Normal ageing changes in men Decreased testosterone hormone levels Weaker erection to erectile dysfunction (ED) More more intense or prolonged physical stimulation for erection Orgasms are fewer and weaker Reduced force and amount of ejaculation Increased refractory period Normal ageing changes in women Vaginal wall thinning Decreased/delayed vaginal lubrication Labia atrophy Vagina shortens Cervix may descend downward into the vagina Loss of fat pad over pubic symphysis Vaginal contractions become fewer and weaker during orgasm Many of these changes are a result of loss of estrogen Disease changes Heart Disease Diabetes Depression Breast and Prostate Cancers HIV/AIDS Cognitive Impairment/Dementia There a number of medical conditions that cause sexual dysfunction among older people, including: Diagnosis and management of sexual health needs Consult with your General Practitioner to diagnose sexual problems and develop a plan of care to meet the sexual health needs. Healthwise. (2020). Sexuality and Physical Changes With Ageing. https://www.uofmhealth.org/health-library/hw159186#hw159192 Source Many older men and women remain sexually active through their later years. Physiological changes with ageing and the treatments of disease have impact on sexual function. Alternative options to compensate for disease and normal ageing changes can help older adults to improve sexual health and well-being. Human being are actually never too old to enjoy a happy and healthy sex life. Am I Too Old For Sex? Compensate for normal ageing and disease changes Have longer fore-play arousal time For men, consider improving erectile function by using vacuum pumps, injection therapy, implants, and oral erectile agents such as sildenafil Citrate (Viagra®), vardenafil HCL (Levitra®), and tadalifil (Cialis®) For women, consider use of artificial water based lubricants and estrogen gels/patches/creams for vaginal dryness For cognitively impaired older adults or those without partners living in residential aged care facility or with family, privacy and safe environment for masturbation should be provided together with a sexual “tool kit” such as Individual tubes of lubricants, condoms, and erotic materials (movies, magazines) Practice safer sex techniques When sexual intercourse is uncomfortable or not possible consider alternative positions or forms of intimacy Vaginal Intercourse Use a lubricated latex or polyurethane male condom or the female condom Hold the condom trim while having sex Visually check the condom during sex Change the condom when changing activities or if the sex lasts a long time Use your own condom so you will know that it was stored correctly Oral Sex Use a non-lubricated latex condom as soon as the penis is erect to prevent pre-cum from contacting the mouth, which can contain HIV Use dental dam, a cut-open latex Oral sex on a man Oral sex on a woman glove, a non-lubricated condom, or non-microwaveable plastic wrap Other Safer Sex Tips Repeated or rough vaginal, anal, and oral sex play can cause damage to the linings of these areas, which can increase the chance of HIV or another STI. The Well Project. (2022). Safer Sex. https://www.thewellproject.org/hiv-information/safer-sex?gclid=Cj0KCQiA_8OPBhDtARIsAKQu0gYmq5sQjjFoSWCi4xnZhEYLSXEr- Cr2GjKEnMndqJsVJtnwsEznatoaAkRjEALw_wcB Source It's never too late for safer sex. If you do not have a sexually transmitted infection or disease (STI or STD), practicing safer sex will help you to ensure that you do not get one. If you have a STI, safer sex can protect your partner and prevent you from getting another STI. Fisting, Handballing, or Fingering Use latex gloves to protect yourself from your partner's body fluids as HIV can travel into the bloodstream through cuts or cracks on hands or fingers Activity-Specific Safer Sex Tips Anal Intercourse Use a strong latex condom with plenty of lubricant. Condom is less likely to break if the anus is massaged with finger or sex toy to help relax the muscles Sex with Sex Toys Put a condom on a dildo before use as sex toys can transmit STIs from one partner to another Do not share a dildo without washing it thoroughly with hot soapy water Clean sex toys every time after use Sex toys can be cleaned with 10 percent hydrogen peroxide. No-Risk Safer Sex Activities Masturbation: touching your own genitals Phone sex, cybersex, talking dirty, and sharing sexual fantasies Intimacy without sex: hugging, touching, massage