The psychological impact of aging on sexuality and relationships

Aging has a powerful impact on the quality of relationships and sexual func tioning. The psychological impact of aging after midlife is a particularly timely topic given improved medical and psychological understanding of sexu ality in both women and men, as well as more effective treatment for age-re lated sexual dysfunctions. It is time to dispel the stereotype of the midli fe relationship as the continuation of a traditional heterosexual marriage with grown or almost grown children in order to more effectively address em otional and sexual issues arising in relationships. Regardless of the lengt h or nature of the relationship, however, its quality is enhanced by emotio nal intimacy, autonomy without too much distance, an ability to manage stre ss and distractions by external factors, and achieving a satisfying sexual equilibrium. Perception of the quality of the primary relationship and sexu ality is influenced by the other factors in a person's life. Thus, the rela tionship must be examined and issues must be addressed taking these externa l factors into consideration. Among the most powerful external factors is o ne's occupation or avocation, as it tends to strongly influence one's sense of identity, self-esteem, and self-worth in all areas of life. To understa nd and treat effects of aging on sexuality, it is important to address the three components of sexual desire: drive, beliefs/values, and motivation, a s well as the sexual equilibrium within the primary relationship. It is als o essential to understand how the physiological changes in male and female sexual functioning affect desire and equilibrium. Other health-related chan ges that occur with aging must be recognized and addressed, including the f act that the oldest of old women will outlive their corresponding male coho rt. Treatment implications for these issues are discussed.