Introduction
We all remember our first love, the first kiss and the seemingly huge efforts we were willing to make for the loved one. When we are young, we love intensely and our energy, both physical and mental, is at sky-high levels. In this article I address the mental, emotional and spiritual components that managed to keep up our efforts we invested for the loved one, as well as the physical, hormonal, physiological aspects such as muscle tone, which were at their once-in-a-life-time high in our youth and tremendously contributed to a sex life with a drive which felt out of this world.
In a first step, I explain what happens with the passage of time, why our physical energy decreases, but also the ways in which we can recover it, the vitality and enthusiasm of our youth, in order to be able to enjoy life once again as we get older and, in an almost ironical twist of fate, regain our appetite for love. While the physical part, i.e., hormonal, biological aging, general physiological health, has indeed its own effect over time on our lives, there is also the unseen dimension: the mental, emotional and spiritual factors which impact our quality of life, in particular our sexual drive, as to be detailed in the second part of this article.
Beyond the causes discussed further below, cultural factors can have an additional major importance in sexual dysfunctions among women, being a consequence of the national and/or local culture, customs, on top of other factors such as pollution, nutrition and other people’s influences. (https://pubmed.ncbi.nlm.nih.gov/29929499/)
1. The physical part
The hormones
The natural aging process includes the menopause phase in women, which is strongly positively correlated with the decrease in sexual activity in women. (1) In men’s case, the aging process comes with a decrease in testosterone, equally contributing to the gradual reduction of the sexual activity. Testosterone and estrogen are the main drivers of sexual appetite, so maintaining a balanced hormonal level is important for both women and men.
Luckily, with the progress of science, new supplements and therapies have emerged, able to re-balance the hormonal level, such as testosterone replacement therapy for men and an increasingly wide range of supplements which can help re-balance hormones in women, which contain minerals such as magnesium, vitamins such as vitamin D3, B, and essential extracts. It is essential that a specialist recommends these supplements in addition to an accommodating diet as women age.
In a nutshell, it is fully normal to have lower sexual activity for both men and women as they get older, but poor(er) health is a major factor to decreased sexual activity. (2)
Aging
The older we get, our body inevitably goes through the natural aging process which will naturally reduce our sexual activity, as proved by a study conducted on 1.680 participants over the age of 60 by Swedish National Study on Aging and Care: Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adults ≥60 Years of Age (2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072140/). Sexual activity among study participants decreased to 70% for those aged 60-66 up to 10% for those 90 years old and above. Thus, although the number of older adults is growing quickly, we still do not know much about their sexual activity and satisfaction. The study aimed to explore sexual activity and satisfaction in people aged 60 and older, while also looking at how factors like age, gender, living arrangements, income, education, physical ability, and health affected these aspects. Researchers collected and analyzed data from 1,680 participants over 60, taken from the Swedish National Study on Aging and Care, and involved statistical tests in order to understand the relationships between different factors. Among key findings, it was revealed that about 10% of participants aged 90 and older were still sexually active: in the entire group, 46% of people were sexually active, with more men (55%) than women (40%) reporting sexual activity, but with men more likely to report being dissatisfied with their sex lives compared to women. Overall, 24% of the participants expressed dissatisfaction with their sexual lives. Sexual activity and satisfaction were higher in those who reported better health and lived with a partner. In conclusion, sexual activity continues throughout life, even into one’s 90s, with about 10% of people older than 90 remaining sexually active. Men were more likely to report dissatisfaction, while women tended to be more satisfied with their sex lives. Most importantly, the findings suggested that healthcare professionals should consider addressing sexuality when caring for older adults.
Like in all the articles published on Vitixa, we do our best to look at the positive side and discover things which can help us be among those people who benefit from the advantages of technology and science: after all, why not being one of the lucky 10% of the 90-years olds who are still sexually active, like those participants in the Swedish study mentioned above, thus enjoying life at its fullest for as long as possible?
Food
We all are fully aware that the foods we ingest have a direct impact on our health: moreover, the specialized literature analyzes quite intensively the relationship between nutrition and sexual activity. A positive correlation results from the triangle made up by an active sexual life, our mental state which is crucial and the food we eat, which in turn has a very strong impact on our mental state. The positive mood following the consumption of healthy, unprocessed food causes, more often than not, states of joy and almost euphoric well-being, which can, indeed, actually increase sexual appetite. Diets rich in unprocessed products and vegetables stabilize blood sugar and give a constant and constantly high level of energy while simultaneously reducing the level of anxiety and stress (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299929/#bibr1-15598276211007113). In this concern, it has been proven that the Mediterranean diet, based on fruits, vegetables, nuts, whole grains and olive oil and fish, among its many benefits such as anti-inflammatory effects due to its richness in monounsaturated fats and complex (refined) carbohydrates and antioxidants, is negatively correlated with sexual dysfunctions in women as well as their fertility: thus, in addition to aging, certain lifestyle factors that are difficult to change, such as smoking, high caffeine and alcohol intake, stress, intense sports, ongoing exposure to environmental pollutants, and poor eating habits, can negatively affect a woman’s fertility.
