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A Study of Sexuality and Health among Older Adults in the United States
Open accessAbstract
BACKGROUND: Despite the aging of the population, little is known about the sexual behaviors and sexual function of older people. METHODS: We report the prevalence of sexual activity, behaviors, and problems in a national probability sample of 3005 U.S. adults (1550 women and 1455 men) 57 to 85 years of age, and we describe the association of these variables with age and health status. RESULTS: The unweighted survey response rate for this probability sample was 74.8%, and the weighted response rate was 75.5%. The prevalence of sexual activity declined with age (73% among respondents who were 57 to 64 years of age, 53% among respondents who were 65 to 74 years of age, and 26% among respondents who were 75 to 85 years of age); women were significantly less likely than men at all ages to report sexual activity. Among respondents who were sexually active, about half of both men and women reported at least one bothersome sexual problem. The most prevalent sexual problems among women were low desire (43%), difficulty with vaginal lubrication (39%), and inability to climax (34%). Among men, the most prevalent sexual problems were erectile difficulties (37%). Fourteen percent of all men reported using medication or supplements to improve sexual function. Men and women who rated their health as being poor were less likely to be sexually active and, among respondents who were sexually active, were more likely to report sexual problems. A total of 38% of men and 22% of women reported having discussed sex with a physician since the age of 50 years. CONCLUSIONS: Many older adults are sexually active. Women are less likely than men to have a spousal or other intimate relationship and to be sexually active. Sexual problems are frequent among older adults, but these problems are infrequently discussed with physicians.
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“The only study by Lindau et al 31 presenting a relatively higher prevalence of arousal dif fi culties (ie, lubrication) of 41.9% was conducted in patients with diagnosed and undiagnosed diabetes.”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
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“In the past few years, however, a number of well-publicized studies have investigated the sexual activity of those as old as 94.”
From Medicalization and the Refashioning of Age-Related Limits on Sexuality (2012) · cites this paper as Lindau et al., 2007
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“Thus, interpretation of the results of this study is dif fi cult, because diabetes a risk factor for sexual dysfunction.”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
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“Nevertheless, in Australia, 19 Sweden, 17 the United States, 16,22,31 and Canada 32 the prevalence of orgasmic dysfunction seems to be approximately 16% to 25%”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
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“Orgasmic dysfunction also was higher for older women in the Iranian and U.S. samples.”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
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“The prevalence of sexual activity declines with age (particularly between 57 and 85 years of age), especially among women (Lindau et al., 2007; see Table 1).”
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“Evidence suggests that negative societal attitudes about women_s sexuality at older ages may limit discussion about sex by both the patient and the provider, particularly if the provider is younger or male.(25,42) Furthermore, sexual problems attributed to aging may be perceived as normal and irreversible, and women m…”
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“3% reported to be sexually active,which is in accordance with population data.(36) There were no differences between treatment groups with regard to sexual functioning or symptoms.”
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“The articles reviewed provided consistent evidence that older people who experience sexual difficulties tend not to seek medical help (AARP, 2005; Brock, Moreira, Glasser, & Gingell, 2006; Gott, 2001; Gott & Hinchliff, 2003b; Hill, Bird, & Thorpe, 2003; Laumann, Glasser, Neves, & Moreira, 2009; Lindau, Leitsch, Lundbe…”
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“Normative data on sexuality and sexual problems in the population, such as those recently reported by Lindau and colleagues [14], could be shared with the patient in the form of a written hand-out or brief conversation to legitimize sexual interest/desire or concerns.”
