Let's Talk About Sex: Over 65

According to Michael Werner, M.D., medical director and founder of Maze Men's Sexual & Reproductive Health, based in New York City and Purchase, New York, the most common concerns men face with regard to sexual health in later years are:

• A decrease in testosterone levels
• A decrease in libido
• More erectile dysfunction (ED) problems
• Taking longer to climax, especially through intercourse
• Difficulty sustaining an erection, shortening the duration of sex

All of these occurrences are perfectly normal and natural. You might not have the same sexual desire you did when you were younger, which is OK. Hormonal changes, medication, physical impairments and illness over various periods of your life can all contribute to a lower sex drive for both men and women.

Queen noted it is very common for men to need direct physical contact to get aroused and erect, as compared to when they were younger.

"If a man and his partner don't expect this, they may not discover it on their own, both waiting for an erection to present itself," she said. "[All that's needed] is some pleasurable touch."

If you are struggling with low libido, low mood or sexual dysfunction problems and feel it's affecting your relationship, don't hesitate to speak to your healthcare provider. Don't be embarrassed—your doctor has heard your story before, likely many times. They can guide you through treatments and lifestyle adaptations that can help you rekindle your sex drive if that's what you'd like to do.

Justin Houman, M.D., reproductive urologist and men's health specialist at Tower Urology on the Cedars-Sinai Medical Center campus in Los Angeles, stressed that anything good for your heart health is good for your sexual health. He recommended the following three key strategies to maintain healthy sexual function:

• Eat a healthy, balanced diet including lean protein, green leafy vegetables, fruits and complex carbohydrates.
• Sleep around seven to nine hours each night, beneficial for both testosterone levels and mood.
• Get at least 20 to 30 minutes of cardiovascular exercise five days a week.

"If you continue these three lifestyle elements over the years, the decrease in sexual function will be much slower," Houman explained. "And don't forget, these lifestyle tips are equally important for women, not just men."

Burkett observed that for women, the 60s are a great age for sex.

"Women who may have struggled with menopause have now come back to feeling fabulous," she said. "They often feel more confident in their bodies and start to do what they really want with their time."

According to Burkett, genital nerve endings may become less sensitive at this age, so having the same form of vaginal intercourse might not be the best option for achieving pleasure.

"Things on the outside, though, will still be working just fine," Burkett said. "So masturbation, adding vibrators, and giving yourself permission to try new toys and activities can be important at this stage of life."

If you haven't had sex in a long time, it can be uncomfortable when you resume. Queen advised masturbation to keep the genitals feeling their best.

"We do sometimes prescribe women vibrators at this age as it stimulates blood flow," Burkett said. "Using a vibrator regularly can help your vagina stay healthy."

Many people find they become more comfortable with masturbation as they age because they're more comfortable with their body.

"Therapists frequently see midlife-and-older people who have stopped having any kind of sex for a period of time and then find a new partner," Queen said. "It can be easier for them to resume partnered sex if they have continued masturbation while they were single."

Masturbating can be a great way to figure out what you really enjoy. You're never too old to experiment and try new things and you're definitely never too old to enjoy sex toys. Taking time to experiment with your own body can be beneficial for sex in your relationship, especially when you share those discoveries with your partner. You may find your definition of sex begins to evolve, too. Many people forget women don't need penetrative sex to orgasm, just as men don't need an erection to orgasm.

You've heard it before, but communication is key. If you don't talk about sex, your body and what makes sex pleasurable, you won't be able to adapt to all that's happening to your body. Sex may look a little different than it used to when you get older, but you can experience just as much pleasure—maybe more—as you did when you were younger.