Metabolic issues like diabetes, obesity, and high cholesterol – often linked to high-calorie diets – are thought to harm fertility (https://pubmed.ncbi.nlm.nih.gov/31547562/). They may either directly damage egg health or interfere with the hormonal system that controls egg development. Obese women, in particular, often have reduced sensitivity to insulin, leading to high insulin levels, which may contribute to Polycystic Ovary Syndrome (PCOS). Because of this, adjusting one’s diet to improve insulin sensitivity can be a helpful, drug-free way to prevent infertility.
Following a Mediterranean diet to maintain a healthy weight may also help protect the ovaries and their function. Additionally, oxidative stress, which can impair egg maturation, may be reduced by consuming enough protein, antioxidants, and specific supplements, which can help protect egg health (https://pubmed.ncbi.nlm.nih.gov/31231310/).
General health
General health has a major importance in sexual activity. Serious diseases such as surgical interventions, cardiovascular diseases, cancer, diabetes, hypertension are associated with sexual inactivity. Maintaining optimal health is essential: two studies addressed this issue frontally. The first study – The association of physical and mental health with sexual activity in older adults in a retirement community (2013, https://pubmed.ncbi.nlm.nih.gov/23981252/) – started from the assumption that understanding sexual activity in older adults is important when looking at their overall health, but not much research has focused on how specific health issues affect whether older adults remain sexually active, so that its authors looked at how mental and physical health conditions were linked to sexual inactivity in people aged 55 and older living in The Villages, Florida. Methodologically, the study included 22,654 adults aged 55 and older, with 1,879 participants over 80 and examined the relationship between 22 different self-reported health issues and sexual inactivity.
The researchers used a method called “logistic regression” to assess how likely people were to be sexually active, considering their health conditions. They looked at men and women separately. Other factors included age, race, education, income, overall health, and marital status. The following were the key findings:
- About 55% of men and 45% of women said they were sexually active.
- People who walked at least 1-2 times a week, joined clubs, stayed socially and physically active, didn’t smoke, took fewer medications, drank alcohol moderately, and reported good mental health or strong social support were more likely to be sexually active.
- Sexual inactivity was linked to serious health issues such as cancer, bladder and bowel problems, major surgeries, poor vision, mental health conditions, heart disease, diabetes, high blood pressure, and high cholesterol.
- For men, sexual inactivity was also linked to hearing loss and dementia. For women, additional factors included skin conditions, joint or back problems, gastrointestinal issues, alcohol misuse, chronic wounds, and gum disease.
In conclusion, one might assert that both mental and physical health issues have a similar impact on sexual inactivity in older men and women. On the other hand, staying sexually active was connected to better physical, social, and emotional well-being.
The starting point of the second study – Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms (2018, https://pubmed.ncbi.nlm.nih.gov/29929499/) – was the fact that female sexual dysfunction is a common issue affecting 41% of women of reproductive age worldwide. While the causes of this problem are complex and differ from country to country, understanding the risk factors and ways to prevent it can help healthcare professionals identify women who may be at risk and suggest changes to reduce the likelihood of sexual dysfunction. Methodologically, researchers reviewed studies conducted between 2000 and 2014 that looked at how common female sexual dysfunction is and what factors predict it in women of reproductive age. They analyzed the main causes of sexual dysfunction, focusing on the type of sexual practices and the level of development in different countries. Furthermore, the review included 135 studies from 41 countries, but brought forth that the factors which influenced female sexual dysfunction varied depending on where the study was conducted, the type of sexual norms in the region, and the level of gender inequality. Common risk factors linked to sexual dysfunction included poor physical and mental health, stress, abortion, genital problems, female genital mutilation, dissatisfaction in relationships, past sexual abuse, and religious beliefs.
Protective factors that helped prevent dysfunction included getting married at an older age, regular exercise, daily affection, open communication with a partner, having a positive body image, and receiving sex education. On the other hand, some factors, like age, education, employment, being in a relationship, race, alcohol use, smoking, and masturbation, had uncertain effects. Conclusively, it could be argued that female sexual dysfunction significantly affects women’s sexual and reproductive health, with various biological, psychological, and social factors contributing to this issue. Healthcare providers should be aware of the many risk factors affecting women of reproductive age and future prevention efforts should focus on addressing changeable factors like promoting physical activity and improving access to sex education, while continuing international efforts to empower women.
