Relationships and sexual expression in later life: a biopsychosocial perspective

Abstract

The literature on sexual activity and ageing has grown substantially in the past 20 years. Until recently, a medicalized perspective dominated. In the past decade research based on a social-relational perspective has emerged. We summarize recent work from both perspectives. In addition to the effects of disease on sexual functioning of men and women over the age of 50, this review emphasizes sexual expression among older couples, newly emerging topics such as human immunodeficiency virus (HIV) in the older adult, and older lesbian and gay sexuality. Sexual functioning in both males and females continues in later life, while sexual satisfaction within their relationships is dependent upon individual responses to age-related changes. As the life course continues, some older married couples begin to desire emotional intimacy, stability, and continuity in addition to or instead of penetrative sex. This also appears to be characteristic of relationships involving two (older) women. As the world's population over 50 continues to grow there is an increasing interest in older adult's sexuality. This signals progress toward understanding healthy sexual relationships. IntroductionUntil recently, the research literature on later life sexual activity has been dominated by studies identifying physical and mental health barriers. The sexual expression of typical, healthy older persons is a relatively neglected topic of research, which makes it difficult to develop generalizable models of sexual relationships in later life. We cannot provide accurate information and support for older persons who wish to remain sexually active, or provide evidence-based advice to individuals and couples seeking counseling. There are little data on the potential benefits of sexual activity for quality of life. Data on which to base policy decisions regarding housing, sexual health care, and related programs for this age group are also limited.We begin this review with a brief discussion of measures of sexuality. Next we summarize the data consistent with the medical model, focusing on ageing, physical health, mental health and medications as influences on sexual activity. In this context, we review the literature on sexual dysfunctions. Then we turn to research based on the alternative biopsychosocial model, focusing on attitudes, relationship status, and quality of relationship as important influences. We will review the limited literature on two new topics of research, the impact of human immunodeficiency virus (HIV) on sexual functioning and

Sexuality in Older Adults (65+)—An Overview of The Recent Literature, Part 2: Body Image and Sexual Satisfaction

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Biopsychosocial Approach — A Modern Demand for Interdisciplinarity

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The Effectiveness of Sexual Enrichment Counseling on Sexual Assertiveness in Married Women: A Randomized Controlled Trial

“…This makes women, despite legitimizing their relationships in marriage, to be in conflict with their sexual assertiveness or lack of it. Researches on self-expression revealed that when people trust each other and express their thoughts and feelings, they may develop an intimate relationship and this improves the sexual intimacy of couples and help them enjoy their sexual relationship more (21).…”