Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-28T18:52:41.795Z Has data issue: false hasContentIssue false

10 - Sexuality and ageing

Published online by Cambridge University Press:  05 June 2012

Rebecca Flyckt
Affiliation:
University Hospitals of Cleveland
Sheryl A. Kingsberg
Affiliation:
University Hospitals of Cleveland
Ian Stuart-Hamilton
Affiliation:
University of Glamorgan
Get access

Summary

OVERVIEW

This chapter examines the topic of sexuality in older adults: sexual behaviours and attitudes about ageing; types of sexual dysfunction and their prevalence; physiology and pathophysiology of the male and female sexual response; medical conditions affecting sexuality; endocrinological, psychiatric and psychosocial factors; female and male sexual dysfunctions and disorders; assessment and treatment considerations.

Introduction

In this new millennium, the topic of sexuality in older adults has finally come of age. Whereas conversations about the sexual behaviours of mature men and women were once whispered and private, it is now acceptable openly to discuss these matters in magazines and newspapers, on television, and even at dinner parties. The psychological and physiological impact of ageing on sexuality is particularly timely for a variety of reasons. The first reason has been labelled the ‘Viagratization of America’, a phenomenon that has expanded worldwide (Kingsberg, 2002). The development of phosphodiesterase type-5 (PDE-5) inhibitors, beginning with Viagra (sildenafil) in 1998, sparked a renewed interest in exploring the sexual activities of older people. Once men had a non-invasive method for treating the inevitable sexual effects of ageing, the topic took the media world by storm. Previously a matter of patient reticence, older men began to present to their physicians anticipating the provision of particular therapies to enhance sexual performance. Viagra became a household name. Even a former American presidential candidate, Bob Dole, became a spokesperson for Viagra and discussed his erectile dysfunction (ED) in television ads.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

