Abstract
We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples’ sexual health should be managed, not just in the context of their age, gender, and general health, but also within their existing sexual relationship.
Similar content being viewed by others
References
Bacon, C. G., Mittleman, M. A., Kawachi, I., Giovannucci, E., Glasser, D. B., & Rimm, E. B. (2003). Sexual function in men older than 50 years of age: Results from the health professionals follow-up study. Annals of Internal Medicine, 139(3), 161–168.
Bancroft, J., Loftus, J., & Long, J. S. (2003). Distress about sex: A national survey of women in heterosexual relationships. Archives of Sexual Behavior, 32(3), 193–208.
Baumeister, R. F., Catanese, K. R., & Vohs, K. D. (2001). Is there a gender difference in strength of sex drive? Theoretical views, conceptual distinctions, and a review of relevant evidence. Personality and Social Psychology Review, 5(3), 242–273.
Blanker, M. H., Bosch, J. L. H. R., Groeneveld, F. P. M. J., Bohnen, A. M., Prins, A., Thomas, S., & Hop, W. C. J. (2001). Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: Prevalence, concern, and relation to sexual activity. Urology, 57(4), 763–768. doi:10.1016/S0090-4295(00)01091-8.
Christopher, F. S., & Sprecher, S. (2000). Sexuality in marriage, dating, and other relationships: A decade review. Journal of Marriage and the Family, 62(4), 999–1017. doi:10.1111/j.1741-3737.2000.00999.x.
Corona, G., Lee, D. M., Forti, G., O’Connor, D. B., Maggi, M., O’Neill, T. W., … Group, E. S. (2010). Age-related changes in general and sexual health in middle-aged and older men: Results from the European Male Ageing Study (EMAS). Journal of Sexual Medicine, 7(4 Pt 1), 1362–1380. doi:10.1111/j.1743-6109.2009.01601.x.
DeLamater, J. (2012). Sexual expression in later life: A review and synthesis. Journal of Sex Research, 49(2–3), 125–141. doi:10.1080/00224499.2011.603168.
Fenton, K. A., Johnson, A. M., McManus, S., & Erens, B. (2001). Measuring sexual behaviour: Methodological challenges in survey research. Sexually Transmitted Infections, 77(2), 84–92.
Field, N., Mercer, C. H., Sonnenberg, P., Tanton, C., Clifton, S., Mitchell, K. R., … Johnson, A. M. (2013). Associations between health and sexual lifestyles in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 382(9907), 1830–1844. doi:10.1016/S0140-6736(13)62222-9.
Hill, J., Bird, H., & Thorpe, R. (2003). Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology (Oxford), 42(2), 280–286.
Impett, E. A., & Peplau, L. A. (2002). Why some women consent to unwanted sex with a dating partner: Insights from attachment theory. Psychology of Women Quarterly, 26(4), 360–370. doi:10.1111/1471-6402.T01-1-00075.
Karraker, A., DeLamater, J., & Schwartz, C. R. (2011). Sexual frequency decline from midlife to later life. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66(4), 502–512. doi:10.1093/geronb/gbr058.
Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., … GSSAB Investigators’ Group. (2005). Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. International Journal of Impotence Research, 17(1), 39–57.
Laumann, E. O., Paik, A., Glasser, D. B., Kang, J. H., Wang, T., Levinson, B., … Gingell, C. (2006). A cross-national study of subjective sexual well-being among older women and men: Findings from the Global Study of Sexual Attitudes and Behaviors. Archives of Sexual Behavior, 35(2), 145–161. doi:10.1007/s10508-005-9005-3.
Lindau, S. T., & Gavrilova, N. (2010). Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. British Medical Journal, 340, c810. doi:10.1136/bmj.c810.
Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O’Muircheartaigh, C. A., & Waite, L. J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357(8), 762–774. doi:10.1056/NEJMoa067423.
Mak, R., De Backer, G., Kornitzer, M., & De Meyer, J. M. (2002). Prevalence and correlates of erectile dysfunction in a population-based study in Belgium. European Urology, 41(2), 132–138.
McKinlay, J. B. (2000). The worldwide prevalence and epidemiology of erectile dysfunction. International Journal of Impotence Research, 12(Suppl 4), S6–S11.
Mercer, C. H., Tanton, C., Prah, P., Erens, B., Sonnenberg, P., Clifton, S., … Johnson, A. M. (2013). Changes in sexual attitudes and lifestyles in Britain through the life course and over time: Findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). Lancet, 382(9907), 1781–1794. doi:10.1016/S0140-6736(13)62035-8.
Mercer, C. H., Wellings, K., & Johnson, A. M. (2013b). What’s new about Natsal-3? Sexually Transmitted Infections. doi:10.1136/sextrans-2013-051292.