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Hill, E. K., Sandbo, S., Abramsohn, E., Makelarski, J. A., Wroblewski, K., Wenrich, E. R., McCoy, S., Temkin, S. M., Yamada, S. D., & Lindau, S. T. (2010) · Cancer · doi:10.1002/cncr.25832 · Cited by 184
“Studies of women with and without cancer repeatedly indicate that women across the life course value sexuality as an important part of life and health and believe it appropriate to discuss sexual issues with a physician.(2,9) Yet physicians, including oncologists who care for women with breast and genital tract cancer…”
BackgroundNappi, R. E., Martini, E., Cucinella, L., Martella, S., Tiranini, L., Inzoli, A., Brambilla, E., Bosoni, D., Cassani, C., & Gardella, B. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00561 · Cited by 196
“Dyspareunia is generally less reported later in life mainly because older women are less likely to still have a spousal or other intimate relationship (83).”
BackgroundInfluentialField, N. M., Mercer, C. H., Sonnenberg, P., Tanton, C., Clifton, S., Mitchell, K. R., Erens, B., Macdowall, W. G., Wu, F. C. W., Datta, J., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)62222-9 · Cited by 192
Affirmative old age - the ageing body and feminist theories on difference
Sandberg, L. J. (2013) · International Journal of Ageing and Later Life · doi:10.3384/ijal.1652-8670.12197 · Cited by 172
“Studies are increasingly preoccupied with the sexualities of older people, who are reported to continue to be sexually active and more sexually satisfied (Beckman et al. 2008; Herbenick et al. 2010; Lindau et al. 2007).”
BackgroundGlobal Sensory Impairment in Older Adults in the United States
Correia, C., Lopez, K. J., Wroblewski, K., Huisingh-Scheetz, M. J., Kern, D. W., Chen, R. C., Schumm, L. P., Dale, W., McClintock, M. K., & Pinto, J. M. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13955 · Cited by 172
Sexual Activity and Sexual Satisfaction Among Older Adults in Four European Countries
Træen, B., Štulhofer, A., Janssen, E., Carvalheira, A. A., Hald, G. M., Lange, T., & Graham, C. A. (2018) · Archives of Sexual Behavior · doi:10.1007/s10508-018-1256-x · Cited by 171
Social Care Networks and Older LGBT Adults: Challenges for the Future
Brennan-Ing, M., Seidel, L., Larson, B., & Karpiak, S. E. (2014) · Journal of Homosexuality · doi:10.1080/00918369.2013.835235 · Cited by 167
Rosenberger, J. G., Reece, M., Schick, V., Herbenick, D., Novak, D. S., Pol, B. J. V. D., & Fortenberry, J. D. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02438.x · Cited by 167
Liu, H., Waite, L. J., Shen, S., & Wang, D. H. (2016) · Journal of Health and Social Behavior · doi:10.1177/0022146516661597 · Cited by 166
Spitzer, M., Basaria, S., Travison, T. G., Davda, M. N., Paley, A., Cohen, B., Mazer, N. A., Knapp, P. E., Hanka, S., Lakshman, K. M., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-10-201211200-00004 · Cited by 163
“Physiologic system Cardiovascular 4 (6) 2 (3) 0.”
Management of Human Immunodeficiency Virus Infection in Advanced Age
Greene, M. L., Justice, A. C., Lampiris, H. W., & Valcour, V. (2013) · JAMA · doi:10.1001/jama.2013.2963 · Cited by 168
More than Sexual Function: Predictors of Sexual Satisfaction in a Sample of Women Age 40–70
Dundon, C. M., & Rellini, A. H. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01557.x · Cited by 187
Rubin, H., & Campbell, L. (2011) · Social Psychological and Personality Science · doi:10.1177/1948550611416520 · Cited by 160
“This decline is multiply determined by factors including age-related reductions in sexual capacity (Greenblat, 1983; Kinsey et al., 1953; Lindau et al., 2007; Rosen et al., 2004), decreased interest in sex with a long-term partner (i.e., habituation effects; James, 1981), and major life events such…”
BackgroundBergeron, S., Reed, B. D., Wesselmann, U., & Bohm-Starke, N. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0164-2 · Cited by 158
Gerstenberger, E. P., Rosen, R. C., Brewer, J. V., Meston, C. M., Brotto, L. A., Wiegel, M., & Sand, M. S. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01871.x · Cited by 160
Recent advances in the treatment of erectile dysfunction
Mobley, D. F., Khera, M., & Baum, N. H. (2017) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2016-134073 · Cited by 161
Sexual function in elderly women: a review of current literature.
