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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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“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
Experimental — accuracy not yet measuredIn the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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BackgroundInfluentialSexual concerns among kidney transplant recipients
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“Comparable pictures have been also reported by Lindau et al. (2007) who observed a 28% prevalence of lack of interest in sex (and the concomitant rate of 68% of bothered men owing to reduced libido) in a national probability sample of 3005 US adults (1455 men) aged 57 – 85 years.”
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Sexual Behavior and Attitudes Toward Sex of Older Adults Living with HIV
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Sexual behaviours and sexual health among middle-aged and older adults in Britain
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“4 12 In addition, sexually transmitted infections (STIs) are increasing among the older age groups, 13 and few older adults report speaking to their doctor about sex at all.”
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“…maintain varying degrees of sexual activities and are prone to a variety of high-risk sexual behaviors due to the lack of AIDS knowledge and risk awareness (Johnson, 2013; Kim et al., 2019), and the percentage of men who have sexual desires was much higher than that of women (Lindau et al., 2007).”
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Are geriatricians guilty of failure to take a sexual history?
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“The NSHAP was conducted to examine social networks, overall health, and sexual practices of older adults.(19) Adults were targeted for possible participation in the NSHAP study from a previous population-based study, the Health and Retirement Study.”
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“[10,11] The study also included the apparent lack of expression of sexuality to their partners indicating that communicating issues regarding sexuality is difficult in general.[10,12,13] These included attitudinal barriers such as myths around sexuality and aging; physiological barriers such as sexual dysfunction; or…”
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Living in a Paradox: How Older Single and Widowed Black Women Understand Their Sexuality
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“While the majority of research examining sexual risk behaviors in older adults has focused on HIV-seronegative persons (Lindau et al., 2007), studies have begun to examine sexual behavior in older adults living with HIV/AIDS (Cooperman et al.”
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“Erectile dysfunction (ED) and premature ejaculation are the two most common complaints of male patients presenting with sexual dysfunction.([2]) ED is defined as a man’s consistent or recurrent”
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BackgroundResultInfluentialAge Effects on Women’s and Men’s Dyadic and Solitary Sexual Desire
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“2016;14(2):178-84 sexuality found it normal for older individuals to have a sexual life.”
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“In addition, physiological and emotional states as well as morbidity are also related to sexual function in old age (Kontula & Haavio-Mannila, 2009; Lindau et al., 2007).”
BackgroundManagement of Hypertension with Female Sexual Dysfunction
Zhong, Q. P. W., & Anderson, Y. K. (2022) · Medicina · doi:10.3390/medicina58050637 · Cited by 19
“In a survey of 1550 women whose ages ranged from 57 to 85 years, 43% of the respondents reported a low sexual desire, 39% had difficulty with vaginal lubrication, 34% had an inability to climax, 17% experienced pain, and 23% reported non-pleasurable sex [13].”
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Should being aged over 70 years hinder penile prosthesis implantation?
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“Condom use is uncommon in the elderly because of no contraceptive need and a perceived low risk of acquiring infections (5).”
BackgroundOspemifene for the Treatment of Vulvovaginal Atrophy and Dyspareunia in Postmenopausal Women
McLendon, A. N., Clinard, V. B., & Woodis, C. B. (2014) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.1465 · Cited by 16
“3, 11 Despite the high prevalence of sexual problems in postmenopausal women, only 22% have spoken to a physician about their issues, and just 1% take medication for their symptoms.(12) Although more than 40% of those surveyed would consider treatment, more than 70% of women recounted never being asked about this symp…”
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“…evaluate sexual functioning in the preceding four weeks, a modified version that referred to a period of six months prior to participation was employed to better reflect older women’s patterns of sexual activity, which are less frequent than their younger counterparts (e.g., Lindau et al., 2007).”
BackgroundMethodManagement and rehabilitation of neurologic patients with sexual dysfunction
Basson, R. J., & Bronner, G. (2015) · Handbook of clinical neurology · doi:10.1016/b978-0-444-63247-0.00024-9 · Cited by 16
“Misgivings that patients are too old for sex can be allayed by reports confirming that more than half of people aged 57–85 and about one-third of those aged 75–85 are still sexually active (Lindau et al., 2007).”
