Contrary to popular opinion, a low sex drive isn't always a "normal" part of aging. For both men and women, it can actually be a sign of a more serious health condition.
According to the Centers for Disease Control and Prevention, about 75% of people over the age of 65 have multiple chronic conditions — and long-term health problems have the potential to impact your desire to have sex in some way, says Lauren Streicher, MD, the medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago, and the author of Sex Rx.
To some extent, it makes sense that our sex drive sags with age. "Biologically, there's only one reason to have sex, and that's to reproduce," says Dr. Streicher. "When you age, your sex drive is going to decline, and that's normal, but 'normal' doesn't necessarily mean 'acceptable.'"
This is especially the case now, when life spans are at the highest: "Because women and men are living longer, we see a lot of new relationships start in people's 50s, 60s, 70s, and 80s," says Dr. Streicher. "Sexual activity and desire of sexual activity has really taken on much more relevance."
Here are four conditions that might — in one way or another — dampen your desire to have sex.
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Too-high blood sugar levels (a characteristic of diabetes) can cause damage to the nerves and blood vessels. Men with diabetes are about three times more likely to develop erectile dysfunction (or an inability to keep or get an erection) than those without diabetes.
Nerve damage can also cause vaginal dryness and painful sex for women. "The majority of the content of normal vaginal lubrication is water, which [is passed through the] small vessels," says Dr. Streicher. "Meaning, if you have diabetes and small vessels disease, you're also going to have a much greater tendency for dryness." In addition to keeping your blood sugar levels under control (and with medication if necessary), using vaginal lubrication can help combat the dryness, says Dr. Streicher.
It's not just a "man's" disease: Heart disease — including heart failure and atherosclerosis — kills more women in the United States than any other condition, accounting for almost one in four female deaths. And a lack of blood flow doesn't just cause ticker trouble. When the arteries in the body begin to narrow (for example, due to a buildup of plaque), it becomes harder for blood to flow to the genital area. This causes men to have trouble maintaining an erection, and causes women's clitorises and labia to become less sensitive, interfering with their ability to orgasm.
Although there may be limitations to what you can do, physically speaking, it's important to talk to your doctor about what is possible. "The starting point is to talk to your cardiologist," says Dr. Streicher. And if this isn't his or her area of expertise, you can always seek out a second opinion, she says.
More than two in five women aged 65 and older have urinary incontinence, and the majority of them, according to the National Association for Continence, have a type called "stress urinary incontinence," which occurs when stress is placed on the bladder. Pregnancy and childbirth are common culprits; both can weaken the muscles of the pelvic floor.
Women with weaker pelvic floor muscles can not only have a harder time reaching orgasm, but they might also be in pain during sex, says Dr. Streicher. Plus, many of them may avoid sex for fear of urinating on their partner, she says. Working with a pelvic floor therapist can help strengthen those muscles, as could doing Kegels.
Depression can cause changes in hormone levels and in neurotransmitters like dopamine and serotonin, says Dr. Streicher. As a result, "it can cause a dramatic decline in libido, but so can antidepressants," she says. "Sometimes it's hard to know which it is, or whether they are both [responsible]."
If your libido takes a clear dive in the aftermath of starting an antidepressant, tell your doctor about it and ask about alternative medications. Still, Dr. Streicher cautions that in most cases, the solution is not always that simple. "I always caution people that this is not a do-it-yourself project," she says.
If you suspect that your lowered sex drive might be caused by a medical issue, make an appointment with your doctor.
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