Mitchell, K. R., Mercer, C. H., Ploubidis, G. B., Jones, K. G., Datta, J., Field, N., … Wellings, K. (2013). Sexual function in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 382(9907), 1817–1829. doi:10.1016/S0140-6736(13)62366-1.
Mitchell, K. R., Ploubidis, G. B., Datta, J., & Wellings, K. (2012). The Natsal-SF: A validated measure of sexual function for use in community surveys. European Journal of Epidemiology, 27(6), 409–418. doi:10.1007/s10654-012-9697-3.
Morley, J. E., & Tolson, D. T. (2012). Sexuality and ageing. In A. J. Sinclair, J. E. Morley, & B. Vellas (Eds.), Pathy’s principles and practice of geriatric medicine (5th ed., pp. 93–102). New York: Wiley.
Nehra, A., Jackson, G., Miner, M., Billups, K. L., Burnett, A. L., Buvat, J., … Wu, F. C. (2012). The Princeton III consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clinic Proceedings, 87(8), 766–778. doi:10.1016/j.mayocp.2012.06.015.
Nicolosi, A., Laumann, E. O., Glasser, D. B., Moreira, E. D., Paik, A., Gingell, C., & Be, G. S. S. A. (2004). Sexual behavior and sexual dysfunctions after age 40: The Global Study of Sexual Attitudes and Behaviors. Urology, 64(5), 991–997. doi:10.1016/j.urology.2004.06.055.
O’Connor, D. B., Corona, G., Forti, G., Tajar, A., Lee, D. M., Finn, J. D., … Wu, F. C. (2008). Assessment of sexual health in aging men in Europe: Development and validation of the European Male Ageing Study sexual function questionnaire. Journal of Sexual Medicine, 5(6), 1374–1385. doi:10.1111/j.1743-6109.2008.00781.x.
ONS. (2011). Office for National Statistics. Retrieved 5 March, 2014 from http://www.ons.gov.uk/ons/rel/npp/national-population-projections/2010-based-projections/index.html.
Sanchez-Cruz, J. J., Cabrera-Leon, A., Martin-Morales, A., Fernandez, A., Burgos, R., & Rejas, J. (2003). Male erectile dysfunction and health-related quality of life. European Urology, 44(2), 245–253.
Steffick, D. E. (2000). Documentation of affective functioning measures in the health and retirement study. Ann Arbor, MI: HRS Health Working Group.
Steptoe, A., Breeze, E., Banks, J., & Nazroo, J. (2013). Cohort Profile: The English Longitudinal Study of Ageing. International Journal of Epidemiology, 42(6), 1640–1648. doi:10.1093/ije/dys168.
Suzman, R. (2009). The National Social Life, Health, and Aging Project: An introduction. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(Suppl 1), i5–i11. doi:10.1093/geronb/gbp078.
Thompson, I. M., Tangen, C. M., Goodman, P. J., Probstfield, J. L., Moinpour, C. M., & Coltman, C. A. (2005). Erectile dysfunction and subsequent cardiovascular disease. Journal of the American Medical Association, 294(23), 2996–3002. doi:10.1001/jama.294.23.2996.
Tiefer, L. (2002). Sexual behaviour and its medicalisation. Many (especially economic) forces promote medicalisation. British Medical Journal, 325(7354), 45.
Tristano, A. G. (2009). The impact of rheumatic diseases on sexual function. Rheumatology International, 29(8), 853–860. doi:10.1007/s00296-009-0850-6.
Waite, L. J., Laumann, E. O., Das, A., & Schumm, L. P. (2009). Sexuality: Measures of partnerships, practices, attitudes, and problems in the National Social Life, Health, and Aging Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(Suppl 1), i56–i66. doi:10.1093/geronb/gbp038->.
Acknowledgements
We thank the study participants. DML is a Research into Ageing Fellow. This study was funded by the National Institute on Aging (Grants 2RO1AG7644-01A1 and 2RO1AG017644) and a consortium of UK Government departments coordinated by the Office for National Statistics. JN and NP were supported by the fRaill project (Grant MRC G1001375/1) as part of the cross-research council Life Long Health and Well-being Programme. The lead author (DML) confirms the independence of all co-authors from funders and sponsors. The ELSA datasets are publicly available from the UK Data Service at www.ukdataservice.ac.uk. ELSA documentation (including questionnaires) is available from the Institute for Fiscal Studies at http://www.elsa-project.ac.uk. Stata® do.files are available from DML at david.m.lee@manchester.ac.uk.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, D.M., Nazroo, J., O’Connor, D.B. et al. Sexual Health and Well-being Among Older Men and Women in England: Findings from the English Longitudinal Study of Ageing. Arch Sex Behav 45, 133–144 (2016). https://doi.org/10.1007/s10508-014-0465-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-014-0465-1