At 81, Hélène Bertrand, MD, and her 90-year-old husband continue to enjoy a fulfilling sex life. Once every week or two, they share intimate moments that lead to orgasm and, as Bertrand puts it, “a very good night’s sleep.”
“Over 36 years of marriage, we’ve learned the moves that our partners like and delight in giving each other pleasure,” said Bertrand, a retired physician. “Our satisfying sex life improves the quality of our marriage. You don’t have to be 20 years old to have a good sex life.”
Research shows that many older adults maintain active sex lives well beyond 65. According to a 2018 National Poll on Healthy Aging, 40 percent of those aged 65 to 80 are sexually active. Among respondents with a romantic partner, more than half reported engaging in sexual activity.
Yet as the population ages, medical care has not kept pace with this reality. Gaps in knowledge and understanding persist. Senior living communities often lack policies that respect sexual expression, particularly for LGBTQ residents. Even health care professionals frequently underestimate or neglect the sexual needs of older adults, influenced by stereotypes that dismiss them as asexual or deem sex “unnecessary” after reproductive age.
“Sexuality is a critical aspect of quality of life, yet it’s rarely discussed,” said Sivan Perdue, LCPAT, an art therapist certified in dementia care and sexual health.
The Longevity of Love
Several factors explain why older adults are enjoying more sexual longevity. Many are living longer, healthier lives. Those shaped by the sexual revolution often retain more open attitudes toward sexuality as they age. Medical advances, including treatments for erectile dysfunction, and hormonal therapies, have extended the potential for satisfying sex lives.
For those seeking connections after the death of a partner or divorce, dating apps like OurTime and SeniorMatch open a wider pool of possible partners for romance and intimacy. One in six Americans ages 50 and older (17 percent) have tried using a dating site or app at least once, according to research from the Pew Research Center.
“Today, older adults are more likely to participate in the hook-up culture of casual encounters and condomless sex,” according to a 2023 report in The Lancet, “Sexual activity of older adults: let’s talk about it.”
Positive portrayals of later-life romance in pop culture also play a role. Movies like It’s Complicated and TV series like Grace and Frankie show older adults embracing active sex lives and candidly discussing intimacy. Even reality TV, with shows like The Golden Bachelor, portrays romance as ageless.
Bertrand credits hormone therapy and a healthy lifestyle for the enduring intimacy she and her husband enjoy. Both have taken hormones since their 50s. She started using an estrogen patch in her 50s to counter menopause symptoms like depression, insomnia and hot flashes. Hormone therapy poses potential downsides—including a higher risk for breast cancer—but Bertrand thinks it’s worth the risk.
“Life’s too short,” she said.
Decreasing Libido
While 40 percent of older adults report they are sexually active, that leaves 60 percent who are not. It’s common for men and women to experience a gradual decline in libido beginning in their 50s, often triggered by factors like hormonal changes and chronic disease or disability.
Sagging skin and other age-related physical changes may make some feel more inhibited sexually. Many medications prescribed to older adults can also dampen desire or affect functioning, including blood pressure medications, pain medications, statins and others. Obesity can interfere with sexual function, both at the hormonal and psychological level.
Some older adults simply lack partners. More than one-third of Baby Boomers aren’t currently married. Compared to previous generations, fewer Boomers got married in the first place, and among those who did, more ended up divorced or separated. Also, as people are living longer, the divorce rate for those 50 or older is rising.
Some older adults lose partners to death. Jo McCormack (not her real name), 72, grew up during the sexual revolution and made the most of it, enjoying multiple liaisons with men in her youth. She never married but entered a long-term, monogamous relationship in her 30s that lasted 33 years, until her partner’s death.
“We had a very satisfying sex life, but when he died, my libido died with him,” she said. “I’ve always had a lot of men in my life, but now, I have no desire.”
Online dating does widen the pool of potential love matches for older adults—if they’re comfortable using dating apps. Some find the technology too daunting. And online dating can be frustrating.
“Many of us [people over 50] have to swim through a dispiriting sea of hundreds of people, most of whom we are unlikely to ever want to date,” writes Maggie Jones in the New York Times. “That includes profiles that are fake, created by scammers to try to lure private information from users. And while most profiles are real, sometimes their photos are not so much. More than one person told me that photos can be so outdated or filtered that they barely recognized their date when they met.”
Rising Risks
Increased sexual activity among older adults has coincided with a surge in STIs [sexually transmitted infections]. Between 2010 and 2023, STI rates among adults over 65 skyrocketed, with chlamydia tripling, gonorrhea increasing sixfold, and syphilis, nearly tenfold. Overall, STI rates among those 55 and older climbed from three to five cases per 100,000 in 2010 to 17.2 per 100,000 in 2020.
Despite these trends, older adults often lack basic STI knowledge. Few health care providers address sexual health with patients over 65 proactively. Among sexually active older adults, only 17.3 percent reported discussing sexual health with a provider in the past two years, and in most cases, patients initiated the conversation.
