Sex education in later life

Sex education in later life starts from a proven fact: sexuality has no expiry date. Desire, affection, intimacy and pleasure continue after 50 and into old age, even as the body and its rhythms change. Good information helps you adapt to those changes without fear and ask for help when you need it.

What the evidence shows

The World Health Organization (WHO) points out that sexual health matters "to both the young and the elderly". A large study in the New England Journal of Medicine (Lindau and colleagues, 2007, DOI 10.1056/NEJMoa067423), covering more than 3,000 people aged 57 to 85 in the USA, found that 73% of those aged 57 to 64 had been sexually active in the past year, along with 53% of those aged 65 to 74 and 26% of those aged 75 to 85. Yet only 38% of men and 22% of women had discussed sex with a doctor since turning 50.

Menopause: changes and solutions

Menopause usually happens between 45 and 55. Falling oestrogen can cause vaginal dryness, itching or pain during sex, and changes in desire. You don't have to put up with it: lubricants, vaginal moisturisers and low-dose vaginal oestrogen ease these symptoms, and other treatments can be discussed with a doctor. We cover this in sexuality during menopause and how to choose a personal lubricant.

"Andropause": a misleading term

The NHS calls "male menopause" or "andropause" unhelpful terms. In men, testosterone does not drop suddenly: it falls gradually, by about 1% a year from the age of 30 or 40, and this decline alone rarely causes problems. A genuine late-onset testosterone deficiency is uncommon and more likely with obesity or type 2 diabetes. Low desire or erection problems are often linked to stress, depression, poor sleep, alcohol, smoking or heart and circulation problems. That is why it is worth seeing a doctor: erectile dysfunction can be an early warning sign of heart disease.

Health, medication and wellbeing

Diabetes, high blood pressure, chronic pain, surgery and some medicines (antidepressants, blood pressure tablets) can affect sexual response. There are almost always alternatives. Looking after your sexuality at this stage includes:

• Asking your doctor: many side effects can be managed by adjusting or changing a medicine.
• Staying active and rested: exercise improves circulation, mood and energy.
• Adapting positions and pace: with arthritis or limited mobility, cushions and side-lying positions help. Find ideas in our limited mobility and arthritis guide.
• Looking after your heart: if you have a heart condition, see our heart-healthy sex guide.

Contraception and STIs still matter

Until menopause is confirmed, pregnancy is possible. Ireland's Health Service Executive (HSE) advises continuing contraception for two years after your last period if it happens before 50, one year if it happens at 50 or over, and says you can stop at 55. Sexually transmitted infections don't depend on age either: with new partners, condoms and testing remain useful. Vaginal dryness makes small tears more likely, so lubricant also helps with prevention.

Intimacy, partners and new relationships

Later life can bring more time, self-knowledge and freedom, without the pressure of having children. Intimacy is not only intercourse: touching, massage, kissing or masturbation are all full ways of enjoying sexuality. It is also a time of new relationships after separation or bereavement. Communication and consent remain the foundation, as in sex education in adulthood.

Common myths

• "Older people don't feel desire." False: the evidence shows otherwise.
• "After menopause, sex always hurts." Dryness can be treated effectively.
• "You don't need condoms at my age." They prevent pregnancy until menopause is confirmed and reduce STI risk at any age.
• "It's inappropriate to raise this with a doctor." It is a normal part of a consultation.

When to see a doctor

Book an appointment if pain during sex keeps happening, if you have vaginal bleeding after menopause, if erection problems persist, if low desire is upsetting you, or if you may have been exposed to an STI. Bleeding after menopause should always be checked.