,AARP/Modern Maturity Sexuality Survey (1999) Washington, DC: National Family Opinion (NFO) Research.
,American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text revision (DSM-IV-TR). Washington, DC: APA.Google Scholar
Anastasiadis, A.G., Salomon, L. and Ghafar, M.A.et al. (2002) Female sexual dysfunction: state of the art, Current Urology Reports, 3(6), 484–91.CrossRefGoogle ScholarPubMed
Avis, N.E. (2000) Sexual function and ageing in men and women: community and population based studies, Journal of Gender-Specific Medicine, 37(2), 37–41.Google Scholar
Avis, N.E., Stellato, R., Crawford, S.et al. (2000). Is there an association between menopause status and sexual functioning?, Menopause, 7, 297–309.CrossRefGoogle ScholarPubMed
Bachmann, G.A. and Leiblum, S.R. (2004) The impact of hormones on menopausal sexuality: a literature review, Menopause, 11(1), 120–30.CrossRefGoogle ScholarPubMed
Basson, R. (2000) The female sexual response: a different model, Journal of Sex & Marital Therapy, 26(1), 51–65.CrossRefGoogle ScholarPubMed
Basson, R. (2001) Human sex-response cycles, Journal of Sex & Marital Therapy, 27(1), 33–43.CrossRefGoogle ScholarPubMed
Basson, R., Leiblum, S., Brotto, L.et al. (2003) Definitions of women's sexual dysfunction reconsidered: advocating expansion and revision, Journal of Psychosomatic Obstetrics and Gynaecology, 24(4), 221–9.CrossRefGoogle ScholarPubMed
Bem, D. (1965) An experimental analysis of self-persuasion, Journal of Experimental Social Psychology, 1, 199–218.CrossRefGoogle Scholar
Berman, J.R. and Goldstein, I. (2001) Female sexual dysfunction, Urology Clinics of North America, 28(2), 405–16.CrossRefGoogle ScholarPubMed
Berman, L., Berman, J., Felder, S.et al. (2003) Seeking help for sexual function complaints: what gynecologists need to know about the female patient's experience, Fertility and Sterility, 79(3), 572–6.CrossRefGoogle ScholarPubMed
Braunstein, G.D. (2007) Management of female sexual dysfunction in postmenopausal women by testosterone administration: safety issues and controversies, Journal of Sexual Medicine, 4(4 Pt 1), 859–66.CrossRefGoogle ScholarPubMed
Braunstein, G.D., Sundwall, D.A., Katz, M.et al. (2005) Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women; a randomized, placebo-controlled trial, Archives of Internal Medicine, 65(14), 1582–9.CrossRefGoogle Scholar
Buster, J.E., Kingsberg, S.A., Aguirre, O.et al. (2005) Testosterone patch for low sexual desire in surgically menopausal women: a randomized trial, Obstetrics and Gynecology, 105, 944–52.CrossRefGoogle ScholarPubMed
Davis, S.R. (2001) Testosterone treatment: psychological and physical effects in postmenopausal women, Menopausal Medicine, 9(2), 1–6.Google Scholar
Davis, S.R., Moreau, M., Kroll, R.et al. (2008) Testosterone for low libido in postmenopausal women not taking estrogen, New England Journal of Medicine, 359(19), 2005–17.CrossRefGoogle Scholar
Feldman, H.A., Goldstein, I., Hatzichristou, D.G.et al. (1994) Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Ageing Study, Journal of Urology, 151(1), 54–61.CrossRefGoogle Scholar
Freedman, M. (2000) Sexuality in post-menopausal women, Menopausal Medicine, 8, 1–4.Google Scholar
Gatz, M., Kasl-Godley, J.E. and Karel, M.I. (1996) Ageing and mental disorders, in Birren, J. and Schaie, K.W. (eds), Handbook of the psychology of ageing, 4th edn. San Diego, CA: Academic Press, 365–82.Google Scholar
Gentili, A. and Mulligan, T. (1998) Sexual dysfunction in older adults, Clinics in Geriatric Medicine, 14, 383–93.Google ScholarPubMed
Ginsberg, T.B. (2006) Ageing and sexuality, Medical Clinics of North America, 90(5), 1025–36.CrossRefGoogle ScholarPubMed
Gray, A., Feldman, H.A., McKinlay, J.B.et al. (1991) Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Ageing Study, Journal of Clinical Endocrinology and Metabolism, 73(5), 1016–25.CrossRefGoogle Scholar
Greenblatt, R.B. (1942) Hormone factors in libido, Journal of Clinical Endocrinology and Metabolism, 3, 305.Google Scholar
Gresser, U. and Gleiter, C.H. (2002) Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil and tadalafil – review of the literature, European Journal of Medical Research, 7(10), 435–46.Google ScholarPubMed
Hartmann, U., Philippsohn, S., Heiser, K.et al. (2004) Low sexual desire in midlife and older women: personality factors, psychosocial development, present sexuality, Menopause, 11(6 Pt 2), 726–40.CrossRefGoogle Scholar
Henry, J. and McNab, W. (2003) Forever young: a health promotion focus on sexuality and ageing, Gerontology and Geriatrics Education, 23(4), 57–74.CrossRefGoogle Scholar
Kaiser, F.E. (2003) Sexual function and the older woman, Clinics in Geriatric Medicine, 19(3), 463–72.CrossRefGoogle ScholarPubMed
Kaplan, H.S. (1977) Hypoactive sexual desire, Journal of Sex & Marital Therapy, 3, 3–9.CrossRefGoogle ScholarPubMed
