Sex and the Mature Couple

Linda J. Waite, Ph.D., University of Chicago

Most people want to have a warm, loving, sexually satisfying relationship with their spouse or partner throughout their lives. And many couples manage to achieve this goal. But life presents challenges to healthy sexuality as people—and couples—age. And these challenges affect women and men differently, but since most couples have one of each, they face many of the same issues eventually.

Recently, the National Social Life, Health and Aging Project, which I head, interviewed over 3000 men and women between the ages of 57 and 85 as part of a study of intimacy and health. We spoke to people across the United States, in their homes. As part of this study we asked our participants in some detail about their sex lives. Here is what we learned from their answers.

The biggest challenge to sexual function and health in later life comes from the illness, disease and declines in functioning that often appear with age. The figure below shows the proportion of men and women with a spouse or romantic partner who had sex in the past year. The blue lines show the proportion for men, the red lines show the proportion of women. The solid blue lines shows the proportion of married or romantically attached men in excellent or very good health who had sex, for those ages 57 to 85 years old. Even among this privileged group by the time they are 85, most are not having sex. For those in worse health, this retreat from sex happens earlier; among men in good health—the dashed blue line—half are sexually inactive by their late 70s. Married men in fair or poor health are about equally likely to be having as not having sex by about their early 70s.

The situation for women is bleaker, as this figure shows. Married or partnered women in the best health—the solid red line—have about a 50-50 chance of any sex life at all until their late 70s, which is about the same as men in fair to middling health. But women in the worse health—the dotted red line—become sexually inactive in their late 60s, on average.

Singlehood and Gender

These figures tell only part of the story, the part for men and women with a spouse or romantic partner. But marriage vows often include a pledge “til death do us part”, an expected end to a successful relationship. When death parts men or women from their marriage partner, it usually separates them from their only sexual partner; very few widowed men or women have sex with someone to whom they are not married or romantically connected.

This figure shows the proportion of men and women who have a spouse or romantic partner at various ages. Again, we see these for people in the best health, middling health and not-so-good health.

Among men in the best health, more than 8 in 10 still have a wife or partner in their 80s; compare this to more like 3 in 10 of healthy women the same age. The gender gap in partnership is present by the mid-50s but turns into a yawning chasm by the mid-70s. By about 75 most women no longer have a spouse or partner.

Clearly, men are advantaged in the quest to live to the end with a partner, because men tend to marry younger women and because at any age, men are more likely to have died; til death do us part most often means until the man dies.

Sex over Time – the Bad and Good

For those who are married or partnered at older ages, what are the chances of having a satisfying sex life? We asked people whether over the last year they had any of the following symptoms lasting a few months or more, including a lack of interest in sex, difficulty achieving or maintaining an erection (for men), difficulty with lubrication (for women), lack of pleasure from sex, climaxing too quickly (for men), inability to climax, pain during sex, or anxiety about performance. About half of all the people who we talked to said they had at least one sexual problem that bothered them and almost a third reported having two or more. The most common problem for men was erectile dysfunction. The most common problem for women was lack of interest.

For the most part, there is no increase in reports of sexual problems, like pain or lack of interest in sex, with age for either men or women who remain partnered and sexually active. The single exception is men’s erectile dysfunction, which increases with age. In fact, older sexually active women were less likely than younger women (remember the youngest were 57) to complain of pain during sex and less likely to complain of lack of interest. The sexually-active septuagenarians were just as satisfied with their sex lives as those three decades younger!

Predictors of Sexual Problems

The strongest predictors of sexual problems seem to be poor mental health and dissatisfaction with one’s relationship. The men and women most likely to report that they lacked interest in sex for several months or more over the last year tend to show relatively high levels of anxiety, stress, and depressive symptoms. Depressed men were more likely to have had erectile dysfunction and difficulty achieving orgasm. Women with poor mental health were also much more likely to say they were unable to achieve orgasm and lacked pleasure from sex. And both men and women who were dissatisfied with their relationship more often lacked interest in sex or found it not pleasurable.

Some of the challenges to an active, healthy sex life during middle age and later happen to many couples. Chances are that at least one member of the couple will develop an illness or disability at some point in later life.

Our research suggests that physical health challenges can be met if men and women maintain their mental health. Although depression, anxiety and stress are common, they are also amenable to treatment. And for those who maintain sexual activity well into their golden years, the experiences are just as rewarding.