Let's Talk About Sex: In Your 50s

Once you reach your 50s, you may need more stimulation to achieve an erection or orgasm. But what's the hurry? More foreplay and masturbation can make sex more intimate.

Carol Queen, Ph.D., staff sexologist at San Francisco-based Good Vibrations and author of "The Sex & Pleasure Book: Good Vibrations Guide to Great Sex for Everyone," said this decade of life tends to pose more health challenges: in women, the impacts of menopause, and in men, erectile issues. But age doesn't define your sex life. Yes, it can throw some additional physical and hormonal challenges into the ring, but many people find sex gets better with age. There are even some health benefits you may not have considered.

For instance, sex is a form of exercise, and having it regularly might come with both physical and mental health benefits. In 2019, researchers from University College London spoke to 2,577 men and 3,195 women ages 50 and older about their sex lives. According to the results, participants enjoyed life more when they were sexually active. Plus, men who continued to have a busy sex life as they aged had better cognitive performance than those who didn't.

To help you reap those benefits, experts have some advice on maintaining a healthy sex life despite age-related challenges.

Justin Houman, M.D., reproductive urologist and men's health specialist at Tower Urology in Los Angeles, said erectile dysfunction becomes more common once you reach your 50s, affecting 50 percent to 60 percent of men.

"As men age, erections aren't as strong as they were before, therefore, there could be a drop-off in sexual satisfaction," Houman explained. "Also, refractory time increases as we age, meaning there is a longer time period before we can get aroused again."

Men must realize that as they get older, they should probably expect to have erection issues, said Michael Werner, M.D., medical director and founder of Maze Men's Sexual & Reproductive Health, based in New York City and Purchase, New York.

"If you know it might happen and you're not embarrassed about it, you can seek treatment early," Werner said. "People aren't embarrassed about getting other age-related conditions, like cataracts or osteoarthritis, so accepting you might have erection issues means you can manage it.

"There's always a way to treat erectile problems, so don't get discouraged if you try a medication and it doesn't work," he added. "A specialist in reproductive health can talk you through all your treatment options. Basically, if you have a penis, we can get you hard."

However, Queen noted it's important to remember that having an erection is not essential and may not be what your partner needs for good sex—especially if the presence of the erection means other arousing activities are neglected.

"An erection does not necessarily provide optimal pleasure to either partner, and if there are sexual changes to arousal and sensation, working with both of those will be at least as important as the presence of an erection," Queen explained.

It's also worth remembering that if your partner is similar in age to you, they're likely experiencing changes to libido, too. Communication is vital to make sure you're on the same page about sex.

The average age of women going through menopausal transition is 52, said Linda Burkett, M.D., a physician in the obstetrics and gynecology department at VCU Health in Virginia who specializes in pelvic health and urogynecology.

"Perimenopausal years can be plus or minus five years from the average, so it's a huge period of time that women will notice changes," Burkett said.

A reduction in hormones through menopause, plus a changing metabolism and energy levels, can cause a drop in libido.

"And it affects women in different ways which can impact sexual health, such as mood, increased anxiety and increased irritability, making sexual relations more challenging," Burkett added.

In addition to the hormonal and emotional impact of menopause, there are also physical concerns to consider.

"It's not unusual for women in this age bracket to begin developing urinary tract infections due to a decrease of estrogen and changes to the vaginal flora," Burkett said, noting that you should speak to your OB-GYN if UTIs recur.

Hormonal treatment options—such as vaginal estrogen in cream, oil and insertable forms—and nonhormonal treatment options alike can help with menopause-related UTIs. Your OB-GYN can help you get to the root cause of the problem and find the best treatment option for you.

"The genitourinary tract lining can become thinner, more friable, dry and more easily irritated, so a lubricant can make a big difference when having sex," Burkett said. "Coconut oil is a fantastic natural lubricant, and I recommend it to a lot of women."

However, keep in mind that coconut oil is not latex condom-compatible, and some people may have sensitivities to it. Queen advised using a water-based lubricant if you want to avoid oil.

Finally, if you're thinking about hormonal management for menopause, Burkett advised that it's safest to begin during or very soon after menopause.

"The biggest risks come when you have a period of no hormone and then [you] add hormones," Burkett explained. "Suddenly adding hormones that your body didn't have before increases the risk of things like a blood clot, stroke or heart attack."

If you decide to explore hormonal treatment options, it's better to speak to your OB-GYN sooner rather than later.

"However, there are some great nonhormonal treatment options," Burkett added. "These can work on brain receptors which help with mood and sexual desire, which can be very effective during menopause."

If menopause affects your sex life, there are several different types of treatment available—hormonal and nonhormonal—that can help make sex more comfortable and desirable. For many couples, age improves communication and intimacy, leading to better sex, so don't let menopause halt your sex life.