Alteration in Sexual Appetite Across Ages - Yet, Persists Rather Than Vanishes Absolutely

As individuals advance in age, pervasive myths about a significant drop or even cessation of sexual desire persist. These stereotypes fail to encapsulate the multitude of ways one's libido can evolve with age, not only experiencing fluctuations but also experiencing improvements.

Physical intimacy is an integral part of overall health and well-being, and enjoyable, fulfilling sex in one's 40s, 50s, 60s, and beyond is not only possible but common.

Libido Fluctuations with Age

Various factors contribute to changes in sexual desire over time. For instance, one might recall strong sexual desires during the teenage years or while in college. Sex drive may also increase with the onset of a new relationship or decrease under high levels of stress. These changes are natural and expected.

As individuals age beyond their 20s and 30s, hormonal changes within the body will impact desire for sexual activity as well.

In women and those assigned female at birth, reduced estrogen levels, often occurring around menopause, have been linked to decreased libido. Testosterone levels, while present in women as well, begin to decrease earlier, in the 20s or early 30s. The decline in both hormones can contribute to a decrease in sexual desire, but age, rather than hormone levels, appears to have a stronger correlation with diminished sexual desire in individuals maintaining their ovaries, according to Susan Reed, MD, MPH, MS, a gynecologist at UW Medical Center - Roosevelt.

Lower estrogen levels may also lead to vaginal dryness and thinner vaginal tissues, making penetrative sex painful.

In men and those assigned male at birth, testosterone levels start to decline in the mid- to late-30s, though this decline may be delayed in healthier individuals.

Additional Factors

It's essential to note that hormonal changes are not the only factors influencing sexual desire. As individuals enter their 30s and beyond, they may face responsibilities such as caring for children or aging relatives, work commitments, and established routines that often lack novelty. These factors, when combined with hormonal changes, can significantly impact one's sexual desire.

Medications, alcohol, marijuana, and various other substances can also decrease libido. Additionally, chronic health conditions, such as diabetes and heart disease, cancer treatments, medications like antidepressants, antihistamines, and hormonal birth control, mental health conditions such as anxiety or depression, and a history of distressing sexual experiences or physical or sexual assault can impair sexual desire.

Improving Sex Life in Later Years

It's crucial to recognize that feelings of low libido are often a concern only when they cause distress. If one continues to enjoy sexual activity despite a decrease in frequency, then there is no issue to address.

However, if low libido is causing distress, various solutions may help revive sexual desire.

Address Health Concerns or Pain

When dealing with chronic medical conditions or bothersome symptoms, discussing treatment options with a healthcare provider is essential. Specifically, addressing pain or discomfort experienced during sex can help improve sexual satisfaction.

Creams, tablets, vaginal rings, or dissolving capsules of estrogen or the hormone DHEA can help alleviate vaginal pain during penetration. In cases related to desire, testosterone supplementation may be beneficial as well, though it is not an FDA-approved treatment for females in the United States. Prescribing testosterone to women typically involves the use of male-approved formulations at a significantly lower dose. Testosterone pellets should be avoided due to their association with addictive behaviors and increased cancer risks, according to Reed.

Pelvic floor therapy, vaginal dilators, or mental health counseling may also be helpful, depending on the specific issue at hand. Certain oral medications may be employed, but Reed typically reserves them for last resort scenarios, as their benefits are fewer and the potential side effects can be significant.

For those experiencing trouble obtaining erections, Viagra and Cialis are widely recognized as safe and effective treatment options. Low testosterone levels may also play a role in sexual struggles, making it advisable to undergo a blood test to check for any potential deficiencies.

Feeling embarrassed discussing sexual issues with healthcare providers is common, but it is essential to address these concerns, as one's sexuality is integral to overall health.

Incorporate Lubricants

Lubricants can benefit individuals in various situations, regardless of their partner or the type of sexual activity engaged in.

When used to alleviate vaginal dryness, Reed recommends products with a pH of 4 or 5, which closely matches the pH of a woman's vagina, and products that are iso-osmolar at less than or equal to 380 mOsm/kg, ensuring balanced lubrication. Many natural, oil-based, or silicone lubricants meet these criteria, though it is important to avoid using oil-based lubricants with latex condoms, as they can cause leakage or holes in the material.

Reflect on Desires and Needs

It is acceptable if traditional sexual activities like penetrative vaginal sex no longer appeal. Alternatively, if an individual only desires sex once a month or emphasizes exploring self-pleasure, it is essential to consider what truly satisfies in one's sexual experiences, free of judgment or external pressure.

For many older women, penetrative vaginal sex may no longer be a priority, according to Reed. Engaging in acts of physical intimacy that do not involve penetrative penile sex remains beneficial for overall well-being.

For men and individuals with a penis, the ability to achieve an erection may be what matters most, even if intercourse is not frequent. Alex Anawalt, MD, an endocrinologist at UW Medical Center - Roosevelt, emphasizes the importance of understanding exactly what a patient seeks, noting that focus should not always be on sexual intercourse but on the ability to experience excitement.

Communicate Openly with Partner

If a lack of sexual desire causes distress not only for the affected individual but also for their partner, open and honest communication is crucial. A dialogue focused on finding ways to enhance or spice up the sex life together, rather than placing blame, is more likely to promote positive change.

If discussions between partners prove difficult, couples therapy can be a useful resource.

Experiment and Be Open-Minded

Innovative sexual experiences offer a wealth of possibilities for pleasure, either alone or with a partner. Researching new techniques and exploring various options can lead to newfound enjoyment. It is essential to maintain an open mind, even when initial attempts may lead to awkward or messy situations, as long as they are consensual.

More individuals are becoming empowered to explore their sexual preferences thanks to the discussion of these topics on social media platforms. Reed has noticed an increase in patients interested in using vibrators, a trend attributed to online conversations. While social media can provide valuable insights, it's equally important to keep in mind that the portrayal of sex in popular media may not reflect reality, particularly when it comes to depictions of sex in TV and pornography. Ultimately, one should engage in sexual activities that feel good and bring satisfaction.

"If you think something is going to make sex better, it often will," says Anawalt.

Various factors, such as hormonal changes, life responsibilities, medications, and health conditions, can impact sexual desire as individuals age.
In both women and men, hormonal fluctuations play a role in changes to the libido, with women experiencing decreased libido due to reduced estrogen levels, often around menopause, and men experiencing a decline in testosterone levels in the mid- to late-30s.
Mental health conditions, such as anxiety or depression, and past distressing sexual experiences or physical or sexual assault can also impair sexual desire.
Improving sexual lives in later years involves addressing health concerns or pain, incorporating lubricants, reflecting on desires and needs, communicating openly with partners, experimenting, and being open-minded, and seeking help from professionals like healthcare providers or therapists when necessary.
Sexual exploration through researching new techniques and using sex toys, such as vibrators, can lead to newfound enjoyment, while it's important to critically evaluate representations of sex in popular media and engage in sexual activities that bring satisfaction.