Sex and intimacy later in life

As a women’s health GP with a special interest in sexual health, I know that what makes a healthy or satisfying sex life can mean different things for different people.

The bottom line is, there is no such thing as normal. There are many different ways to explore intimacy as we age, either as an individual or together.

For many women, this might mean learning and exploring what feels good now, rather than repeating what worked in the past.

Here are my tips for adapting sex and intimacy to the physical or emotional changes we experience over time.

Work with body changes

Bodies get older and, with time, it’s natural for them to change. This might mean physical differences, such as hip replacements, a chronically sore back or painful knees.

If you’re experiencing discomfort, you can experiment with different sexual positions by using pillows to help avoid physical pain.

And remember, sex doesn’t have to involve penetration, particularly if that becomes painful.

For men, changes in getting and maintaining erections or having orgasms can also impact how they experience intimacy. This can have an effect on both partners, and it’s important to discuss it together, without judgement.

You may also need to be realistic about shifts that happen after menopause, and other long-term changes to our health.

It’s good to know that midlife can also be a period that brings partners closer, particularly when there is open, healthy communication.

Talk about sex and desire

As we get older, it becomes even more important to talk openly with our partner about sex, especially as stress can have a big impact on desire and connection.

It’s beneficial to talk about intimacy, even if it feels awkward, and accept that levels of desire may change over time.

Instead of only talking with a partner about having a ‘high’ or ‘low’ sex drive, some sexual therapists also encourage couples to talk about what generally turns them on and turns them off.

Knowing what this means for you and your partner can help with understanding each other’s needs, desires and concerns. It might be a conversation you have regularly and come back to as your health and bodies continue to change.

Use lubrication

Ageing can also bring on other symptoms, such as vaginal dryness and irritation.

These changes can happen as your oestrogen levels start to fall, which occurs around menopause. Oestrogen stimulates collagen production, which impacts tissue elasticity, stretch and lubrication.

Sex should not be painful and lubrication – or ‘lube’ – can be important for all people to explore to help reduce discomfort. Finding good lubricationcan enhance and support the sexual experience.

Water-based lubes available at chemists and supermarkets are often designed to use with condoms. But an oil or silicon-based lubricant may be better for some women if you don’t need to use condoms. Whatever you use, it’s important to buy from a reputable company.

Talk to your doctor or pharmacist if you need more information.

Prioritise your sexual health

The importance of practising safer sex and testing for sexually transmitted infections (STIs) does not go away later in life.

Many people with long-term, heterosexual partners might not be used to testing for STIs or using condoms. STIs might not have been spoken about openly in your education or with your families. This can lead to many misconceptions.

Many STIs do not have obvious symptoms. It’s important to know how STIs are spread and how to have safer sex as we age. Often, testing is non-invasive and can be done with a self-collected swab or a simple urine test.

There might be added conversations to have with your health professional if one partner is bisexual or is exploring their sexuality later in life.

If you don’t feel comfortable talking to your usual doctor, you can also speak to an online or telehealth doctor about STI screening and safer sex.

Be flexible to different forms of intimacy

New stages of life bring different ways of thinking about sex and sexual wellbeing. The importance of emotional wellbeing is often also closely linked with how confident and connected we feel as we age.

As well as changes to the body, there might also be a loss of libido, change in partner or shift in relationship. It’s important to be aware of what can affect your sex life through the life course, so you can adapt.

You might get your intimacy just from connection with your partner, and that’s also normal. So don’t feel judged if you are not getting intimacy the same way that somebody else is.

For both partners, there may be less focus on penetrative intercourse and more on touch, connection and other forms of closeness.

When things change, sometimes you have to redefine what sex means for you.