AGING AND SEXUALITY

Recent research suggesting that a high proportion of men and women rem ain sexually active well into later life refutes the prevailing myth t hat aging and sexual dysfunction are inexorably linked. Age-related ph ysiological changes do not render a meaningful sexual relationship imp ossible or even necessarily difficult. In men, greater physical stimul ation is required to attain and maintain erections, and orgasms are le ss intense. In women, menopause terminates fertility and produces chan ges stemming from estrogen deficiency. The extent to which aging affec ts sexual function depends largely on psychological, pharmacological, and illness-related factors. In this article I review the physiologica l sex-related changes that occur as part of the normal aging process i n men and women. I also summarize the effects on sexual function of ag e-related psychological issues, illness factors, and medication use. A n understanding of the sexual changes that accompany normal aging may help physicians give patients realistic and encouraging advice on sexu ality. Although it is important that older men and women not fall into the psychosocial trap of expecting (or worse, trying to force) the ki nd and degree of sexual response characteristic of their youth, it is equally as important that they not fall prey to the negative folklore according to which decreased physical intimacy is an inevitable conseq uence of the passage of time.