When it comes to older people having sex, the conversation is often swept under the rug—like passion and pleasure are reserved only for the under-40 crowd. That couldn’t be further from the truth.

The reality is, older adults are still having sex—and want to keep having it. Maintaining a healthy sex life as we age doesn’t just support connection and confidence, it also plays a key role in physical and emotional well-being.

We spoke to Dr. Martina Ambardjieva, MD, urologist, and PhD graduate, to break down the facts around sexual health for the aging population—and how to keep things sizzling, no matter what birthday you’re celebrating next.

Older People Having Sex: What Physical Changes Come with Age—And How to Navigate Them

Let’s face it: bodies change with age, and sex changes along with them; however, that doesn’t mean it disappears. In fact, understanding those changes is the first step to working with them—not against them.

“The first group of causes includes pathological conditions that affect blood vessels, such as diabetes, atherosclerotic plaque, inflammatory diseases, and thrombosis,” says Dr. Ambardjieva. Keeping these conditions under control with proper medication, healthy eating, and regular physical activity can help maintain sexual function and confidence.

Hormonal shifts are another key factor—particularly testosterone levels in men and estrogen levels in women. “In such cases, testosterone replacement therapy may be beneficial,” she adds. Women experiencing vaginal dryness from decreased estrogen can turn to gels, tablets, and lubricants to ease discomfort.

For men recovering from prostate surgery, nerve damage can take time to heal, but options like Kegel exercises, vacuum erection devices (VEDs), or even intracavernosal injections may help. “In some cases, a penile implant may be necessary,” Dr. Ambardjieva explains.

Plus, let’s not ignore psychological factors. Stress, anxiety, and performance pressure can all mess with libido, which is why regular movement and professional mental health support can be game changers.

Keeping the Spark Alive: Intimacy Isn’t Just for the Young

Let’s be clear: just because you’ve got a few more laugh lines and a little less cartilage doesn’t mean passion is off the table. In fact, one of the biggest predictors of a fulfilling sex life later in life is how you connect with your partner.

“The most important factor is open communication with the partner, which leads to a stronger emotional connection,” says Dr. Ambardjieva. “This can be supported through frequent hugs, touches, and kisses.” Physical intimacy doesn’t always have to lead to sex—sometimes, it’s the emotional closeness that keeps the fire going.

Of course, age-related changes like menopause or erectile dysfunction might require some creative adaptation. Lubricants can make intimacy more comfortable, while medications and prosthetic devices support function. What matters is staying curious, open, and adjusting your approach as needed.

Honestly, sex that comes from deep trust and communication? It tends to be better anyway.

Let’s Talk About It: Why Communication Matters More Than Ever

Great sex in your 60s, 70s, or 80s starts with excellent communication—awkward as it might feel at first. “When couples feel emotionally connected, they’re more likely to stay sexually engaged and satisfied, even when facing physical or health-related challenges,” says Dr. Ambardjieva. That connection builds through honesty, vulnerability, and yes, a sense of humour.

When partners can talk openly about what feels good, what doesn’t, and what might need a little support, they’re far more likely to find real satisfaction. This isn’t the time to make assumptions or tiptoe around discomfort. Share fantasies, fears, and frustrations.

Be honest about any physical limitations, and work together to find new rhythms that feel good for both of you. Sexual intimacy isn’t a static thing—it’s an evolving, ever-adaptable dance.

Staying Proactive: Health Screenings and Medical Check-Ins That Matter

Let’s not gloss over the medical side of things. If something feels off, it’s worth getting checked out. “If someone experiences pain during intercourse, they should definitely visit a doctor,” Dr. Ambardjieva says. “If a man is unable to achieve an erection, he should see a urologist. It’s important to check hormone levels, and sometimes it’s necessary to assess for other conditions like Peyronie’s disease or prostate health.”

Many older adults don’t realize how closely their sexual health ties in with other medical conditions, whether you have a penis or a vagina. Screening for diabetes, cardiovascular disease, and inflammation-related illnesses is key. Don’t brush off stress as ‘just part of life.’

Dr. Ambardjieva recommends speaking with a psychologist if emotional or mental well-being is interfering with intimacy. Addressing these things early can prevent minor issues from snowballing into long-term concerns—and keep the bedroom a place of pleasure, not frustration.

Getting Creative: Adapting Routines and Exploring New Forms of Intimacy

You don’t have to do it the same way you did in your twenties—and honestly, why would you want to?

Ageing opens the door to explore intimacy in new, more meaningful ways. “Couples can adapt their sexual routines by embracing flexibility and creativity in their intimacy,” Dr. Ambardjieva explains. “As they age, physical changes may require adjustments, but emotional connection and communication remain essential for a fulfilling relationship.”

This might mean trying different positions, using pillows or props for support, or investing in high-quality lubricants. It could also mean redefining what sex looks like for you—whether that’s massage, extended foreplay, mutual touch, or just lying together in shared closeness.

Holding hands or kissing deeply can reignite that emotional connection and build trust. What matters most is that both partners feel safe, respected, and excited to keep exploring together.

Breaking the Silence: Overcoming Embarrassment and Speaking to Your Doctor

Even with the best intentions, many older adults still hesitate to bring up sexual health with their doctor. It can feel awkward, personal, or downright uncomfortable. However, silence isn’t the solution.

“For older adults who feel hesitant or embarrassed to discuss their sexual health concerns with a medical professional, online consultations can be a great option,” says Dr. Ambardjieva. “This allows the patient to remain anonymous, which can make the conversation feel more comfortable and less intimidating.”

She adds that it’s essential to remember that sexual health is a vital part of your overall well-being—not a niche concern or a luxury. “There are also many resources and mediums available, such as online forums, educational videos, or support groups, that can help overcome any barriers and provide valuable guidance and reassurance.”

By removing the stigma, we open the door to a healthier, more confident, and much more satisfying experience—not just in the bedroom, but in life overall.

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Older people having sex is not a punchline—it’s a fact of life. And it’s a beautiful, healthy, and deeply human one, at that. Sexual health in later years might look different, but it still deserves attention, respect, and support. From managing physical changes and medical concerns to deepening emotional intimacy and trying new things, there’s no expiry date on connection or pleasure.

Talking about it, asking questions, and embracing both the fun and the awkward are all part of maintaining a fulfilling sex life—at any age. So go ahead, crack the jokes, giggle a little, but keep the conversation going.

Older People Having Sex: Why It’s Time to Talk About Sexual Health and Ageing (Without Blushing)