Introduction

Romantic relationships are important to well-being and quality of life at any age. While sex is an integral part of the lives of many older adults, this topic remains understudied and infrequently discussed. In October 2017, the University of Michigan National Poll on Healthy Aging asked a national sample of adults age 65–80 about their perspectives on relationships and sex and their experiences related to sexual health.

Romantic Relationships

A majority of older adults reported they are married or partnered (66%), 12% are widowed, 15% divorced or separated, and 7% never married. Men were more likely to be married or partnered (73%) than women (60%). Of those not married or partnered, 18% said they are in a relationship. Taken together, nearly three in four (72%) of those 65-80 reported having a current romantic partner (married, partnered, or in a relationship).

Most respondents with a romantic partner have been in the relationship for 10 years or longer (92%) and 4% fewer than five years. Among those who did not have a current romantic partner, 13% had been on a date with someone new in the past two years.

Perspectives on Sex

Most older adults (76%) agreed that sex is an important part of a romantic relationship at any age. Men were more likely to agree (84%) than women (69%).

Two in five (40%) indicated that they are currently sexually active. Sexual activity decreased with age (46% age 65–70, 39% age 71–75, and 25% age 76–80). Men were more likely to report being sexually active compared with women (51% vs. 31%) as were those who self-reported that their health was excellent, very good, or good compared with those with fair or poor health (45% vs. 22%). About half of those with a romantic partner (54%) and 7% of those without one reported they are currently sexually active. The vast majority of those who were sexually active (92%) reported that sex is an important part of a romantic relationship.

“Sex is important to my overall quality of life.” Over half (54%) agreed with this statement, with more men (70%) agreeing than women (40%). Those with a romantic partner were more likely than those without a partner to agree (61% vs. 36%). Those who reported being sexually active were more likely than those who were not to agree that sex was important to their quality of life (83% vs. 35%).

About two in three respondents (65%) described being interested in sex (30% extremely or very interested, 35% somewhat interested). Half of men (50%) reported being extremely or very interested in sex as compared to 12% of women. Younger respondents were more likely than older respondents to report being extremely or very interested in sex (34% age 65-70, 28% age 71-75, and 19% age 76-80).

Nearly three in four older adults (73%) indicated they were satisfied with their sex life (37% extremely or very satisfied, 36% somewhat satisfied). Women were more likely to be extremely or very satisfied than men (43% vs. 31%), as were those with a romantic partner as compared with those without one (40% vs. 30%), and those in better health as compared with those in worse health (40% vs. 28%).

Nearly one in five men (18%) and 3% of women reported they had taken medications or supplements to improve sexual function in the past two years. Among those who had taken medications or supplements, three in four (77%) said it was helpful.

Discussions about Sexual Health

One in six respondents (17%) reported speaking with their health care provider about their sexual health in the past two years. Of those who had talked with their health care provider, three in five (60%) initiated the conversation themselves, and 40% reported that their health care provider brought up the topic. The majority of those who had spoken with their health care provider (88%) reported that they felt comfortable discussing their sexual health, regardless of who initiated the conversation.

“If you were to have a problem with your sexual health, who would you talk to about it?” Most older adults (62%) said they would talk with their health care provider, while 36% would talk to their spouse/partner. One in ten (10%) said they would speak to a friend, family member, or other person, and 17% said they would not talk to anyone.

Implications

While it is clear that sex is important for many older adults, it is not often discussed. The majority of adults age 65 to 80 indicated that sex is an important part of a romantic relationship at any age and important to their quality of life, though only about half of those in a relationship reported being sexually active.

The majority of those with a romantic partner reported being in a long-term relationship. Dynamics in a relationship change over time, as do the bodies and health of the partners. Changes in lifestyle and responsibilities (retirement, caregiving) can likewise contribute to fluctuations in interest and frequency of sexual activity.

The observed connection between self-reported health status and sexual activity warrants further exploration. A limitation of this study is that it is not possible to determine whether poor health contributes to lack of sexual activity or whether not being sexually active contributes to poor health. Similar percentages of those in better and worse health reported that sex is important to their quality of life, and those in poor health reported engaging in sex less frequently and indicated they were less satisfied. This illustrates the importance of sex and sexual health, regardless of health status.

It is notable that nearly one in five men in this age group reported taking medications or supplements to improve sexual function in the past two years. Some of these older adults may be taking prescription medications, but others may be taking supplements which are not required to be reviewed by the Food and Drug Administration. Given potential side effects and drug interactions, providers should ask patients about supplement use.

The differences in responses between men and women are also worthy of mention. Men were more likely to report being interested in sex and a greater proportion of men said sex is important to their quality of life, though women were more likely to report that they were satisfied. Gender differences in perspectives on sex may result in differing expectations and challenges, even for long-term relationships.

To this end, conversations about sex in a relationship are important. However, sex can be a difficult topic to broach with a romantic partner, as evidenced by the fact that only one in three respondents indicated they would talk to their partner about sexual health problems.

While two in three respondents said they would talk with their health care provider if they had a problem with their sexual health, 83% had not spoken with their health care provider about their sexual health in the past two years. Older adults should be encouraged to speak with their providers about concerns and questions related to their sexual health. Those who had these discussions reported that they felt comfortable doing so, even if they did not initiate the conversation.

Fewer than half of those who spoke with their health care provider said it was their health care provider who initiated the conversation. Clinicians should inquire about and offer opportunities to discuss sexual health. Raising the topic can help older adults to better understand and address problems related to this important component of overall health and quality of life.

Data Source and Methods

This National Poll on Healthy Aging report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for the University of Michigan’s Institute for Healthcare Policy and Innovation. National Poll on Healthy Aging surveys are conducted using GfK’s KnowledgePanel®, the largest national, probability-based panel in the U.S. Surveys are fielded two to three times a year with a sample of approximately 2,000 KnowledgePanel® members age 50–80.

This survey was administered online in October 2017 to a randomly selected, stratified group of older adults age 65–80 (n=1,002). Respondents were selected from GfK’s web-enabled KnowledgePanel® which closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the U.S. Census Bureau.

The completion rate was 75% among panel members contacted to participate. The margin of error is ±1 to 3 percentage points and higher among subgroups.

Findings from the National Poll on Healthy Aging do not represent the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

Citation

Solway E, Clark S, Singer D, Kirch M, Malani P. Let’s Talk about Sex. University of Michigan National Poll on Healthy Aging. May 2018. Available at: http://hdl.handle.net/2027.42/143212

Scholarly Publication

Agochukwu-Mmonu N, Malani PN, Wittmann D, et al. Interest in sex and conversations about sexual health with health care providers among older U.S. adults. Clin Gerontol. 2021;44(3):299-306. doi:10.1080/07317115.2021.1882637 (Awarded best paper by a new and emerging professional published in Clinical Gerontologist for 2021)