5.10: Sexuality in Middle Adulthood

Couples can continue to enjoy physical intimacy and may engage in more foreplay, oral sex, and other forms of sexual expression rather than focusing as much on sexual intercourse. Risk of pregnancy continues until a woman has been without menstruation for at least 12 months, however, and couples should continue to use contraception. People continue to be at risk of contracting sexually transmitted infections, such as genital herpes, chlamydia, and genital warts. In 2014, 16.7% of the country’s new HIV diagnoses (7,391 of 44,071) were among people 50 and older, according to the Centers for Disease Control and Prevention (2014e). This was an increase from 15.4% in 2005. Practicing safe sex is important at any age, but unfortunately adults over the age of 40 have the lowest rates of condom use (Center for Sexual Health Promotion, 2010). This low rate of condom use suggests the need to enhance education efforts for older individuals regarding STI risks and prevention. Hopefully, when partners understand how aging affects sexual expression, they will be less likely to misinterpret these changes as a lack of sexual interest or displeasure in the partner and more able to continue to have satisfying and safe sexual relationships.

People in mid-adulthood continue to be sexually active. In fact, some find themselves leading some of the most sexually fulfilling years of their lives. Women in their 40s are more likely to reach orgasm than younger and older women because they have had more opportunities to learn about their sexuality and be more secure in their relationships. Relationship security promotes orgasmic consistency among women. The 1992 National Health and Social Life Survey, (NHSLS) data shows that married women are most likely to reach orgasm consistently, followed by cohabiting women, then single women regardless of racial or ethnic differences. The analysis of NHSLS data by Laura Carpenter (2009) found that among 1,053 heterosexual participants of study aged 40 to 59, women were less likely to be sexually satisfied than men were and there is a reversal of gender-role stereotype among people in midlife: women's emotional satisfaction was closely associated with bodily sexual practices, whereas men's physical pleasure was linked to relational factors. Midlife is the time when physical changes and changes in sexual response occur as the years pass; however, sexual activity among people in all age groups is influenced not only by physical changes but also by psychological well-being, feeling of intimacy, and cultural expectation.

The Midlife Transition and Sexuality

Sexuality is an important part of people’s lives at any age, and many middle aged and older adults are very interested in staying sexually active (Dimah & Dimah, 2004). According to the National Survey of Sexual Health and Behavior (NSSHB) (Center for Sexual Health Promotion, 2010), 74% of males and 70% of females aged 40-49 engaged in vaginal intercourse during the previous year, while 58% of males and 51% of females aged 50-59 did so.

Despite these percentages indicating that middle adults are sexually active, age-related physical changes can affect sexual functioning. For women, decreased sexual desire and pain during vaginal intercourse because of the hormonal changes have been identified (Schick et al., 2010). A woman may also notice less vaginal lubrication during arousal which can affect overall pleasure (Carroll, 2016). Men may require more direct stimulation for an erection and the erection may be delayed or less firm (Carroll, 2016). As previously discussed men may experience erectile dysfunction or experience medical conditions (such as diabetes or heart disease) that impact sexual functioning. Couples can continue to enjoy physical intimacy and may engage in more foreplay, oral sex, and other forms of sexual expression rather than focusing as much on sexual intercourse.

It is important to note that risk of pregnancy continues until a woman has been without menstruation for at least 12 months and couples where pregnancy is possible should continue to use contraception. People continue to be at risk of contracting sexually transmitted infections, such as genital herpes, chlamydia, and genital warts. In 2014, 16.7% of the country’s new HIV diagnoses (7,391 of 44,071) were among people 50 and older, according to the Centers for Disease Control and Prevention (2014e). This was an increase from 15.4% in 2005. Hopefully, when partners understand how aging affects sexual expression, they will be less likely to misinterpret these changes as a lack of sexual interest or displeasure in the partner and more able to continue to have satisfying and safe sexual relationships. Practicing safe sex is important at any age, yet adults over the age of 40 have the lowest rates of condom use (Center for Sexual Health Promotion, 2010).