Maggie Syme, PhD, a research psychologist at Massachusetts General Hospital, noted that the US Preventive Services Task Force only recommends STI screening for patients up to age 65. By contrast, doctors routinely ask younger patients about their sexual health and habits. For people ages 16-25, sex education is readily available in schools and colleges.
“But there are very few resources for older cohorts,” Syme said. “So, we have more older people engaging in sexual relations with new partners but lacking the resources and information to help them minimize risk.”
Syme would like to see more public health campaigns aimed at older adults, such as the “Age is not a condom” social media campaign launched by ACRIA, an HIV-related nonprofit in New York state.
If there’s one man with multiple partners in an assisted living community, that’s a recipe to start an STI outbreak.
—Martha Kempner
Condoms aren’t a foolproof solution, however. Condom use can pose practical challenges for older couples, cautions Leanna Wolfe, PhD, author of 177 Lovers and Counting: My Life as a Sex Researcher (Rowman and Littlefield, 2024.)
“An older man needs a certain amount of stimulation, and a condom may not allow for that,” she said. Also, it’s difficult to apply a condom when the male isn’t fully erect, or if the couple is employing lubricants for vaginal dryness, a common problem for older women. (If condoms aren’t fail-safe, other preventive options include regular testing for STIs, limiting sexual partners to a mutually monogamous relationship, and possibly getting relevant vaccinations, such as HPV.)
Many senior living communities lack policies that ensure residents’ safety while supporting their right to sexual expression. Sivan Perdue helps communities craft guidelines that address the reality of residents enjoying sexual activity.
“It’s a matter of educating staff that sexuality is completely normal, that residents have a right to their privacy and that staff should not impose their beliefs,” she said. “Policies should also ensure inclusivity for LGBTQ residents. No one should feel they have to go back into the closet in their later years.”
Residents living with dementia pose special issues. People with dementia have the right to sexual relationships if they desire them, Perdue adds. But whether an individual has the capacity to give consent is a complex question that requires careful, case-by-case consideration.
The gender imbalance among older adults may also contribute to the rise in STIs, according to Martha Kempner, author of the Sex on Wednesday newsletter and co-author with Pepper Schwartz of 50 Great Myths of Human Sexuality (Wiley-Blackwell, 2015.) Because women live nearly six years longer than men, on average, there are fewer male partners available for older women.
“If there’s one man with multiple partners in an assisted living community, that’s a recipe to start an STI outbreak,” Kempner said.
Waning Desire
While more people are enjoying longer sex lives, sexual activity does change as people age.
“I think the common misconception is that nothing works after a certain age,” Kempner said. “Things get a little more complicated as we age, but there are ways around that. Viagra and other performance enhancing treatments can help address erectile dysfunction in men. Lubricants can combat vaginal dryness.”
Developing a satisfying sex life in later life often means expanding one’s sexual vocabulary.
“Many older adults have limited ideas of what constitutes ‘sex,’” according to Leanna Wolfe. “They think sex is only sex if it’s penile-vaginal intercourse.”
Partnered sex and intercourse may not be possible due to age-related issues such as arthritis, mobility limitations, effects of medication or serious health conditions. Oral sex, for example, often works better for older adults, according to Wolfe.
Good communication, always key to a good sex life, is essential for older adults. However, sex is often a difficult topic to broach with a romantic partner, according to the National Poll on Healthy Aging. Only one in three respondents indicated they would talk to their partner about sexual health problems.
But communication is critical for couples navigating changes in sexual desire. If both partners lose interest in sex in a relationship, that’s not necessarily a problem, but couples whose levels of interest and desire become unequal must negotiate those changes. Good communication can lead to effective compromises—like scheduling times for intimacy or agreeing to “maintenance sex” to enhance the relationship, even if one partner isn’t necessarily in the mood.
To keep the spark alive, one woman sends her partner flirtatious text messages and makes sure he knows what “stokes the fire” for her.
When couples have unequal sex drives, it’s important not to sweep the issue under the rug, advises Maryon Stewart, author of Manage Your Menopause Naturally (New World Library, 2020.)
“When your libido is low, expecting your partner to understand what is going on, without explaining, is an easy trap to fall into,” she said.
Waning desire hasn’t happened with Lynn Johnson, 62, and her 77-year-old male partner. They’ve been together 15 years.
“We’re both a bit baffled by it,” she said. “That’s a long time to want someone badly. The best way I can describe it is chemistry.”
Johnson was in a long marriage previously, which was sexless for many years. “I was determined never to be in a relationship again where that was the case,” she said. “I’m just really cognizant of how to keep that alive.”
To keep the spark alive, Johnson incorporates playful gestures, like sending flirtatious text messages. She’s vocal with her partner about what “stokes the fire” for her, as well as what turns her off. If her partner spends too much time on his phone, or in his own head, she reminds him that that “dims the flame.”
That’s how good communication keeps the spark alive, Bertrand notes, and it’s important to be specific.
“Tell your partner what pleases you and how you like it done,” she said. “Sex is a two-way street.”
