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Article Excerpt
The Impact of Aging on Sexual Activity
Sexuality and the desire for intimacy are essential and important human features from birth until death. Gerontologists and other medical experts generally agree that continued sexual interest and activity can be therapeutic for older men and women (Willert & Semans, 2000). Aging women who have a partner with whom they can enjoy intimacy are in better mental health compared with women without this kind of partner. For most elderly people, sexual activity is still an important means for expressing love and caring (Campbell & Huff, 1995).
Numerous studies have identified a decrease in sexual interest and activity in old age (Araujo, Mohr, & McKinlay, 2004; Beutel, Schumacher, Weidner, & Brahler, 2002; Blanker et al., 2001; Dennerstein & Lehert, 2004; Hayes & Dennerstein, 2005; Laumann et al., 2005; Lindau et al., 2007; Marsiglio & Donnelly, 1991; Nicolosi et al., 2006). This transition has been explained, for example, by biological and psychological factors, diseases, mental conditions, boredom with the relationship, and widowhood (DeLamater & Sill, 2005; Thienhaus, 1988). However, seldom have these factors been comprehensively studied by representative national survey samples.
In analyzing the data, it is necessary to distinguish between the role and impact of aging as such and membership in a specific generation. Aging plays an important role in sexuality, but the generations subsequent to the era of sexual revolution of the 1960s and 1970s have considerably modified their sexual values and behavior patterns. Carpenter, Nathanson, and Kim (2007) found that lower levels of satisfaction in older age stemmed from generational differences rather than from aging per se. This transition will apparently continue in subsequent generations.
Biological factors have an indisputable effect on sexual activity among the elderly, but they do not directly determine it. Numerous studies have shown that as men age, they undergo adaptations in physiology, hormonal levels, and sensory capacities that reduce, on average, human sexual desire and activity (Bartlik & Goldstein, 2001; Bortz, Wallace, & Wiley, 1999). Chronic disorders such as cardiovascular disease, hypertension, diabetes, arthritis, and prostate disease may have a negative effect on sexual functioning and response (DeLamater & Sill, 2005). There are also psychological impacts of illnesses and surgical interventions on sexual functioning.
DeLamater and Sill (2005) believed that biological factors provide a necessary, but not sufficient, condition for sexual functioning. To come up with a comprehensive approach to aging sexuality, a bio-psychological perspective is needed--one that combines biological, psychological, and socio-environmental factors and realms.
In the psychological realm, sexuality includes identity, body image, self-esteem, eroticism, emotions, and their expression and imagination (Badeau, 1995). Good quality sexual intimacy is only achievable by individuals who are mature, independent, have good self-esteem and trust, and respect their partners; in short, those who have the capacity for emotional intimacy (Kingsberg, 2002).
In the social realm, Trudel, Turgeon, and Piche (2000) listed a number of social determinants and factors that influence sexual activity. These include social taboos; conjugal status; and knowledge about sexuality, self-esteem, and attitudes toward sexuality. In other words, the expressions of sexuality in a given society are governed also by common ideas, norms, and regulations. In the moral and religious realms, sexuality embodies learned individual values (Badeau, 1995).
In the social realm, the availability of a partner definitely influences sexual expression, as does the quality of interaction and communication with that partner. Aging can be related to sexual desire and activity through the social influences that are a result of the longer duration of relationships. If a long-term relationship has been unsatisfactory, a new relationship may have a positive impact on sexual functioning.
Some people may take their emotional and sexual relationship for granted and become lazy and inattentive in their sexual activities. Lifelong psychological conflicts may come to the fore as couples age (Beutel et al., 2002). External factors, such as the needs of aging parents or grandchildren, may draw emotional energy away from a couple (Kingsberg, 2000). Many older, widowed women drift into a state of sexual disinterest. The death of a spouse often leads to a cessation of sexual activity. By turning off their interest in something they do not have and see little likelihood of getting, a widow may prevent herself from becoming frustrated or depressed (DeLamater & Sill, 2005).
The Impact of Aging on Sexual Desire and Sexual Dysfunction
Kingsberg (2002) argued that sexual desire refers to people's interest in being sexual and is determined by the interaction of three related, but separate, components: (a) drive, (b) beliefs and values, and (c) motivation. Hartmann, Philippsohn, Heiser, and Ruffer-Hesse (2004) added to this conceptual approach by offering that sexual desire is facilitated by engagement in sexual situations with physical and subjective feelings of arousal. Experiencing pleasure triggers arousal, which subsequently triggers desire. Arousal and desire coexist and reinforce each other.
Sexual dysfunction is the inability to react emotionally or physically to sexual stimulation in a way expected of the average healthy person or according to people's own standards. Sexual dysfunction may affect various stages in the sexual response cycle--desire, excitement, and orgasm (Kingsberg, 2002). In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; American Psychiatric Association, 2000), sexual problems are classified into four major areas: (a) sexual desire disorders, (b) sexual arousal disorders, (c) orgasmic disorders, and (d) sexual pain disorders (Malatesta, 2007).
There have been numerous attempts to measure the determinants of decreased sexual interest. Bartlik and Goldstein (2001) found that in retirement, diminished income, divorce, unresolved anger, separation from loved ones, medical illness, major depression, and the use of certain medications can lead to diminished sexual desire. Hartmann et al. (2004) reported that decreased sexual interest was related to self-reported negative emotional and psychological feelings (e.g., lower self-esteem, insecurity, and loss of femininity).
DeLamater and Sill (2005) found that having a partner was a significant predictor of desire among women but not among men. Their results suggested that a woman's desire is attuned to her relationship context, but a man's desire is not. Among men, sexual problems tend to be more associated with physical health and aging than among women (Laumann et al., 2005).
According to Laumann et al.'s (2005) global study, older age consistently increased the likelihood of most sexual problems among men but not among women. Only lubrication problems (problems with sexual desire were not measured) were positively associated with female older age.
This article has two principal aims:
1. To describe how relationships, sexual desire, frequency of sexual intercourse, and quality of sex evolve, on average, as men and women age, and as the duration of a relationship increases.
2. To analyze the determinants or predictors of the variation in frequency of sexual intercourse and sexual desire among aging men and women with a special focus on whether age as such has a significant effect on sexuality in the aging population, even after controlling for the effects of other relevant predictors.
Method
Participants
Two national sex surveys were conducted in Finland in 1992 and 1999. The data collection was financed by the Academy of Finland (1992) and the Finnish Ministry of Social Affairs and Health (1999). No commercial or interest groups provided financial support for the studies. The samples were drawn at random from national population registers. They were representative of the total population within the age range (18-74 years) chosen for this study.
The sample in 1992 was 2,250. The 1992 survey was conducted by trained interviewers from Statistics Finland (the government's central office of statistics). The researchers participated in the training of the interviewers. Most of the interviewers were middle-aged women. The respondents were sent a letter before an interviewer made personal contact with them.
To reduce the potential influence of taboos against open discussions of sexual matters, the titles of the studies indicated that they also covered other aspects of life in addition to sexuality. The 1992 Finnish study was entitled, "A National Survey of Human Relations, Sexual Attitudes and Lifestyles." In 1992, 2,250 Finns (aged 18-74 years) completed face-to-face interviews during which each interviewee also completed, in privacy, a self-administered questionnaire that covered the intimate questions. The response rate was 76%.
In 1999, a mail survey with mostly the same questions was conducted in Finland. The sample drawn from a national population register was 3,269; 1,496 responses were received from persons aged 18 to 81, corresponding to a response rate of only 46%. To compare the results with the first survey, people older than 74 years are excluded here. The data analyzed here is from...
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