BackgroundSensory Dysfunction and Sexuality in the U.S. Population of Older Adults
Zhong, S., Pinto, J., Wroblewski, K., & McClintock, M. (2018) · Journal of Sexual Medicine · doi:10.1016/j.jsxm.2018.01.021 · Cited by 11
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BackgroundInfluentialPatient Expectations of Sexual Activity After Total Hip Arthroplasty
Harmsen, R. T. E., Oudsten, B. L. D., Putter, H., Leichtenberg, C. S., (on behalf of the LOAS Study Group), Elzevier, H. W., & Nelissen, R. G. H. H. (2018) · JBJS Open Access · doi:10.2106/jbjs.oa.18.00031 · Cited by 16
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Intimacy between care home residents with dementia: Findings from a review of the literature
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“Nonetheless, interest in intimacy does not always diminish with age (Byers, 1983; Lindau et al., 2007).”
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“In response to the integrative biopsychosocial model, it is essential to go beyond the simple identification of cultural differences to explore potential, underlying social and psychological mechanisms that may account for those differences (c.f., Lewis 2004 ).”
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Viana, H. B., & Madruga, V. A. (2010) · Revista Brasileira de Qualidade de Vida · doi:10.3895/s2175-08582010000200004 · Cited by 15
Mastroianni, J., Thompson, J. A., Shifren, J. L., Zuckerman, A. L., & Pereira, K. C. (2020) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000001668 · Cited by 17
“topic with their health care provider due to negative societal attitudes associated with midlife and older age sexuality.(1,11,12)”
BackgroundAssociation between sarcopenia and erectile dysfunction in older males
Sürmeli, D. M., Karpuzcu, H. C., Atmış, V., Coşarderelioğlu, Ç., Yalçın, A., Varlı, M., & Aras, S. (2021) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2021.104619 · Cited by 14
Child Maltreatment and Couples’ Sexual Health: A Systematic Review
Bergeron, S., Bigras, N., & Vaillancourt‐Morel, M. (2022) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2022.04.002 · Cited by 16
The continued ageing of people with AIDS in Italy: recent trend from the national AIDS Registry.
Camoni, L., Règine, V., Raimondo, M., Salfa, M. C., Boros, S., & Suligoi, B. (2014) · Annali dell Istituto Superiore di Sanità · doi:10.4415/ann_14_03_12 · Cited by 15
Sexuality in nigerian older adults
Olatayo, A. A., Kubwa, O. O., & Ajayi, E. A. (2015) · Pan African Medical Journal · doi:10.11604/pamj.2015.22.315.7617 · Cited by 15
“Even though patients' medical ailments were the most commonly reported reason for sexual inactivity in our study, this was contrary to the findings by Lindau et al where partners' physical health accounted for the significant sexual inactivity [6].”
BackgroundResultInfluentialMurphy, P. J., McSharry, J., Casey, D., Doherty, S. A., Gillespie, P., Jaarsma, T., Murphy, A. W., Newell, J., O'Donnell, M. J., Steinke, E. E., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011219 · Cited by 16
“Sexual inactivity before entering cardiac rehabilitation will not be an exclusion criterion as previous behaviour is not an accurate predictor of future sexual behaviour or need for information,(27) and even sexually inactive older adults and those who may be very ill value sexuality as an important part of life and h…”
BackgroundThames, A. D., Hammond, A., Núñez, R. A., Mahmood, Z., Jones, F., Carter, S. L., Bilder, R. M., Fisher, S., Bivens-Davis, T., & Jones, L. (2018) · Journal of Women s Health · doi:10.1089/jwh.2017.6777 · Cited by 15
“Consistent with previous reports, 7,57 a majority of the women reported that their physician overlooked asking questions about their sexual health.”
Goethe, V. E., Angerer, H., Dinkel, A., Arsov, C., Hadaschik, B. A., Imkamp, F., Gschwend, J. E., & Herkommer, K. (2018) · Sexual Medicine · doi:10.1016/j.esxm.2018.08.001 · Cited by 15
Medication Use and Sexual Function: A Population-Based Study in Middle Aged Women
de Moraes, A. V. G., Valadares, A. L. R., Filho, J. F. L., Costa‐Paiva, L., & Pedro, A. O. (2019) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2019.06.004 · Cited by 16
Online Sex Addiction After 50: an Exploratory Study of Age-Related Vulnerability
Ševčíková, A., Blinka, L., Škařupová, K., & Vašek, D. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-019-00200-3 · Cited by 17
Kim, H. S., Kang, J. H., Yang, S. Y., & Kim, N. K. (2020) · Surgical Laparoscopy Endoscopy & Percutaneous Techniques · doi:10.1097/sle.0000000000000779 · Cited by 15
“Age at operation (range) (y) 44 (19-50) Age (range) (y) 46 (21-56) BMI (range) (kg/m2) 23.”
