Our bodies change through every life stage and so does our sexual function. Your desire and sexual response is likely to be different at 20, at 40, and at 60. As people reach their 50s, 60s and beyond there are some common issues that can present challenges to sexual activity and intimacy. For example, it may take longer to get aroused, pain during sex may become an issue, and you may experience changes to the way you orgasm, ejaculate, or have sensations. Adapting to sex in an older body may mean switching up your sexual practices, but it doesn’t mean you can’t keep having satisfying sex. Changing your habits might even open up new possibilities for pleasure and connection.

Common sexual challenges later in life

There are generally two types of physical issues that affect sexual expression later in life: 

• Changes in your genitals that affect sexual function. This can include vaginal dryness, or prostate issues. Hormonal changes are one of the main causes for this. 
• Other bodily changes that affect your sex life. This can include dealing with arthritis, or resuming sex after surgery. Even though these concerns are not directly sexual in nature, they can have a big impact on your sex life.

Learn more about some of these common issues and tips for managing them.

1. Vaginal dryness and pain with penetration

Menopause, the last menstrual period, happens at approximately age 51 (the average age in the US) and the hormonal changes around this time can have a significant affect on sex for some people. Natural vaginal lubrication usually reduces after menopause, and the skin and tissues of the vulva and vagina can become thinner and more fragile. The vagina itself can even shrink in size. All of these changes can make penetration uncomfortable, painful, or even impossible for some older adults.

Treatment‍

Quality lubricant is a good addition to your sex life at any age, but if you’re experiencing vaginal pain, it is a must. Try using a silicone lubricant for long-lasting, silky lubrication. But using a lubricant may not be enough for some people. Estrogen cream, or hormone replacement therapy (HRT) can help, but they’re not safe or suitable for everyone. It’s important to take your time to build arousal and to go slow with penetration. Note that for some people, penetration just might not be an option anymore. In that case, try alternatives like doing more oral sex or using a clitoral vibrator. 

2. Erectile dysfunction‍

Erectile dysfunction can occur at any age, but it becomes more common in later life due to changes to blood vessels and hormones. Diabetes, high cholesterol, and heart conditions can all cause erection difficulties; so can medications for high blood pressure, Parkinson’s disease, and for chemotherapy. Having an enlarged prostate or undergoing prostate surgery can also affect your erections, sometimes permanently.

Treatment

For some people using erection medications like Viagra or Cialis is an option. Ask your healthcare provider if this is right for you because this option is not safe or appropriate for everyone. For a different method, try using a penis pump to help you get an erection, and a cock ring to help you sustain the erection. If your erections have become unreliable, or are no longer possible, it does not mean your sex life is over. Focusing on oral sex, using your hands, or toys can bring a lot of pleasure to you and your partner. Taking the focus off penetration can encourage you to be more creative — it may be the perfect time to try tantra, or to experiment with sensation play.

3. Orgasm difficulties

Sexual sensation may be less intense, it can become harder to reach orgasm, and orgasms may not feel as strong. Giving yourself plenty of time to get aroused and build up stimulation is essential, but even with all the time in the world, orgasm may just be more elusive. On the other hand, orgasm can also become less predictable. For some, it may be more difficult to control ejaculation.

Treatment‍

Trying a vibrator is a great idea if you want to experience more intense sensation. The stronger vibrations might be just what you need to push you over that threshold to orgasm. There are lots of ways to use vibrators as there are different types for different body parts — some vibrators are for clits, others are for penises, anal, etc. For another stimulation technique, try edging. Not only can edging help you experience more pleasure, edging can also help with ejaculation control.

You can also try scheduling a sexual activity with your partner. While this might not sound sexy at first, scheduling sex can actually be a great way to build anticipation, and to designate lots of time to be with your partner. Why not pencil in a whole morning for sexual pleasure? Knowing it’s in your schedule means you can prepare with toys and lube and other things you want to use. You can look forward to it in the days beforehand. 

4. Arthritis and pain in your joints

Arthritis and sore or stiff joints are other common challenges people often face as they age. Pain in the hips can make it difficult to spread your legs. Back, knee, and elbow pain can all make certain sex positions uncomfortable. Arthritis in the hands can affect dexterity, making it difficult to rub a clit or use a sex toy with the same precision as you used to. 

Treatment

Your healthcare provider may be able to help you with treatments or medications to ease your symptoms, but either way, you may have to adapt your sexual practices so that they’re more comfortable for you and your partner. Side-by-side sex may be more comfortable than missionary, for example, and doggy style might be off the menu. There are still lots of ways you can enjoy intimacy. Supporting your hips, back or belly (depending on your position) with pillows can be a great idea. You could even invest in some Liberator cushions designed especially to support your body during sex.

5. Chronic illness

Chronic illnesses, such as diabetes, cardiovascular issues, vision problems, lung disease, dementia, bladder problems and more, are things that a lot of older adults have to navigate. Chronic health issues can affect your libido, your sexual function, your level of energy, and might just make sex seem less important in the face of these often serious conditions. For most people it is safe to still have sex, but it is worth discussing with your doctor because sex might not be safe for all older people with chronic illnesses.

Treatment

Be ready to adapt your sexual activities to accommodate your health limitations. For example, it may be necessary to stick to sex positions that are less demanding on the body. You might want to make sure things don’t get too strenuous by bringing in sex toys for added stimulation when your body needs a rest. Some people find that masturbation helps pain and is a good way to keep in touch with their own pleasure. As always, lube is a must and adding pillows to support you and your partners’ bodies is a great option.

6. After surgery, cancer, or medical event

A serious medical event can be frightening and have long-term effects on your health and well-being. Prostate surgery can lead to erection and ejaculation difficulties, the medications and surgery for breast cancer can significantly change your body, a stroke can have lasting effects on your movement, and after a heart attack, you may need to refrain from strenuous activity. 

Treatment

When you or your partner experience a significant medical event, it’s important that you speak with your doctor to understand how it will affect your sex life and when you can resume sex — it will be different for everyone. As for those with chronic illness, adapting your sexual positions and activities may be necessary, taking your time, and using equipment like lube, sex toys, and pillows for support. These kinds of health concerns can also have a big psychological impact, so talking to a counselor might also help to rebuild confidence and sexual interest after this kind of health scare.

The bottom line

Our bodies change through life, and the later years can bring a range of health challenges that can affect physical capacity, libido, and enjoyment of sex. Despite the challenges, however, you can keep enjoying sexual activity by adapting and adjusting your sexual practices. That said, it is natural to feel a sense of sadness and loss for what you used to enjoy — whether it’s a certain sex position you can no longer do, or the way you used to orgasm more easily. 

But living within the limitations of an older body does not mean the sex (solo or partnered) needs to be less satisfying. Taking more time, adding toys, props, and lube, trying tantra or kink, switching up positions, and spending more time on oral sex or sensual massage are just some of the ways sex can continue to be enjoyable, intimate and pleasurable at any age.