Kingsberg, S.A. (2002) The impact of ageing on sexual function in women and their partners, Archives of Sexual Behavior, 31(5), 131–7.CrossRefGoogle ScholarPubMed
Kingsberg, S.A. and Janata, J.W. (2007) Female sexual disorders: assessment, diagnosis and treatment, Urology Clinics of North America, 34, 497–506.CrossRefGoogle Scholar
Kingsberg, S.A., Simon, J.A. and Goldstein, I. (2008) The current outlook for testosterone in the management of hypoactive sexual desire disorder in postmenopausal women, Journal of Sexual Medicine, 5 (Suppl 4), 182–93; quiz 193.CrossRefGoogle ScholarPubMed
Kinsey, A.C., Pomeroy, W.B. and Martin, C.E. (1948). Sexual behavior in the human male. Philadelphia: W.B. Saunders.Google Scholar
Kinsey, A.C., Pomeroy, W.B., Martin, C.E.et al. (1953) Sexual behavior in the human female. Philadelphia: W.B. Saunders.Google Scholar
Laumann, E.O., Paik, A. and Rosen, R.C. (1999) Sexual dysfunction in the United States: prevalence and predictors, Journal of the American Medical Association, 281(6), 537–44.CrossRefGoogle ScholarPubMed
Laumann, E.O., Paik, A., Glasser, D.B.et al. (2006) A cross-national study of subjective sexual well-being among older women and men: findings from the Global Study of Sexual Attitudes and Behaviors, Archives of Sexual Behavior, 35(2), 145–61.CrossRefGoogle ScholarPubMed
Laumann, E.O. and Waite, L.J. (2008) Sexual dysfunction among older adults: prevalence and risk factors from a nationally representative U.S. probability sample of men and women 57–85 years of age, Journal of Sexual Medicine, 5(10), 2300–11.CrossRefGoogle ScholarPubMed
Leiblum, S.R. (1991). The midlife and beyond. Presented at the 2th Annual Postgraduate Course of the Psychology Professional Interest Group of the American Fertility Society, ‘Sexual dysfunction: patient concerns and practical strategies’, October, Orlando, FL.
Leif, H.I. (1977) Inhibited sexual desire, Medical Aspects of Human Sexuality, 7, 94–5.Google Scholar
Lenahan, P. and Ellwood, A. (2004) Sexual health and ageing, Clinics in Family Practice, 6(4), 17–39.Google Scholar
Lepper, M., Greene, D. and Nisbett, R. (1973) Undermining children's interests with extrinsic rewards: a test of the ‘overjustification hypothesis’, Journal of Personality and Social Psychology, 28, 129–37.CrossRefGoogle Scholar
Levine, S.B. (1992) Sexual life. New York: Plenum Press.CrossRefGoogle Scholar
Lindau, S.T., Schumm, L.P., Laumann E.O. et al. (2007) A study of sexuality and health among older adults in the United States, New England Journal of Medicine, 357(8), 62–74.CrossRefGoogle ScholarPubMed
Martin, C.E. (1975) Marital and sexual factors in relation to age, disease, and longevity, in R.D. Wirdt, , Winokur, G. and Roff, M. (eds), Life history research in psychopathology, vol. 4. Minneapolis, MN: University of Minnesota Press, 326–47.Google Scholar
Masters, W.H. and Johnson, V.E. (1966) Human sexual response. New York: Bantam Books.Google Scholar
Meston, C.M. and Frohlich, P.F. (2000) The neurobiology of sexual function, Archives of General Psychiatry, 57(11), 1012–30.CrossRefGoogle ScholarPubMed
Mulligan, T. and Katz, P.G. (1989) Why aged men become impotent, Archives of Internal Medicine, 149(6), 1365–6.CrossRefGoogle ScholarPubMed
Mulligan, T. and Moss, C.R. (1991) Sexuality and ageing in male veterans: a cross-sectional study of interest, ability, and activity, Archives of Sexual Behavior, 20(1), 17–25.CrossRefGoogle ScholarPubMed
Mulligan, T., Retchin, S.M., Chinchilli, V.M.et al. (1998) The role of ageing and chronic disease in sexual dysfunction, Journal of the American Geriatrics Society, 36, 520.CrossRefGoogle Scholar
Nakagawa, S., Watanabe, H., Ohe, H.et al. (1990) Sexual behavior in Japanese males relating to area, occupation, smoking, drinking and eating habits, Andrologia, 22(1), 21–8.CrossRefGoogle ScholarPubMed
,National Council on the Aging (1998) Healthy sexuality and vital aging. Washington, DC: National Council on the Aging.
Nicolosi, A, Laumann, EO, Glasser, DB.et al. Global Study of Sexual Attitudes and Behaviors Investigators' Group (2004) Sexual behavior and sexual dysfunctions after age 40: the Global Study of Sexual Attitudes and Behaviors, Urology 64(5), 991–7.CrossRef
Nolen-Hoeksema, S. and Rusting, C. (1999) Gender differences in well-being, in Kahneman, D., Diener, E. and Schwarz, N. (eds), Well-being: the foundations of hedonic psychology. New York: Russell Sage Foundation, 330–50.Google Scholar
,North American Menopause Society (NAMS) (2007) The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of the North American Menopause Society, Menopause, 14(3), 355–69.Google Scholar
Ofman, U., Kingsberg, S.A. and Nelson, C.J. (2008) Sexual problems and cancer, in DeVita, V.T., Hellman, S. and Rosenberg, S.A. (eds), Cancer: principles and practice of oncology. Philadelphia: Lippincott Williams and Wilkins, 2804–15.Google Scholar
