2/5 In which ways does sex stay the same as we age?

Part 2 of our ultimate guide on how to have the best sex possible, from your 20s to your 70s and beyond.

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in which ways does sex change as we age

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Part 2 of our ultimate guide on how to have the best sex possible, from your 20s to your 70s and beyond. We want to arm readers with practical advice that they can implement to have a satisfying and healthy sex life regardless of their age. 

In which ways does sex stay the same as we age?

Are there any golden rules that always apply? What misconceptions about sex in your 20s that you want to dispel? What misconceptions about sex in your 60s and above that you want to dispel?

It is easy to think that the biggest factors shaping our experience of intimacy will be the physical ones. Obviously, our health status matters: in fact, research shows that sexual function can be seen as a marker of both general health, and quality of life. One study even suggested that having 100 orgasms a year was linked to an extension in life expectancy. This makes sense: arousal and climax rely on healthy tissues, a good blood supply and a functioning nervous system to coordinate it all.

It is a misconception, however, to think that good sexual function is only possible with healthy, young body parts. It is pertinent to remember that our brains are our biggest sexual organ, with enormous capacity to amplify our turn ons and arousal (after all, some people can achieve climax without any touch at all), or to slam the brakes on it all through distraction, anxiety or disassociation.

One simple way of looking at ageing and sex is to appreciate that our experience of sex at any age can be said to rest upon four pillars of sexual health: our sexual function, our sexual body, our sexual identity, and our sexual relationship. Anything that creates impact in any one of these areas has the capacity to fundamentally alter our sex lives. The average journey from our 20s to our 70s will be full of such changes.

Sexual Function

This refers to the parts of our bodies specifically involved in the processes of desire, arousal, pleasure and climax. The proper function of these body parts is dependent upon our general health –in particular, the state of our hormones, nervous systems and blood vessels. Over time, age can significantly impact how these parts of us work, for example, through the impacts of diabetes, heart disease, cancer treatment, medications or surgery.

Sexual Body

This refers to all the other aspects of our physical selves that we use for sexual activity. This might include having joints that move flexibly and are pain free, so we can move into the sexual positions that work best for us. Or it can be something as simple as having enough saliva to enjoy kissing or oral sex. Much of this function we take for granted in youth, but ageing and illness brings impacts in many of these areas, limiting how easily we can do the things we most enjoy doing.

Sexual Identity

Our sexual identities are unique to us – our likes and dislikes, longings, kinks and aversions. As already discussed, this erotic template has its roots in our scripts and lived experienced. Even our sense of what is taboo (and therefore, often, the most arousing to us) is drawn from what we absorbed about sex growing up.  This is perhaps why in the US, more Republicans than Democrats will report fantasies about cuckolding – it is simply less exciting to think about if you are more liberal.

Sexual identities and fantasies tend to change and evolve over time as our own roles and experiences change – and as we age, we may experience impactful life events such as the birth of children, serious illness, bereavement, divorce or retirement. Such things change our sense of who we are – and so our sense of our sexual selves often alters alongside this.

Sexual Relationship

Who we choose, or are able to play out our sexuality with matters.

Statistics show us that it is less likely these days that we will stay with one partner for life. In fact, we understand that where there is successful long term monogamy, this may well have been achieved through allowing the relationship with our partner to grow and change – effectively creating a series of “new” relationships with that same person over the years.

From our earliest fumbles, to our first girlfriend/boyfriend and even our first marriages – who we choose (or are able) to have sex with can serve to both expand, and contract, the quality and variety of our sexual experiences. Most of us will have a portion of our sexual selves lived out through solo sex, and a portion shared with a sexual partner (or partners). Studies show we rarely share all of our erotic palette with a partner – one study of couples in long term relationships showed they could predict less than 60% of what the other liked sexually.

What stays the same?

Though our bodies, erotic palettes and relationships change over time, there are some aspects of our sexuality that tend to remain more static. Sexual orientation (for example being gay, heterosexual, bisexual, pansexual or asexual) is one element of sexual identity that tends to remain relatively stable over time, though some will certainly experience more fluidity and change in orientation than others. This doesn’t mean that our sexual behaviour (including the gender of the people we sleep with) won’t vary over the years, or our ability to embrace our orientation, or embark on relationships that reflect who we are sexually, romantically or emotionally attracted to.

There are also certain themes relating to sexual fantasy or desire that tend to remain surprisingly predictable over time, too. Known as the four cornerstones of eroticism, the vast majority of our sexual fantasies or desires will fall into one of these categories: longing and anticipation, violating prohibition, searching for power or overcoming ambivalence. And, despite what you may imagine, the research on sexual fantasy shows many of our daydreams feature surprisingly constant faces -that of our current partner (or when single, our ex).

What changes?

Clearly our bodies change significantly over the years. Female bodies, for example, may experience pregnancy, birth or breastfeeding. Each of these fundamentally changes the normal hormonal milieu, and with it our ability to experience desire, arousal and climax. The main hormone of lactation, for example, is prolactin. This has a suppressive effect on female sex hormones and can make climaxing during sex more difficult. Many women also suffer with vaginal dryness when breast feeding due to lower oestrogen levels. These changes are very common – but many women are not warned they will happen, or that simple treatments like vaginal oestrogens can be both safe and effective.

