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Sex Still Important to Older Men
  MedPage Today
Published: December 07, 2010
Action Points
* Explain that interest and involvement in sex remain strong among many men as they age -- even into their 90s.
* Note that among men who reported not being sexually active, almost half said their main reason was because of physical problems or limitations.
Interest and involvement in sex remain strong among many men as they age -- even into their 90s, an Australian cohort study found.
Among 2,783 men ages 75 to 95, 48.8% (95% CI 47 to 50.6) felt that sex was still at least somewhat important in their life, according to Zo‘ Hyde, MPH, of the University of Western Australia in Crawley, and colleagues.
And almost one-third of men in this age group (30.8%, 95% CI 29.1 to 32.5) reported having sex at least once within the previous year, the researchers reported in the Dec. 7 issue of Annals of Internal Medicine.
Data are inadequate on the attitudes and behaviors surrounding sex among older men, as well as the physical and social factors that influence their sexual activity.
So Hyde and colleagues undertook a population-based study of community-dwelling men, interviewing them at three time points between 1996 and 2009 about their health and sexual activity.
Testosterone levels also were measured at each visit.
Three-quarters were married or in a long-term relationship, and 85.9% reported having had some sexual activity during their lifetime.
Most had had sex only with women, and most had only one partner.
Among the 857 men who continued to be sexually active, more than half said they were satisfied with the frequency of sex, while 43% said they would like to have sex more often.
Participation in sex declined over time, from 39.6% (95% CI 36.7 to 42.4) of men 75 to 79 having had sex at least once during the previous year, to 11% (95% CI 4.2 to 17.8) among those in their 90s having had sex that often.
A similar pattern was seen for men who continued to consider sex important to them, which decreased from 59% (95% CI 56.2 to 61.8) of men in their 70s to 20.9% of those over 90 (95% CI, 12.5 to 29.3).
Among men who reported not being sexually active, almost half said their main reason was because of physical problems or limitations.
Other reasons included lack of interest and physical problems for their partner.
On multivariate cross-sectional analysis, decreased odds of sexual activity were associated with these factors:
* Increasing age, OR 0.90 (95% CI 0.88 to 0.93, P<0.001)
* Partner's lack of interest, OR 0.10 (95% CI 0.08 to 0.14, P<0.001)
* Partner's physical limitations, OR 0.43 (95% CI 0.30 to 0.60, P<0.001)
* Osteoporosis, OR 0.60 (95% CI 0.42 to 0.85, P=0.004)
* Prostate cancer, OR 0.38 (95% CI 0.29 to 0.51, P<0.001)
* Diabetes, OR 0.69 (95% CI 0.55 to 0.88, P=0.002)
* Antidepressant use, OR 0.52 (95% CI 0.36 to 0.77, P=0.001)
* Beta-blocker use, OR 0.68 (95% CI 0.55 to 0.85, P=0.001)
A longitudinal analysis had similar results, and also determined that each standard deviation increase in free testosterone was associated with a 20% increased likelihood of having had sex during the previous year.
The researchers noted that while prostate cancer was associated with decreased likelihood of having had sex -- probably because of hormone-based treatments -- prostatectomy was not, "perhaps reflecting improvements in surgical technique."
They observed that the link with diabetes was not surprising, because of the well-recognized detrimental effects of diabetes on sexual functioning.
The association with antidepressant use could reflect either impaired libido relating to depression or the adverse effects of the drugs, they explained, and the association with beta-blocker use most likely related to side effects of the drugs.
The researchers also noted that "an important and novel finding" was the longitudinal association between free testosterone and sexual activity, although they acknowledged that it's unclear whether testosterone therapy would be of benefit, particularly because the most common reason for sexual inactivity was the men's health problems.
Nonetheless, the study suggested that "a substantial proportion of older men may have unmet sexual needs," the authors wrote.
The study's limitations included the possibility of recall and response bias and survivorship effects over time.
They concluded that further research could help elucidate possible ways of improving sexual function in men of this age group.
The study was supported by the National Health and Medical Research Council of Australia and the MBF Foundation of Australia.
Primary source: Annals of Internal Medicine
Source reference:
Hyde Z, et al "Prevalence of sexual activity and associated factors in men aged 75 to 95 years: a cohort study" Ann Intern Med 2010; 153: 693-702.
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