Written by Bethany Stoutamire (Former SDSU Extension Aging in Place Coordinator AmeriCorps VISTA Member) under the direction and review of Leacey E. Brown.
We often talk to teenagers and young adults about sex, going through the ins and outs of protection, consent, and when and with whom they should have it. However, the conversation about sex shouldn’t just end after one conversation or when someone turns eighteen, as it’s not just young people who are sexually active. One study found that 54% of men and 31% of women over the age of 70 are sexually active (the number is lower for women because they are more likely to have lost their spouse or partner). Thus, the birds and bees need to be a continuous situation as our bodies and relationships evolve. So what conversations should we be having about sex as we get older?
If you aren’t “too old” for sex, you aren’t too old for protection.
Because older people aren’t able to get pregnant, many may believe that they don’t need to use protection and many health care providers fail to provide information about safe sex and protection to older patients. However, this cavalier attitude towards sex comes at a price. STDs are quickly rising among older adults. Between 2014 and 2015, syphilis rates increased 31.8% among those between the ages of 55 and 64 and in 2014, the largest percentage of HIV diagnosis was for individuals between the ages of 50 and 54, yet studies suggest that condom use is lowest among men aged 50 and over. Many adults remain sexually active into their sixties and seventies, and due to divorce or death, may be re-entering the dating pool. While today’s baby boomers may have missed the safe sex education that began in the 1980s, it is clear that we need to educate everyone about the prevalence of STDs and ensure that STD testing and protection is made available regardless of one’s age.
Consent can become tricky.
Dementia impacts over 5 million adults, a diagnosis that can have a devastating impact for both the patient and their loved ones. Dementia can change the dynamic of many relationships, including intimate ones. As memory loss and cognitive function declines, deciding when one can or cannot consent to sexual activity is something that is a struggle for family members, law makers, and nursing staff to address. For instance, a couple of years ago a man from Iowa was found not guilty of sexual abuse his wife with dementia. The trial rested on the question if a woman who couldn’t remember the name of her daughter was capable of consenting to sex. There are no easy answers to questions like this and our discomfort and trivialization about the sex lives of older adults only muddles these situations.
Overlooking a patient’s sexual history can lead to untreated symptoms and misdiagnosis.
The sexual activity of older adults can be overlooked by healthcare providers who are either uncomfortable with the idea of older people having sex or assume that their older patients are celibate. However, a lack of STD testing or diagnosis could have many harmful side effects for older patients. For instance, early signs of HIV, such as fatigue, weakness, and changes in memory, may be written off as early signs of aging. Undiagnosed and untreated STDs may also weaken the immune system and make individuals more prone to getting ill or more difficult to recover from an illness.
It is almost always uncomfortable to talk about sex, but talking about the birds and the bees as a continuous life long conversation will lead to less awkwardness and healthier lives.
References & Additional Readings:
- HIV Surveillance Report
- Sexually Transmitted Disease Surveillance
- Seniors' Sex Lives Are Up — and So Are STD Cases Around the Country
- Love and Intimacy in Later Life
- Sexually Transmitted Diseases in Older Adults
- Sex, Dementia and a Husband on Trial at Age 78
- Can a Person with Dementia Consent to Sex?