As men and women age, a variety of physical changes affect sexual functioning and be­havior. We will now discuss these physical changes and their affect on sexual behavior. (We will discuss more of the challenges of aging and health concerns in Chapter 14.)

Physical Changes

As people age, they inevitably experience changes in their physical health, some of which can affect normal sexual functioning (see Table 10.1). Many of these decreases in sexual functioning are exacerbated by sexual inactivity. In fact, the research clearly re­veals that elderly men and women who have remained sexually active throughout their aging years have a greater potential for a more satisfying sex life later in life (Weeks & Hof, 1987). Better knowledge of these changes would help the elderly anticipate changes in their lovemaking.

TABLE 10.1 Physical Changes in Older Men and Women

 

In Men

1. Delayed and less firm erection.

2. More direct stimulation needed for erection.

3. Extended refractory period (12 to 24 hours before rearousal can occur).

4. Reduced elevation of the testicles.

5. Reduced vasocongestive response to the testicles and scrotum.

6. Fewer expulsive contractions during orgasm.

7. Less forceful expulsion of seminal fluid and a reduced volume of ejaculate.

8. Rapid loss of erection after ejaculation.

9. Ability to maintain an erection for a longer period.

10. Less ejaculatory urgency.

11. Decrease in size and firmness of the testes, changes in testicle elevation, less sex flush, and decreased swelling and erection of the nipples.

 

In Women

1. Reduced or increased sexual interest.

2. Possible painful intercourse due to menopausal changes.

3. Decreased volume of vaginal lubrication.

4. Decreased expansive ability of the vagina.

5. Possible pain during orgasm due to less flexibility.

6. Thinning of the vaginal walls.

7. Shortening of vaginal width and length.

8. Decreased sex flush, reduced increase in breast volume, and longer postorgasmic nipple erection.

 

One 50-year-old woman explains how her sex life has improved with age:

When I was in my twenties and early thirties I almost never had an orgasm during in­tercourse, but I still enjoyed it because of the feeling of the closeness you can’t get from anything else. Now, at fifty, I am often orgasmic during intercourse, partly be­cause I have orgasms easier, but mostly because I am more comfortable with stroking my clitoris. (Block, 1999, p. 65)