"Sex" is a sensitive word. Many people avoid talking about it because of the perceived embarrassment. However, a more open attitude would facilitate better understanding and clarification of common misconceptions.
A common misconception is that the elderly do not and should not have sexual desire or sexual activities. This misconception ignores the elders' need for sex and inhibits discussion on this topic. Actually all human beings, old or young, have a natural need for "sex", both physiologically and psychologically. According to research findings, about 50 per cent of the elderly aged 60 to 90 engage in sexual activities on a regular basis.
"Sex" has a broader definition that does not confine itself to merely bodily contact. Sex also includes intimacy and communication between partners. This perspective is crucial because over-emphasis on bodily sensation and physiological performance without giving due regard to intimacy and communication may render unnecessary stress and distress.
With advancing age, there is decreased sensitivity for physiological arousal, for example, longer time or stronger stimulation are required for penis erection, and the time of maintaining erection may be shortened. Over-emphasis on bodily sensation may then lead to the depressing misunderstanding that he is no longer capable of sex. On the other hand, some elderly men may fear that sex is harmful for their health and abstain unnecessarily, thus affecting their intimate relationship with wives. Some other elderly may use drugs, alcohol, or "restoratives" in an attempt to enhance their physiological performance without realizing the hazard.
Many elderly women think sex is not appropriate for them after menopause. The erroneous assumption is that sex is merely for pregnancy and childbearing. Continuous need for sex after menopause is therefore immoral. This misconception may suppress their own need for sex and/ or create difficulty for them to enjoy sex spontaneously. At the same time, decrease in vaginal secretions may lead to pain during sex, hence they may be passive and evasive with their husbands' sexual request, leading to misunderstanding or even relationship problems.
Sexual behaviors with partner are expression of intimate relationship. It is not easy for two persons to enjoy sex if their relationship is poor. Mutual care, concern and acceptance are important elements for both parties to have satisfactory sex.
Some skills and aids may help to overcome and alleviate the difficulties due to physiological changes of old age. For example, adequate rest before having sex, lengthen foreplay, more intense stimulation of the genitals, adopt a less physically-demanding posture for intercourse and use of artificial lubricant like KY Jelly can contribute to more harmonious sex. If necessary, seek a doctor's advice.