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10 Top Sex Ed Tips for Those 50 and Older

Making love is about more than intimacy. It’s good for your health, too

Sex Ed for Grownups
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How sexy are your 50s?

If you think sex is the province of the young, you’re wrong. People in their 20s are having less sex now than ever before, studies show, so it’s possible that you’re as active, or more so, as the average millennial. About a third of us are getting busy several times a week, one survey found.

And most of us are still in the game: 91 percent of men and 86 percent of women in their 50s report being sexually active, although activity levels vary widely. So, there’s no “normal” amount of sex for people our age. What matters more is that you and your partner are happy with your sex life. Men and women age differently, and some studies indicate that sexual interest wanes differently as well. Combine that with emotional and physical issues, and it’s possible that you and your partner aren’t on the same wavelength when it comes to making waves.

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The upsides, however, go way beyond our cravings for intimacy, pleasure and connection. Sex boosts our immune systems, improves self-esteem, decreases depression and anxiety, relieves pain, encourages sleep, reduces stress and increases heart health. (In one study, men who had sex at least twice a week were 50 percent less likely to die of heart disease than their less active peers were.) Another bonus: You burn more calories making love than by watching The Great British Baking Show.

Not only is there a lot of science around the subject of later-life lovemaking; there’s also a range of products and medicines that can help. Take these steps to revitalize your sex life.

1. Connect emotionally

Women are twice as likely as men to lose their enthusiasm for sex in long-term relationships, research shows. The problem isn’t always reduced estrogen; it could be an absence of emotional closeness. In these cases, try listening more, praising more and showing more kindness. Individual, couples and/or sex therapy can help as well. Look for a sex therapist certified by the American Association of Sexuality Educators, Counselors and Therapists.

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2. Address vaginal dryness

It’s one of the top impediments to sex among older women: 34 percent of women ages 57 to 59 experience dryness and discomfort during intercourse, one study found. For help, try over-the-counter remedies before and during sex, such as water-based lubricants (K-Y Jelly and Astroglide), oil-based lubes (olive, coconut and baby oils) and OTC moisturizers (Replens and Revaree). Use these a few times a week, even if you’re not having sex.

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3. Emphasize foreplay

“Regardless of the level of dryness, every woman needs to be primed with foreplay before intercourse,” says Elizabeth Kavaler, M.D., a urologist-urogynecologist at Total Urology Care of New York. Another tip: Encourage a woman to orgasm first, which provides more moisture for intercourse and other penetration.

4. Don’t let ED keep you down

Half of men who are in their 50s experience erectile dysfunction (ED), and the gold standard for treatment is prescription meds. Safe, effective options include Viagra (which lasts for four to six hours), Levitra (four hours), Cialis (up to 18 hours) and Stendra (up to six hours).

For the minority of men who can’t rely on a pill, other choices include alprostadil (a drug that’s self-injected into the penis) and Muse (a suppository that slides into the penis). Vacuum pumps use suction to coax erections, and new treatments include platelet-rich plasma (PRP) therapy, which may regenerate nerves and improve blood circulation.

5. Don’t ignore other conditions

Any problem that affects overall health can interfere with sexual pleasure. “Cardiovascular issues such as high blood pressure, as well as diabetes, can negatively impact blood flow,” which isn’t good for sexual arousal, notes New York ob-gyn Alyssa Dweck, M.D., coauthor of The Complete A to Z for Your V. “And depression or anxiety can reduce the desire or ability to have sex.” The problem? Medicines that treat these conditions may also affect sexual desire and response. Speak with your health care provider about side effects and possibly switching meds or adjusting the dosage or timing.

6. Consider estrogen

Women, if over-the-counter lubricants aren’t doing the trick, consider estrogen replacement therapy (ERT), which treats hot flashes and vaginal dryness. The most common delivery methods are creams and pills (you can self-apply Estrace and Premarin with an applicator or take these in pill form), insertable tablets (with Vagifem, you use an applicator to slide a tiny tablet into the vagina) and a ring (Estring, which your doctor inserts, or you can do this yourself; it needs to be replaced every three months). ERT is not recommended for anyone who has or had breast cancer, or for those who have recurrent or active endometrial cancer, abnormal vaginal bleeding, recurrent or active blood clots, or a history of stroke.

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7. Think about lasers

A treatment called fractional laser therapy can help reduce vaginal dryness without estrogen. It works like this: A laser creates tiny superficial burns in the vaginal canal. As the area heals, this leads to fresher collagen development and increased blood supply, which makes the area more elastic and responsive, Kavaler explains. (She cautions against vaginal rejuvenation surgery, which is a cosmetic procedure: “It can reduce sensitivity in the area and can make orgasms even more difficult to achieve or, in some cases, sexual intercourse permanently painful.”)

8. Confront incontinence issues

In a national poll of more than 1,000 women, nearly half of those over age 50 reported bladder leakage during sex. The primary reason: Sexual stimulation puts pressure on the bladder and urethra. If you’re hoping to get lucky in the hours ahead, avoid consuming beverages or foods with caffeine, such as coffee and chocolate; caffeine stimulates the bladder and acts as a diuretic (citrus fruits and juices are diuretics, too). Men whose prostates have been removed can also experience incontinence during sex. This condition, known as climacturia, can be treated in a number of surgical and nonsurgical ways. Plus, medications such as Ditropan and Vesicare can decrease urination frequency.

9. Turn down testosterone

In late 2020, the American College of Physicians stated that testosterone replacement should no longer be administered to treat a lagging libido (testosterone can have serious side effects, including an increased risk of prostate abnormalities). Denver urologist David Sobel, M.D., offers three easy alternatives: “sleep, reducing stress, and — the big one — exercise.” Even better: Work out with your lover. Seventy-one percent of runners say that running as a couple plays a healthy role in their sex life, according to a 2021 survey according to a 2021 survey.

10. Overcome arthritis aches

About 58 million Americans have arthritis, and over half are younger than 65, reports the Centers for Disease Control and Prevention. Arthritis can limit your ability to engage in sex. In addition, an empathetic partner may resist sex to avoid creating discomfort. An option: Ask your partner to experiment with more comfortable positions. Also, time sex for when you feel best (rheumatoid arthritis pain is usually more acute in the morning), the Arthritis Foundation advises. Taking a warm bath, alone or together, can help relax joints before making love. If the pain is severe, try an OTC medicine such as ibuprofen before having sex, or speak with your doctor about prescription medications.

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