Ambler, D. R., Bieber, E. J., & Diamond, M. P. (2012) · PubMed Central · Cited by 155
Sobecki, J. N., Curlin, F. A., Rasinski, K. A., & Lindau, S. T. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02702.x · Cited by 156
Song, S. H., Jeon, H., Kim, S. W., Paick, J., & Son, H. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.00840.x · Cited by 156
Reece, M., Herbenick, D., Schick, V., Sanders, S. A., Dodge, B., & Fortenberry, J. D. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02009.x · Cited by 158
Sexual Frequency Decline From Midlife to Later Life
Karraker, A., DeLamater, J., & Schwartz, C. R. (2011) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbr058 · Cited by 152
Stein, G. L., Beckerman, N. L., & Sherman, P. A. (2010) · Journal of Gerontological Social Work · doi:10.1080/01634372.2010.496478 · Cited by 195
“However, a 2007 study of over 3000 adults (1550 women and 1455 men) aged 57 to 85 years of age, reported that 73% of respondents aged 57 to 64, 53% of those aged 65 to 74, and 26% of those who were 75 to 85 years of age were sexually active (Lindau et al., 2007).”
BackgroundEfficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder
Simon, J. A., Kingsberg, S. A., Shumel, B. S., Hanes, V., Garcia, M., & Sand, M. S. (2013) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000000134 · Cited by 155
Sexual Function After Treatment for Rectal Cancer: A Review
Ho, V. P., Lee, Y., Stein, S. L., & Temple, L. K. F. (2011) · Diseases of the Colon & Rectum · doi:10.1007/dcr.0b013e3181fb7b82 · Cited by 153
“Fewer women than men were sexually active at any given age, and the differences became larger as age increased.(46) In general, data from studies reporting on sexual function after rectal cancer treatment support the finding that sexual function declines with age.”
ResultSexuality in the context of relationships.
Impett, E. A., Muise, A., & Peragine, D. E. (2013) · American Psychological Association eBooks · doi:10.1037/14193-010 · Cited by 166
Nappi, R. E., Albani, F. L. M., Vaccaro, P., Gardella, B., Salonia, A., Chiovato, L., Spinillo, A., & Polatti, F. (2008) · Gynecological Endocrinology · doi:10.1080/09513590801925596 · Cited by 145
Relationships and sexual expression in later life: a biopsychosocial perspective
Delamater, J., & Koepsel, E. R. (2015) · Sexual & Relationship Therapy · doi:10.1080/14681994.2014.939506 · Cited by 119
“Lindau et al. (2007) reported results from NSHAP, based on face-to-face interviews with a national probability sample of 3005 adults aged 57 85.”
BackgroundMontroni, I., Ugolini, G., Saur, N. M., Spinelli, A., Rostoft, S., Millán, M., Wolthuis, A. M., Daniels, I. R., Hompes, R., Penna, M., et al. (2018) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2018.08.003 · Cited by 145
“Sexual needs of elderly patients should not be underestimated as about 26% of patients between 75 and 85 years of age report being sexually active [149].”
BackgroundParaiso, M. F. R., Ferrando, C. A., Sokol, E. R., Rardin, C. R., Matthews, C. A., Karram, M. M., & Iglesia, C. B. (2019) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000001416 · Cited by 150
“environment can have a significant negative impact on a woman’s sexual health and quality of life.(2-6) Other common changes include progressive loss of vaginal elasticity, vaginal”
BackgroundMcFarland, M. J., Uecker, J. E., & Regnerus, M. (2010) · The Journal of Sex Research · doi:10.1080/00224491003739993 · Cited by 145
“In data from the National Social Life, Health, and Aging Project (NSHAP), only one in four 75- to 85-year-old men report a complete lack of interest in sex, and only about one half of 75- to 85-year-old women say the same (Lindau et al., 2007).”
