By Adina Inescu, clinical sexologist (Brussels and CHU DINANT)

Sexual health, as defined by the World Health Organization (WHO), requires "a positive and respectful approach to sexuality and sexual relations, as well as the possibility of having safe and enjoyable sexual experiences without coercion, discrimination or violence. To achieve and maintain a good state of sexual health, the sexual rights of all individuals must be respected and protected.” Even though we are constantly confronted with sexuality in our present society, the taboo still exists and we will not talk about it.

Today’s society perpetuates the idea that sexuality is linked to youth and beauty. After the age of 50, the discourse on sexuality often revolves around dysfunctions. Having this stereotypical image for young and beautiful people, we are confronted with another reality, over time, the one where we are no longer 20 years old. What about the benefits of sexuality and its contribution to well-being? Positive sexuality does not mean denying what is wrong, but rather highlighting what works and trying to find fulfillment by adapting one’s sexual life to the reality of the person or couple.

Sexuality is... a central aspect of the human being throughout life, which includes sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in the form of thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. Sexuality thus gathers many dimensions but each person does not necessarily feel or live each of them. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, legal, historical, religious and spiritual factors.” 

Attitudes and knowledge about sexuality

Scientific studies show that the more we know about sexuality, the more we have open attitudes towards the expression of sexuality. The questions to be asked about the expression of sexuality in relation to sexual fulfillment can be around the interest of each person for sexuality. The more we see sexuality as an important part of our lives, the more we will invest in finding ways to achieve our sexual well-being. The way we (don’t) live our sexuality is influenced by societal attitudes, which can have a negative impact on the expression of sexuality.

Physiological changes

“Sexuality is perfectly natural, but not naturally perfect” (François de Carufel). Sexuality is unfortunately still reduced to its reproductive function, which leads to questions when stopping this function. But sexual expression can continue its path outside of this reproductive function. Throughout life, the human body experiences changes. Among age-related changes, we may encounter one or more such as hair and skin changes, menopause, lower elasticity and vaginal lubrication, less rigidity of the penis during erection, the need for more time to get an erection, longer orgasm to come, less ejaculation volume as well as a longer refractory period. These physiological changes cannot be denied, but must not prevent sexual expression.

“I find that as I get older… I have an orgasm much faster - I went through menopause and when I was younger I had this fear of getting pregnant… And now that I don’t have to worry about it, I just think it’s kind of easier to have an orgasm than it used to be.”

In order to continue to have a satisfying sex life, it is important to recognize these changes and to talk to the referring doctors, urologists, gynaecologists or sexologists to find solutions.

“We use more lubricant. We just realize that the preliminaries are just going to take longer. [… The positions in which I had a better sexual response do not work for me and I just need to be more creative.”

The benefits of sexuality on general well-being

Sexual expression and intimacy play an important role in quality of life. It encompasses several dimensions, such as life satisfaction, health status, happiness, subjective well-being, autonomy and independence. Several studies have shown associations between health and the expression of sexual activity, both physically and mentally, such as muscle relaxation, improved sleep, better tolerance to pain, less muscle tension, delayed menopause, reduced risk of prostate cancer and increased longevity . Mentally, other forms of affection than sexual activity are associated with lower levels of depression. Finally, other studies have shown the positive impact of sexual expression on psychological well-being, sexual and relational health.

Sexuality in numbers

According to an Irish study, 75% of people aged 50 to 64 report being sexually active. Belgian figures for this age group do not yet exist. The most recent Belgian study on the sexuality of people between the ages of 70 and 99, shows that 31% of participants are sexually active, while 47% of inactive people have experienced physical tenderness in the last 12 months.

In addition, 74% of sexually active people say they are (very) sexually satisfied in the last 12 months and 85% of sexually active people surveyed say they have a (very) good quality of life. Factors that contribute to the expression of sexuality include the presence of a partner, good health, younger age, living at home, and satisfaction with sex life. Many studies also compare people’s sexuality by age group by questioning the frequency of sexual intercourse. The results show that, most of the time, a decrease in the frequency of sexual intercourse and discussions is directed towards dysfunctions. The idea is not to compare the sexuality of people aged 40 with that of people aged 60 or 80. When researchers examine sexuality in later life (80+), through the definition of sexuality and the importance of its expression, the results show that sexuality is an important element in people’s lives, which is expressed differently by age and contributes to overall well-being. Thus, each stage of life comes with its advantages and disadvantages and sexuality changes over time.  

It’s up to us to invent it

Sexuality does not necessarily end at a certain age, whether it is at 50, 60 or 80. Indeed, it evolves and exists according to our desires and context. The knowledge of one’s own body and the body of the other, the acceptance of one’s body and communication with the other are advantages in sexual fulfillment after 50 years.

"I think for me the physical feeling is probably less intense than when I was young, but the emotional part is much better. I can feel more alive, I can be less inhibited, I’m more comfortable with my body. I am able to express myself better and accept his expression better. So even physically, even though it’s not as fantastic as it was, there are other things that compensate to make it better. I prefer the present situation to the past…”

Sexuality is constructed, articulated, and adapted to life situations, whether it is solitary sexuality, whether it is in a long-term couple or in a newly formed couple. For example, sexuality during pregnancy will be adapted according to the needs of individuals, so that during bereavement, sexuality can temporarily stop or can be exacerbated. In the same way that sexuality at 20 is different from that at 40 or 60 or 80. Individuals are different and their needs also evolve over the course of life, whether it is towards the continuation or the cessation of sexuality. It must be the informed choice of the person, and not the result of the received ideas of society.

"Making sure we are intimate and communicating and even if we don’t feel like having sex, there are other ways to be intimate. You don’t necessarily need to have sex to be sexually active… it’s just being intimate in your conversation and you’re holding hands and just taking the time…”

Finally, sexuality is not only penetrative and phallocentric, it is not intended only for couples. For sexual fulfillment, it is up to everyone to invent their sexuality and live it in their own way. Sexuality can be expressed in a variety of ways, whether it is a couple activity or a solitary one, which involves orgasm, intercourse with penetration, masturbation, cuddling, or any other way to express sexual intimacy. Dare to live a fulfilling sexuality at any age!