Unit 1: Sexuality in the third & fourth age

We know that many older people are sexually active, although reports highlight that the frequency is often reduced in comparison to younger cohorts. We also know that the meaning of sexual activity can become broader with age; that older adults do not straightforwardly equate sex with penis-vagina intercourse, and thus sex encompasses activities that younger people may not view as sexual.

   Introduction

We know that many older people are sexually active, although reports highlight that the frequency is often reduced in comparison to younger cohorts. We also know that the meaning of sexual activity can become broader with age; that older adults do not straightforwardly equate sex with penis-vagina intercourse, and thus sex encompasses activities that younger people may not view as sexual.

Sexual activity in later life, when consensual and pleasurable, can have benefits for individuals and couples. In keeping with moderate exercise, sexual activity can benefit physical health. It can improve psychological well-being through intimate connection with another person. As well as providing pleasure, sexual activity can strengthen the relationship between intimate partners.

However, older people can experience barriers to sexual expression due to ageist stereotypes which they may have internalised. For example, they may feel that they should not be interested in sex at their age. Others too may have internalised these views, including doctors, nurses and other professionals, and think that older people are not interested in sex. The implications of this stereotype are that older people might not express their sexuality for fear of reproach, and may not seek or receive help for sexual concerns.

Historically, sexual activity and late adulthood have been incompatible in public discourses and this deeply entrenched view has been repeated and reinforced in a number of ways. For older women in particular, ageism can combine with sexism as women meet negative messages about their value as women as they get older.

While having a partner can influence whether or not an older person is sexually active, not all sexual activity relates to partnered sex. Indeed, older people engage in self-masturbation which may serve to ease sexual tension and provide sexual pleasure in the absence of a sexual partner.

    Key messages 

 

  • Sexual activity can be an important part of quality of life.
  • Sexual activity and intimacy can have benefits for health and well-being in later life.
  • Not every older person will want to be sexually active, and it is important to respect that.
  • Barriers to sexual expression, and seeking and receiving help for sexual concerns, may occur as a result of perceived and actual ageism.

   Learning objectives

        

     At the end of this unit students are expected to:

  1. Understand the meaning of sexual identity and sexual activity within the lives of older people
  2. Be able to explain the ways in which sexual activity can benefit people in later life
  3. Demonstrate awareness of the ways that negative stereotypes such as ageism can affect an older person’s sexuality

   Content 

 

Case study

Six months ago Barbra (aged 70) had major surgery, a total hysterectomy, because of a cancerous tumour. The operation was a success and Barbara feels lucky that the cancer wasn’t anywhere else in her body as, she says, the womb ‘can so easily be removed’. She is also relieved that the cancer was caught at an early stage as she knows that her situation could be very different. Barbra has seen a number of doctors and nurses during her treatment journey, both at the hospital and the primary care surgery. But, amongst all the personal discussions she has had with these health professionals, one area has not been raised - either by her or the health professionals - and that is when it is okay for her to resume sexual intercourse.

As she recovered from the surgery Barbra and her husband Vic have grown closer. She says that ‘cancer will do that to you’. They enjoyed a good sex life prior to her diagnosis and want to resume that level of intimacy. But both of them are fearful of causing damage: Vic doesn’t want to hurt Barbra, and Barbra is unsure if intercourse will ‘undo’ any of the surgery. They are both starting to believe that they will never enjoy sexual intercourse again.

Discussion questions for the case study:

  1. It is important for Barbra and Vic to be able to have sexual intercourse. Why do you think that is?
  2. Should health professionals take a proactive approach to the sexual health of their older clients? If so, how can they do this?
  3. Barbra suspects that she hasn’t been given sexual advice because of her age. Can Barbra do anything herself to find the answers that she seeks?

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Text for Unit 1

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein