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What Sex Is Really Like in Your 50s, 60s and 70s

How to address the challenges to intimacy that arise over the decades

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​Sex — and sexual responses — evolve as people age through their 50s, 60s, 70s and beyond. That doesn’t mean intimate relationships must change for the worse. For some, it gets even better.

“Sex has no expiration date,” says Northern California sex educator Joan Price, who has written five books on sex for older adults. “The idea is to expand the idea of what good sex is. I know a lot of older adults who say they are having the best sex ever because they don’t narrowly define what sex is. There are so many options to choose from.” ​ 

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The sexual landscape we inhabit in later life can become tricky terrain due to age-related issues like vaginal dryness, erection challenges and a low libido. Medical conditions such as arthritis, a bad back and sore joints can also come into play. ​ 

But sexual wellness professionals say that for almost every problem, there is a solution — and that a fulfilling sex life can be lifelong. Here’s how.

Sex in your 50s: A critical decade

​Sexual challenges such as painful intercourse and difficulty with erections begin to surface in your 50s, issues that if left unspoken and untended can alter the course of your sex life. “Sex is not over when challenges arise,” Price says. “This is the time to start speaking candidly and openly with your partner about your sexual needs and the changes that you’re experiencing,” she adds. If concerns and issues aren’t addressed,  she notes, “it can get complicated, with relationship issues becoming clouded in silence.”​

​In their 50s, most men still feel vigorous, though they may notice that the quality of their erection isn’t as firm as it once was and testosterone, a critical hormone, is on the decline.​

​This age can also be a critical time for women, who on average begin menopause at 51. Vaginal dryness and a low libido frequently become issues —­ leading to what Price calls a “desire discrepancy” between partners that can throw sexual intimacy into peril.​

​Almost 90 percent of postmenopausal women will experience some pain when having penetrative sex, says Marilyn Jerome, M.D., a gyne­cologist with Foxhall OB/GYN Associates in Washington, D.C. The reason? Vaginal atrophy or dryness, a condition that’s treatable. A study published in the journal Menopause in 2019 found that almost 71 percent of women ages 40 to 55 who had not yet entered menopause experienced vaginal atrophy and a sharp drop in sexual function.​

​Jerome encourages women in their 50s to begin using over-the-counter lubricants when having sex; her medically prescribed go-to is vaginal estrogen cream, which can plump up the vaginal walls. Many women who have concerns about breast cancer forgo vaginal estrogen — and Jerome says they shouldn’t. The only patients she does not prescribe it for are women being treated for breast cancer and taking aromatase inhibitors.​

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​If a lack of desire comes into play, as it often starts to in your 50s, Price suggests practicing “responsive” arousal, which is driven by physical touch rather than relying on spontaneous, hormonal desire.​

​“If you let yourself enjoy the pleasure of slowly becoming physically aroused by being touched or by other kinds of stimulation, the desire will follow. And this is something that can be yours lifelong,” she adds.​

Sex in your 60s: Meet the challenge

​Left unspoken and untended, sexual challenges that naturally emerge with age can derail one’s love life. As Centreville, Maryland, gynecologist Lisa Webb, M.D., frames it: “If you’ve stopped talking about sex after 60, you’ve probably stopped having it.” Webb urges couples to be “intentional” about sex: “What do you need? What does your partner need? The mechanics don’t really matter, so long as you’re feeling fulfilled. Sex and intimacy can still be rich and rewarding.” ​

​In their 60s, many men face erection challenges, which may cause them to withhold affection. “They don’t want to start what they can’t finish,” says urologist Abraham Morgentaler, M.D., author of The Truth About Men and Sex: Intimate Secrets From the Doctor’s Office. A common fix: Viagra and its competitors, which Morgentaler calls some of the “most studied pills on the planet.”

Medications can also be injected directly into the penis before sex. “It sounds awful, but it’s really easy,” Morgentaler adds. Erections usually last 20 minutes to two hours. Other options include vacuum devices, surgical procedures, and new treatments involving sonic wave energy and a platelet-rich plasma injectable.​

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​Testosterone deficiency can lower men’s libido in their 60s. The good news: In 2019, the FDA approved the first of three oral forms of testosterone. Up to then, treatment was typically by injection or topical creams.​

Pain during intercourse can be a problem during this decade, too, for the same postmenopausal reasons that might plague women in their 50s, Jerome notes. And again, this condition can be treated with lubricants and creams, as well as vaginal estrogen supplements.  ​

​If your desire is lacking, as it can be in your 60s, Price suggests the use of “responsive” arousal. ​

Sex after 70: A changing landscape

​Many couples 70 and older will find successful and satisfying ways of being sexual with each other that differ from the sex they enjoyed when they were younger.​

​“If you ask someone in their 70s what they mean by having sex, they will often give examples of sex that don’t involve intercourse,” says Price, 79. “Take the goal of intercourse out of sex, and you will see that there are many, many ways you can give and receive pleasure.”​

​More than two-thirds of men in their 70s have difficulty with erections — but that doesn’t mean they can’t experience orgasms, Morgentaler notes. “Erections may not be as strong, but we still have the ability to have orgasms without one,” he says. “A majority of men don’t know this.”​

​Achieving or sustaining an erection may become a challenge. Among the fixes for this: medically prescribed pills, injections and testosterone supplements. “I’ve had plenty of patients in their 80s and 90s who continue to be sexual,” Morgentaler says. “Sexuality for both men and women should be celebrated, no matter the age.”​

​Jerome also routinely recommends vibrators to her patients. “It’s OK to have pleasure. It’s OK to do it by yourself. You can be sexual well into your 80s or 90s. There are many ways to be intimate.”​

​Some older couples have a difficult time talking about sex because they grew up in a climate in which the subject was considered taboo. But Price says it’s never too late to talk to your partner about your sexual needs. 

“Keep the conversation going so that you can be comfortable saying: ‘Let’s change position. It hurts my knees. Let’s try something different,’ ” she says. “Couples who have the best sex are couples who have the best conversations.”​

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