4/5 What are the advantages & disadvantages of having sex in each decade?

Part 4 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. 

There is a real risk of stereotyping and playing to heteronormative social scripts when dividing life into decades in this way: the issues raised in each section can, of course, apply to any stage as we travel through our lives.

Sex in our 20s

Though we may be helped or hampered by our still-evolving sense of identity, for many people, our 20s may be a time of experimentation. We can try on different partners and sexual activities – work out what floats our boat and move away from what doesn’t. If we are lucky enough to have good self esteem, and not be burdened by difficult past experiences or traumas, our 20s may mark a decade of sexual discovery and freedom.

The reality, of course, is that many of us will not experience it this way at all. Finding a partner at all may feel difficult – leading to sexual frustration and increasing performance anxiety. Many will turn to alcohol, or other substances, to aid confidence with a new partner – but this can lead to poor performance sexually.

Sexual trauma also warrants discussion. Statistics suggest that this affects roughly 1 in 4 women and 1 in 6 men (who tend to underreport traumatic experiences, making this number a likely underestimate. Body dysmorphia – particularly genital dysmorphia – is also prevalent and can blight confidence, seriously curtailing our ability to enjoy our bodies rather than wish to hide them.  Where we are burdened by anxiety, fear or distracted during sex, we usually struggle with arousal and climax. Pain with penetration, possible throughout life, is also relatively common in the young, too – vaginismus (or anodyspareunia), are painful conditions where the pelvic floor muscles contract, making penetration difficult or impossible – and this may mean that being sexually active feels hopeless.

Our 20s are also often a time when we wish to avoid unwanted pregnancy, and studies suggest that contraceptive choices can also impact our experience of sex – though overall, hormonal contraception tends to improve sexual function on an individual basis, things can feel different. The combined pill may affect libido or lubrication, for example. It has even been shown that women on the pill find different faces more attractive than when they are off hormonal contraception! There is also evidence that the orgasm gap can be very wide at this point – especially in heterosexual hook up sex.

Sex in our 30s

The average age for a first marriage (according to the ONS) is our early 30s for mixed sex couples, and our late thirties or early 40s for same sex relationships. This makes this a decade where big identity and relationship shifts can affect sex.

Whilst emotional intimacy and trust can foster better sexual satisfaction and expression, there may be challenges from trying for pregnancy – whether this brings success, or the distress caused by infertility. Having a baby can also affect the dynamic within a relationship. Studies show the impact on sex is not solely as a result of the physical changes of pregnancy and birth – same sex couples and those who adopt also experience changes to sexual frequency and satisfaction in the first year after becoming parents. Research suggests one in five couples will split up during that year, with changes to the sexual relationship a commonly cited cause.

Sex in our 40s

For female bodied individuals heading into perimenopause at the typical time, the 40s can be a time of enormous physical flux. Sex hormone levels can career up and down at random. Some will experience a surge in sexual interest at times, but many can feel that changes to sleep, hot flushes, and changes in how their bodies look and feel and react to intimate touch make sex feel a much less appealing prospect.  Women who enter menopause as a result of surgery or cancer treatment have a more abrupt and severe onset of symptoms, often coupled with associated additional challenges and trauma relating to what they have been through physically and emotionally. Those who have lost their ovaries will also have an abrupt fall in testosterone, which is recognised to have an impact for many in terms of sexual interest and function.

Male bodies can also hit bumps in the road here: erectile dysfunction becomes more prevalent, and when this includes loss of morning erections should be seen as a red flag that the first signs of heart disease may be on their way within a few years.

The 40s are also known as a time for psychological challenges: ageing feels more real and less abstract; we witness our parents starting to fail and may get our first real sense of our own mortality. It is a classical time for an existential, midlife crisis. It is also the average age for divorce, and the time risk of suicide peaks for men and women. This may translate into a drive to make changes in our lives – including in our sex lives.

Sex in our 50s

Perhaps one impact of the midlife crisis is this surprising statistic about our 50s: it is the decade where we are most likely to be unfaithful. Whereas rates of male infidelity have remained quite stable over time, the numbers have been climbing in women for some time now, bringing them nearly equal with their male equivalent.  Reasons given for cheating in research tend to vary – from impulsively taking opportunities offered, to an urge to feel sexy and desired again, and more alive.

This may all be at odds with our stereotypical view of sex in this decade. The early fifties is the average age of the last period in the UK, bringing with it the challenges of vaginal dryness, clitoral shrinkage and changes in bladder health that can significantly impact on sex, such as increased frequency of UTI and a higher prevalence of leaks and pelvic organ prolapse. Local and systemic HRT, where these are possible, can make a huge difference.

Medication use also starts to increase as we age – and a great many of our regularly used medications can have a significant impact on sex. Antidepressants, blood pressure tablets, painkillers and antihistamines are some of the common culprits leading to loss of desire, lubrication and difficulties with arousal and climax.

Sex in our 60s

One little known impact of ageing is that the “refractory period”, the typical period of inability to be aroused that follows orgasm in male bodies, becomes longer. For some men entering their 60s and 70s, it may be physically impossible to respond to stimulation for hours or even days after orgasm.

Erections can also lose rigidity, and be more easily lost. Drugs such as PDE5 inhibitors can help enormously.  Common brand names include Viagra (sildenafil) or Cialis (tadalafil) and can either be either on a low-dose daily basis – generally better for restoring morning erections and spontaneous sex, as well as improving associated health outcomes – or on a dose by dose, as needed basis. Psychosexual techniques can also be employed to help modify sex, to become more aware of where we are in the arousal cycle and to gain confidence in regaining arousal, and bringing our focus back to our bodies, if this is lost.

There is increasing evidence that PDE5 inhibitors are not only helpful in male bodies – studies show promise for their use in postmenopausal women, and in women with medical conditions impacting arousal, such as type 1 diabetes.

Sex in our 70s  

Though long term illness, disability and surgery is far from the exclusive preserve of the older person, it certainly becomes more prevalent with age. Though sexual problems are the third most common problem cited by cancer survivors (after loss of fitness and fatigue), we rarely talk about how to get sex back on track after significant health challenges.

Whilst the impacts of individual illnesses can vary, what holds true for all is the need for communication, and widening what counts as intimacy. For many couples experiencing a change in their sexual function, sex becomes the elephant in the room. All touch can fall by the wayside, for fear of it being construed as a green light for sex. This can increase feelings of loneliness and loss.

Help does exist: lubricants, changing of medications, and judicious use of toys to enhance or intensify stimulation or limit the depth of penetration can help. Clitoral suckers and the “oh nut”, for example, can be incredibly helpful after gynaecological cancer treatment has altered genital stretch or vaginal size and depth. Tablets, injections and vacuum pumps can help restore erections, and penile implants are offered in an increasing number of centres across the UK. Third sector organisations like Maggie’s, Target Ovarian, Prostate Cancer UK and Bladder Cancer UK offer support and advice to patients hoping to restore an intimate connection with a partner. Psychological support is also vital: illness can make us feel unsafe and helpless, which creates trauma and makes our bodies feel less safe. The treatments we endure can also be unpleasant, and we may learn to distance ourselves from our bodies as a way of surviving. It may take time to restore a sense of safety and hope of pleasure after an experience like this – but it is possible. And it is worth trying – because studies suggest that sexual contact as we age is associated with better relationship satisfaction and quality of life: not just adding years to our lives, but adding life to our years.