Orgasm and Faking Orgasm: Heterosexual Interactions in China
Ford, J. V., Carter, A., & Wong, H. T. H. (2022) · The Journal of Sex Research · doi:10.1080/00224499.2021.2023087 · Cited by 15
“For instance, Laumann et al. (2005) found a trend of increased difficulty reaching orgasm in their sample (age 40–80) as did Lindau et al. (2007) in their sample (age 57– 85; Laumann et al., 2005; Lindau et al., 2007).”
BackgroundBeerepoot, S., Luesken, S. W. M., Huisman, M. A., & Deeg, D. J. H. (2022) · Journal of Applied Gerontology · doi:10.1177/07334648221078852 · Cited by 15
“Several studies have shown that the importance attached to sexuality decreases with ageing (Laumann et al., 2006; Lindau et al., 2007).”
BackgroundPeri-Rotem, N., & Skirbekk, V. (2022) · The Journal of Sex Research · doi:10.1080/00224499.2022.2108745 · Cited by 15
“In addition, we excluded those aged 60 and over, since the prevalence of sexual activity tends to decline at older ages, and older adults are more susceptible to health conditions that affect sexual functioning (Camacho & Reyes-Ortiz, 2005; Lindau et al., 2007).”
BackgroundLoeb, D. F., Aagaard, E., Cali, S. R., & Lee, R. S. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01883.x · Cited by 15
Blair, B., Arnow, B. A., Haas, A. L., & Millheiser, L. S. (2013) · Sex Education · doi:10.1080/14681811.2013.771774 · Cited by 15
“Moreover, the majority of women who do not seek help for a sexual problem wish that they had (Feldhaus-Dahir 2009; Lindau et al. 2007; Mercer et al. 2005; Shifren et al. 2009).”
BackgroundLocalized brain metabolite changes during visual sexual stimulation in postmenopausal women
Kim, T., Kang, H., Park, K., & Jeong, G. (2013) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e318291f816 · Cited by 15
“The most prevalent sexual complaints among postmenopausal women are low libido, difficulty with vaginal lubrication, and inability to climax.(3) Genazzani et al(4) reported that functions of the central nervous systemVparticularly cognitive functions such as memory, recall, recognition, and autonomic controlVworsen du…”
BackgroundIf You Don't Ask Me…Don't Expect Me to Tell
Matzo, M. L., & Hijjazi, K. H. (2009) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0b013e3181b57b59 · Cited by 15
Barmon, C., Burgess, E. O., Bender, A. A., & Moorhead, J. R. (2016) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbw068 · Cited by 15
“Although the frequency of sexual activity in older adults is lower than in younger adults, the majority maintain interest in sexual and intimate behavior (Lindau et al., 2007).”
BackgroundYe, M., DeMaris, A., & Longmore, M. A. (2017) · Marriage & Family Review · doi:10.1080/01494929.2017.1284703 · Cited by 15
“Similarly, if time spent apart or sex is not perceived as having the same level of importance as when individuals were young (Lindau et al., 2007), then they may not be applicable to the marriage in question.”
BackgroundChronic Disease Burden, Sexual Frequency, and Sexual Dysfunction in Partnered Older Adults
Shen, S. (2019) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2019.1610127 · Cited by 15
“For women, an indicator for lubrication problems was used, as this is one of the most common sexual problems older women experience (Lindau et al., 2007).”
BackgroundMethodMasturbation: Breaking the Silence
Shelton, J. D. (2010) · International Perspectives on Sexual and Reproductive Health · doi:10.1363/3615710 · Cited by 15
Flaget-Greener, M., González, C. A., & Sprankle, E. L. (2014) · Sexual & Relationship Therapy · doi:10.1080/14681994.2014.948297 · Cited by 15
“Sexual activity among older adults continues well into their 80s and is associated with higher quality of life among older adults (Lindau et al., 2007; Robinson & Molzahn, 2007; Schick et al., 2010).”
