Sexuality and aging: Clinical perspectives

Despite continuing ageist beliefs that sexuality is a privilege designed only for the young and physically healthy, research continues to indicate that the majority of older adults maintain interest in sexuality and may engage in fulfilling sexual behavior well into their last decade of life. Unfortunately, many professionals remain unaware of general knowledge of elderly sexuality, including the expected and normal physiological changes that can occur within the context of both male and female aging. The presence of chronic illness and other medical problems certainly can influence the expression of an aging adult's sexuality, and emergent research suggests that there are effective ways to cope with menopause, heart disease, arthritis, incontinence, diabetes, sleep disorders, breast cancer, prostate cancer, and erectile dysfunction (ED), among others. Dramatic changes have taken place within the last decade alone in terms of non-surgical treatment for incontinence and ED, with forms of sex therapy, biofeedback, and PDE-5 inhibitors. Regrettably, many aging adults and their care providers remain unaware of their increased risk factors for STDs, including HIV infection via lack of knowledge, changes in the vaginal lining, and typical declines in immune function. Estimates suggest that by the year 2020, more than half of all individuals living with HIV will be over the age of 50. Although some high quality professional books are available for clinicians, they tend to be disjointed research bibliographies, edited volumes on a narrowly focused aspect of elderly sexuality, or texts that are more than 10 years old. With the extent of new information available regarding sexuality and aging, an up to date, empirically based text is necessary.