’s experiences of sexual difficulties and how they may interfere with their life or relationships.

We’ve just published a paper which looked at the self-reported sexual difficulties of people (predominantly heterosexual) who took part in the English Longitudinal Study on Ageing (ELSA). We found that many older adults reported a disruption in their relationship from a sexual difficulty, and described it as depressing or frustrating, saying they were sad at the loss of intimacy. Some even expressed anger at their partner.

A sexual problem was particularly difficult to handle if they wanted to be sexually active, viewed sex as important to the relationship, and felt that they were ‘too young for this’. It also was worse if the partner wouldn’t talk about it or seek professional help.

Switching off or masturbating were ways of coping. Some mentioned they had considered having an affair but they believed in monogamy. Interestingly, it was only women who expressed concern about their partner’s sexual needs not being met as a result of their own sexual difficulties. Indeed, one woman who no longer experienced sexual desire engaged in sexual activity with her husband for this reason.

These negative impacts were buffered when both partners had a sexual difficulty and/or a health problem. Many said that they accepted the absence of sex, that life was fulfilling without it, and that ‘sex was not everything’. They were keen to stress that physical intimacy, e.g. cuddling and holding hands, remained important and kept their relationship strong.

Sexual difficulties were contextualized within the couple relationship. But it’s important to remember that not all older adults are sexually active, or want to be.

The take home message is that older adults experience sexual difficulties in different ways, negatively interfering with well-being and/or relationships for some but not all. There is a diversity of experience which must be acknowledged if we are to counter the current public health messages that to age well we must be sexually active.