BackgroundThe Influence of the Social Environment on Health Behavior
Guardia, J. G. L., & Patrick, H. (2014) · Springer eBooks · doi:10.1007/978-94-017-8542-6_13 · Cited by 15
National Social Life, Health, and Aging Project (NSHAP)
Hawkley, L. C., & Waite, L. J. (2019) · Springer eBooks · doi:10.1007/978-3-319-69892-2_1004-1 · Cited by 15
How has the biopsychosocial model fared in sexual medicine and sex therapy?
Perelman, M. A., Giraldi, A. G. E., Parish, S. J., Wittmann, D. A., Fisher, W. A., Bober, S. L., Pastuszak, A. W., & Pfaus, J. G. (2025) · Sexual Medicine Reviews · doi:10.1093/sxmrev/qeaf029 · Cited by 17
A High Proportion of Patients Have Unfulfilled Sexual Expectations After TKA: A Prospective Study
Harmsen, R. T. E., Haanstra, T. M., Oudsten, B. L. D., Putter, H., Elzevier, H. W., Gademan, M. G. J., Nelissen, R. G. H. H., & and LOAS Study Group (2019) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000001003 · Cited by 14
“Sexual activity is an important aspect of quality of life during all ages [3, 33, 53].”
Background“Shades of Grey”: Exploring Public Opinion about Later-Life Sexuality
Gewirtz‐Meydan, A., & Ayalon, L. (2020) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s071498081900062x · Cited by 13
“Sexual problems such as lubrication difficulties among women, a lack of interest in sex, inability to reach an orgasm, and erectile difficulties among men are all correlated with age and are common among older people worldwide (Laumann et al., 2005; Lindau et al., 2007).”
InfluentialLet's get it on: Addressing sex and intimacy in older cancer survivors
Arthur, E. K., Worly, B. L., Carpenter, K. M., Postl, C., Rosko, A. E., Krok‐Schoen, J. L., Quick, A. M., & Jenkins, L. C. (2020) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2020.08.003 · Cited by 15
Ejegi-Memeh, S., Hinchliff, S., & Johnson, M. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14688 · Cited by 15
“I'm not terribly lonely”: Advancing the understanding of intimacy among older adults
Fitzroy, A. F., Kemp, C. L., & Burgess, E. O. (2022) · Journal of Aging Studies · doi:10.1016/j.jaging.2022.101005 · Cited by 14
Cismaru-Inescu, A., Hahaut, B., Adam, S., Nobels, A., Beaulieu, M., Vandeviver, C., Keygnaert, I., & Nisen, L. (2022) · Journal of Sexual Medicine · doi:10.1016/j.jsxm.2022.01.516 · Cited by 11
Rojanasarot, S., Williams, A. O., Edwards, N., & Khera, M. (2023) · Sexual Medicine · doi:10.1093/sexmed/qfad010 · Cited by 14
“0 (42-57) Londoño44 2012 Kaiser Permanente Southern California MMAS 45-69 57.”
BackgroundLong‐term sexual function after mid‐urethral slings for stress urinary incontinence in women
Solhaug, B. R., Svenningsen, R., Nyhus, M. Ø., & Volløyhaug, I. (2024) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14894 · Cited by 14
“23 In our study, the sexually inactive women were on average 13 years older than the sexually active women, supporting the findings from studies showing a reduction in sexual activity with age.”
BackgroundResultInfluentialSchema via Structure? Personal Network Density and the Moral Evaluation of Infidelity
Schafer, M. H. (2014) · Sociological Forum · doi:10.1111/socf.12072 · Cited by 15
McCarthy, B., & Thestrup, M. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.01051.x · Cited by 14
Idosos: associação entre o conhecimento da aids, atividade sexual e condições sociodemográficas
Batista, A. F. D. O., Marques, A. P. D. O., Leal, M. C. C., Marino, J. G., & Melo, H. M. D. A. (2011) · Revista Brasileira de Geriatria e Gerontologia · doi:10.1590/s1809-98232011000100005 · Cited by 14
“Separado/ divorciado 24 (14,6) 2 8,3 22 91,7 Não respondeu 7 (4,2) 7 100,0 Renda mensal (salários mínimos)”
Bentrott, M. D., & Margrett, J. A. (2016) · Sexuality Research and Social Policy · doi:10.1007/s13178-016-0260-y · Cited by 14
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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