Relationships and sexual expression in later life: a biopsychosocial perspective

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.