People commonly desire to be intimate or close with others as they grow older. Some desire to continue being sexually active, which may require them to modify their sexual activities to accommodate their changing bodies or health. Others may decide not to continue engaging in sexual activities, which is ok, too. Whatever their choice, there are many ways to express one’s sexuality either alone or with a partner (National Institute on Aging, 2017).
Sexual Activity and Aging
As women age with disability, the desire for and enjoyment of sexual activity may be lessened due to some medications, reduced circulation, chronic pain, decreased mobility, weakness, or fatigue (University of Washington, n.d.). Other issues that can affect the sexuality of older women (National Institute on Aging, 2017; University of Washington, n. d) include:
- Bowel and bladder problems including incontinence
- Vaginal changes and dryness, which often occur after menopause, can make vaginal penetration and other types of sexual activity painful
- Difficulty with arousal or reaching orgasm
- Pain or discomfort around the genitals and other areas of the body
- Less interest in sex
- Difficulty becoming aroused
- Illnesses
- Surgeries especially when the breast or genitals are involved
- Concerns about sexually transmitted diseases and infections
Sexual Dysfunction and Aging
“Healthy sexual function requires physical, mental, and emotional well-being. Physical attributes that may limit sexual activity include decreased mobility, alterations in sensation, decreased genital circulation, and pain” (Rosenbaum, 2008). According to Camacho and Reyes-Ortiz (2005), acute and chronic diseases contribute to the decline in sexual function which can cause a decreased interest in sex. Increased mobility limitations in aging can contribute to diminished physical activity which, in turn, could reduce sexual desire.
Women with physical disabilities may want to ask their healthcare provider to rule out or discuss certain causes of limitations in sexual functioning as highlighted by the National Institute on Aging (2017) and others:
- Diabetes can increase the likelihood of vaginal yeast infections, leading to uncomfortable sexual activity
- Heart disease can cause reduced blood flow resulting in problems becoming aroused and achieving orgasm.
- Bladder infections such as bacterial cystitis (Zanni et al., 2003)
- Sexual pain specifically related to the pelvic floor muscles
- Medications that can sometimes cause fatigue, muscle weakness, vaginal dryness, mobility changes, changes in bowel or bladder function, and/or reduced sexual desire
- Self-image changes as one’s body changes with age
- Depression, stress, or anxiety
- Trauma or abuse. For more information, visit our Interpersonal Violence page.
What Can You Do?
If you are experiencing any of the issues mentioned above, consult your healthcare provider. Talking about sex can often be difficult or embarrassing. Nevertheless, it is important to bring up your concerns, especially if your provider does not ask for them first. Try to find a provider with whom you are comfortable. If your provider is unable to help you, ask them to refer you to someone who can help. If you are experiencing vaginal dryness, for example, perhaps your provider could refer you to a physical therapist who can teach you pelvic floor exercises to help with vaginal dryness (Rosenbaum, 2008). Or maybe your provider or a pharmacist could suggest over-the-counter vaginal lubricants.
If you are in a healthy, respectful intimate relationship, take time to discuss the changes you are facing and maybe even together discover new ways to be intimate in older years. Such discovery may include touching and caressing without sexual intercourse. Above all, celebrate your sexuality, your sexual rights, and your sexual health as a woman aging with disability!
Resources
Andrews, A. (2020). A Quick & Easy Guide to Sex & Disability. Limerence/Oni Press.[NOTE: “This guide can help disabled people (and their partners) on their journey toward self-love, better communication, and confidence." –– Alice Wong, Founder and Director, Disability Visibility Project]
Kaufman, M., Silverberg, C., & Odette, F. (2010). The Ultimate Guide to Sex and Disability: For All of Us Who Live with Disabilities, Chronic Pain and Illness. Accessible Publishing Systems.
Mayo Clinic. (2018). Female sexual dysfunction - Symptoms and causes. Accessed December 23, 2021
National Institute on Aging. (2017). Sexuality in Later Life. Accessed December 23, 2021
References
Camacho, M. E., & Reyes-Ortiz, C. A. (2005). Sexual dysfunction in the elderly: age or disease? International Journal of Impotence Research, 17(S1), S52–S56.
National Institute on Aging. (2017). Sexuality in Later Life. Accessed December 23, 2021
Rosenbaum, T.Y. (2008). The role of physical therapy in female sexual dysfunction. Current Sexual Health Reports, 5, 97–101.
University of Washington RRTC on Healthy Aging (n.d.) Factsheet: Aging with a Disability: Tips for Your Sex Life. Accessed December 23, 2021.
Zanni, G. (2004). Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: Results of a cross-sectional study. European Urology,45(5),642-8. DOI: 10.1016/j.eururo.2003.11.023