,Pharmacia Corporation (2001) New research on menopause and sexuality finds women are not seeking medical help for chronic symptoms affecting intimate relationship. Press release, 15 November. Peapack, NJ: Pharmacia.Google Scholar
Phillips, N.A. (2000) Female sexual dysfunction: evaluation and treatment, American Family Physician, 62, 127–36, 141–2.Google ScholarPubMed
Riportella-Muller, R. (1989) Sexuality in the elderly: a review, in McKinney, K. and Sprecher, S. (eds), Human sexuality: the societal and interpersonal context. Norwood, NJ: Ablex, 210–36.Google Scholar
Rosen, R.C., Lane, R.M. and Menza, M. (1999) Effects of SSRIs on sexual function: a critical review, Journal of Clinical Psychopharmacology, 19(1), 67–85.CrossRefGoogle ScholarPubMed
Rosen, R.C., Fisher, W.A., Eardley, I.et al. (2004) The multinational Men's Attitudes to Life Events and Sexuality (MALES) study. I. Prevalence of erectile dysfunction and related health concerns in the general population, Current Medical Research and Opinion, 20(5), 607–17.CrossRefGoogle ScholarPubMed
Rossouw, J.E., Anderson, G.L., Prentice, R.L.et al. Writing Group for the Women's Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial, Journal of the American Medical Association, 288(3), 321–33.
Rowland, D.L., Greenleaf, W.J., Dorfman, L.J.et al. (1993) Ageing and sexual function in men, Archives of Sexual Behavior, 22(6), 545–57.CrossRefGoogle ScholarPubMed
Schiavi, R.C. (1999) Ageing and male sexuality. Cambridge University Press.CrossRefGoogle Scholar
Schiavi, R.C. and Schreiner-Engel, P. (1988) Nocturnal penile tumescence in healthy aging men, Journal of Gerontology, 43(5), M146–50.CrossRefGoogle ScholarPubMed
Schiavi, R.C., Stimmel, B.B., Mandeli, J.et al. (1993) Diabetes mellitus and male sexual function: a controlled study, Diabetologia, 36(8), 745–51.CrossRefGoogle ScholarPubMed
Schnarch, D. (1997) Passionate marriage. New York: Henry Holt.Google Scholar
Senior, K. (2005) Growing old with HIV, The Lancet Infectious Diseases, 5(12), 739.CrossRefGoogle Scholar
Shabsigh, R., Klein, L.T., Seidman, S.et al. (1998) Increased incidence of depressive symptoms in men with erectile dysfunction, Urology, 52(5), 848–52.CrossRefGoogle ScholarPubMed
Shifren, J.L., Davis, S.R., Moreau, M.et al. (2006) Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: results from the INTIMATE NM1 study, Menopause, 13(5), 770–9.CrossRefGoogle ScholarPubMed
Shifren, J.L., Monz, B.U., Russo, P.A.et al. (2008) Sexual problems and distress in United States women: prevalence and correlates, Obstetrics and Gynecology, 112(5), 970–8.CrossRefGoogle ScholarPubMed
Solnick, R.L. and Birren, J.E. (1977) Age and male erectile responsiveness, Archives of Sexual Behavior, 6(1), 1–9.CrossRefGoogle ScholarPubMed
Steidle, C.P., Stecher, V.J., Pace, C.et al.; the SEAR Study Group (2006) Correlation of improved erectile function and rate of successful intercourse with improved emotional well-being assessed with the Self-Esteem and Relationship questionnaire in men treated with sildenafil for erectile dysfunction and stratified by age, Current Medical Research and Opinion, 22(5), 939–48.CrossRef
Geelen, J.M., Weijer, P.H. and Arnolds, H.T. (1996) Urogenital symptoms and their resulting discomfort in non-institutionalized 50-to-75-year-old Dutch women, Nederlands tijdschrift voor geneeskunde, 140(13), 713–16.Google ScholarPubMed
Walsh, K.E. and Berman, J.R. (2004) Sexual dysfunction in the older woman: an overview of the current understanding and management, Drugs & Aging, 21(10), 655–75.CrossRefGoogle ScholarPubMed
Wang, C., Alexander, G., Berman, N.et al. (1996) Testosterone replacement therapy improves mood in hypogonadal men – a clinical research center study, Journal of Clinical Endocrinology and Metabolism, 81(10), 3578–83.Google Scholar
Wang, C., Eyre, D.R., Clark, R.et al. (1996) Sublingual testosterone replacement improves muscle mass and strength, decreases bone resorption, and increases bone formation markers in hypogonadal men – a clinical research center study, Journal of Clinical Endocrinology and Metabolism, 81(10), 3654–62.Google Scholar
West, S.L., D'Aloisio, A.A., Agans, R.P.et al. (2008) Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women, Archives of Internal Medicine, 168(13), 1441–9.CrossRefGoogle Scholar
White, C.B. and Catania, J.A. (1982) Psychoeducational intervention for sexuality with the aged, family members of the aged, and people who work with the aged, International Journal of Aging & Human Development, 15(2), 121–38.CrossRefGoogle ScholarPubMed
Yaman, O., Akand, M., Gursoy, A.et al. (2006) The effect of diabetes mellitus treatment and good glycemic control on the erectile function in men with diabetes mellitus-induced erectile dysfunction: a pilot study, Journal of Sexual Medicine, 3(2), 344–8.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×