BackgroundMethodInfluentialSexual functioning in young adult survivors of childhood cancer
Zebrack, B. J., Foley, S., Wittmann, D., & Leonard, M. (2010) · Psycho-Oncology · doi:10.1002/pon.1641 · Cited by 144
Herbenick, D., Reece, M., Schick, V., Sanders, S. A., Dodge, B., & Fortenberry, J. D. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02020.x · Cited by 155
Fractional CO2 laser for vulvovaginal atrophy (VVA) dyspareunia relief in breast cancer survivors
Pieralli, A., Fallani, M. G., Becorpi, A., Bianchi, C., Corioni, S., Longinotti, M., Tredici, Z., & Guaschino, S. (2016) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-016-4118-6 · Cited by 143
“This condition affects 20–45 % of women [2, 4] and in contrast to post-menopause vasomotor symptoms it becomes progressive over time and less likely to solve without intervention.”
BackgroundNappi, R. E., Kingsberg, S. A., Maamari, R., & Simon, J. A. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12235 · Cited by 142
Gustatory and olfactory dysfunction in older adults: a national probability study
Boesveldt, S., Lindau, S. T., McClintock, M. K., Hummel, T., & Lundstrom, J. N. (2011) · Rhinology journal · doi:10.4193/rhino10.155 · Cited by 142
“Details of the study design have been previously described(19).”
MethodSelf-citationSexual dysfunction in middle-aged women
Blümel, J. E., Chedraui, P. A., Barón, G., Belzares, E., Bencosme, A., Calle, A., Espinoza, M. T., Flores, D., Humberto Izaguirre, L., León-León, P., et al. (2009) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e3181a4e317 · Cited by 140
“This rate is higher than the rate previously reported for Europe and the United States.24,25 However, comparisons are difficult because the targeted age group and length of time used to define sexual inactivity may in fact vary from one study to another.”
ResultSimple Strategies for Vaginal Health Promotion in Cancer Survivors
Carter, J., Goldfrank, D. J., & Schover, L. R. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01988.x · Cited by 138
Metadata
- Authors
- Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O'Muircheartaigh, C. A., & Waite, L. J.
- Affiliations
- University of Chicago (US)
- University of Toronto (CA)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2007-08-23
- Volume
- 357
- Issue
- 8
- Pages
- 762-774
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC2426743
- OpenAlex
- W2107749577
- Cited by
- 2,211
- References
- 40
- Citations by year
- 2026: 59 · 2025: 74 · 2024: 70 · 2023: 92 · 2022: 100 · 2021: 109 · 2020: 196 · 2019: 121 · 2018: 118 · 2017: 127 · 2016: 158 · 2015: 151 · 2014: 147 · 2013: 139 · 2012: 108
- FWCI
- 66.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pfizer
- Johns Hopkins University
- National Institutes of Health
- Johns Hopkins Bloomberg School of Public Health
- Nutrition Obesity Research Center, University of North Carolina
- National Institute on Aging (AG021487, R01AG021487)
- Office of Behavioral and Social Sciences Research (AG021487, 5R01AG021487)
- Office of AIDS Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Sociology and Political Science › Marriage and Sexual Relationships
- Keywords
- sexuality in old age, sexual activity, sexual dysfunction, sexual desire, erectile dysfunction, vaginal lubrication, health status, age differences, gender differences, sexual health
- MeSH terms
- Aged, Aged, 80 and over, Aging, Coitus, Female, Health Status, Humans, Male, Middle Aged, Sexual Behavior, Sexual Dysfunction, Physiological, United States, Logistic Models, Sexuality
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