In general, the female sex hormones (oestrogen, progesterone & testosterone) are important to a woman’s experience of her body and sexuality. They change with each menstrual cycle, with contraception, and at menopause. These hormones help to prime the brain for sexual receptivity and also help with sexual thoughts and fantasies.  Elsewhere in the body, they play an important role too. They help maintain the erectile tissues in the genitals and help us to engorge and lubricate when aroused. This makes it easy to understand why so many women transitioning through perimenopause and menopause report changes in how they experience their sexuality physically and emotionally.

Male bodies don’t emerge from ageing hormonally unscathed either: research suggests about 40% of men over 45 have low testosterone levels. This can lead to low libido, loss of early morning erections and changes in things like the volume of ejaculate or ability (and timing) of climax. As in women, sexual function is about much more than just hormones – but they are a building block for healthy sexual function, and when levels change, it can significantly impact our experience of our bodies. In fact, when male testosterone levels fall down to single figures, it can make erections for sex much more difficult – even rendering drugs like Viagra ineffective. Excess body fat can also hinder sex by creating high oestrogen levels in men, which interferes significantly with the systems needed to maintain healthy function.

From a psychological perspective, age seems to change sexual fantasy too. Justin Leh Millers’ work on this subject (one of the largest studies on this ever done) fascinatingly showed that the content of our fantasies changes as we get older – with a move to more multi-partner scenarios and BDSM content as we progress into middle age. He hypothesises this is a psychological tactic to tackle the loss of novelty as we age, which, if true, is a neat adaptation to the confines of long term monogamy.

What are the Golden Rules?

Sex science tells us certain things hold true for most of us.

Our sexual scripts govern our expectations of ourselves, and our partners

We all have our own “sexual scripts”: the term given to the unspoken rules and “norms” governing our understanding of sex.  We unconsciously absorb these scripts from what we see around us as we grow up.  They provide the framework for our understanding of sex, yet we rarely consider how we came to think as we do, or that no two people will have had exposure to the exact same messages.  These scripts, left unchallenged, will go on to govern our expectations and, ultimately, our experience, of sex. They may create tensions in our relationships if what we think of as “normal” differs significantly from the ideas of our partner.

What can we do about this?

Become aware of where your messages came from, and whether they are helping (or hindering) you now.  This is something we can do on our own, by considering who taught you about sex, whether the messages you received were positive or negative, and whether it opened things up for you sexually or closed you down. Consider whether you still believe in these rules, or norms, from your adult perspective. What would be the impact on any problems you are experiencing if you chose to reject them?

Sexual problems often create shame

Most of us receive no standardised curriculum regarding sexuality beyond what is imparted by awkward teachers taking sex ed lessons at high school.  We are left working it out alone. This lack of useful instruction might explain why we often feel ill-equipped to negotiate the sexual challenges that different ages and stages of our lives can throw at us.

The shame of not knowing can affect professionals too – I’ve known I felt particularly aware of the yawning chasm around my sex education when I worked as a GP. Medical training also largely skims over all things sexual: if it’s not about contraception, pregnancy, STI’s or erectile dysfunction, it doesn’t tend to appear on the curriculum. Unfortunately, this lack of training doesn’t equate to a lack of need.

Sexual problems are an almost universal experience as we go through life. Our sexual function is affected by everything from contraception choice to cancer, yet because the sexual impacts of health issues are rarely discussed by health professionals (in part because we are often lacking in both knowledge and answers), it can mean that when problems crop up, we worry that we are the only ones struggling with this.

What can we do about this?

Shame usually evaporates when given light and air. To stop the sense that it is just us struggling with something, we need to seek others with similar experiences. Understanding that certain life events are associated with typical problems can certainly help. Read up on what is happening, join forums and reach out to professionals – such as COSRT trained therapists, or RELATE, or look for websites and third sector organisations that fill the gaps in the NHS.

We get more excited by novelty – and this can make monogamy a challenge

Another such biological “truth” is that we are sexually wired towards novelty. Research shows our bodies will produce a greater level of arousal (for example, a greater blood flow to genitals, and a larger volume of ejaculate with more motile sperm) when offered a new sexual partner – even if we already have access to a sexually available existing partner. This is known as the “Coolidge Effect”, and it can certainly create challenges as we age – particularly if we live with the same partner from our early 20s through to our 70s.  It is a subject that has been looked at in detail by renowned sexologist Esther Perel. She describes two paradoxical needs within long term relationships: one, a need for attachment, intimacy, and to know everything about our partner (and reciprocally, to be fully seen and accepted by them), the other, a need for distance and novelty in order to feel desire and to be able to eroticise them.

What can we do about this?

To continue to enjoy sex with the same partner as we age, we often need to nurture a little distance from them to allow the growth of both parties. In this way, a thread of novelty and re-discovery can exist, keeping things fresh and interesting through the years. Being able to do this helps safeguard your sex life in the long term. In fact, sexology has even come up with an “erotic equation”:

Attraction + Obstacle = Desire. 

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Throughout this website, we use the term women when describing people who experience hormonal symptoms. However, we acknowledge not only those who identify as women require access to menopause and hormone health information. For example, some trans men, non-binary people, intersex people or people with variations in sex characteristics may also experience menopausal symptoms and PMS/PME or PMDD, and we warmly welcome everyone who needs this support in our clinic.

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