2. The unseen side
Emotional factors
Stress, anxiety
A holistic approach is necessary to take good care of ourselves and for a better understanding of the multiple factors that can affect our sex life. Unfortunately, beyond the physical ailments there is also this unseen part of which different emotional problems are part, which can affect our quality of life, such as anxiety disorders. In the case of women, anxiety can lead to reduced lubrication and in the case of men to a weak erection. As detailed by Giogio Corretti, MD, and Irene Baldi, MD, in their 2007 study The Relationship Between Anxiety Disorders and Sexual Dysfunction, anxiety is a feeling of worry and fear that can come with physical, mental, and emotional symptoms. While it is normal to feel anxious when facing stress or danger, some people seem to experience intense anxiety even during everyday activities, which can lead to distress and interfere with their daily lives.
Anxiety disorders are a group of conditions where anxiety is unusually high and is the main issue. These include panic attacks, specific phobias (like fear of heights or public speaking), social anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), acute stress disorder, and generalized anxiety disorder. Sexual dysfunctions (SDs) refer to problems that affect different stages of the sexual response, including desire, arousal, and orgasm, as well as issues related to pain during sex, as described in the DSM (Diagnostic and Statistical Manual of Mental Disorders).
Equally relevant, in the study The relationship between daily hassles and sexual function in men and women (2014, https://pubmed.ncbi.nlm.nih.gov/24313631/), psychological stress can interfere with sexual function in both mental and physical ways. Long-term stress, in particular, tends to negatively impact sexual health for both men and women. Their research aimed to identify different types of stress that contribute to sexual difficulties and to explore how anxiety and depression play a role in the connection between stress and sexual function. To this end, participants took an online survey, answering questions about their daily stress, anxiety, depression, and sexual function. The results showed that daily stress was linked to lower sexual satisfaction for both men and women and reduced sexual activity for women. Depression played a key role in these effects: the study found a strong connection between daily stress, depression, and anxiety. After analyzing the different types of stress, researchers identified five main categories. Among these, financial stress and stress from having a lower socioeconomic status were linked to lower sexual function for women, but not for men. Overall, women’s sexual health was more strongly affected by stress and depression compared to men. The findings suggest that everyday stress and emotional factors like depression should be considered when addressing sexual health problems.
A further study – A biopsychosocial approach to women’s sexual function and dysfunction at midlife: A narrative review (2016, https://pubmed.ncbi.nlm.nih.gov/27013288/) – addressed that general knowledge that a satisfying sex life is an important part of overall well-being, but sexual problems are common, especially for women in midlife. Thstudy aimed at explaining what sexual function and dysfunction mean, introducing theories about female sexual response, looking at studies on how sexual function changes as women age, and exploring treatment options. Currently, there are four recognized types of female sexual dysfunction:
- Difficulty reaching orgasm (Female Orgasmic Disorder)
- Lack of interest or arousal (Female Sexual Interest/Arousal Disorder)
- Pain during sex (Genito-Pelvic Pain/Penetration Disorder)
- Sexual dysfunction caused by substances or medications.
It is important to underline the fact that good sexual health is more than just the absence of problems. A holistic approach that considers physical, psychological, social, and relationship factors is needed to understand and treat sexual health in women. Thus, most long-term studies show that as women go through menopause, their sexual function often declines, with other factors, such as having a partner, the quality of the relationship, and mental health, also playing big roles. Future research should focus on understanding how sexual function changes as women age and finding safe, effective ways to support healthy sexual function during midlife, so that a holistic approach is needed to fully understand and improve sexual health for midlife women.
The involvement in social activities such as clubs (e.g., dancing, sports, reading associations) can help and is positively correlated with increased sexual activity, as it is important to lead an active social life, meeting people, relating to them and proactively avoid isolation. Moreover, expressing yourself through dance and communicating with other people helps us relax, improve our mood and pay better attention to our partner. Initiating pleasant activities with your partner leads even more to getting closer to him and increasing the attraction within the couple, which leads to restful calm, joy in togetherness and an overall sense of pleasure in each other’s presence – all essential ingredients to stimulating sexual desire.
Rest and long sleep is positively associated with an enhanced sexual drive for the next day and simply as little as one additional hour of sleep can increase the chances of initiating a sexual act with our partner by 14%. In one study – Association between sexual function in women and sleep quality (2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457145/) –, the link between sexual problems and sleep disorders in women was explored. Methodologically, the study was carried out in 2021 and 2022 with 975 women in Spain, all over 18 years old. To gather information, the researchers used the Women’s Sexual Function Questionnaire (FSM-12) and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Both simple and detailed analyses were conducted, taking into account other factors that might affect the results. The odds of having sleep problems were measured before and after adjusting for these factors. The results showed that about 29.2% (285 women) reported some form of sexual dysfunction, while 73.4% (716 women) had sleep disturbances, as indicated by a score of 5 or higher on the PSQI. The average PSQI score was 8.23 points. Nearly all aspects of sexual function were significantly related to sleep disturbances, except for sexual activity and non-penetrative sexual activity. In the detailed analysis, women with sexual dysfunction were almost twice as likely (1.88 times) to have sleep problems compared to women without sexual dysfunction. Overall, sexual dysfunction is closely linked to poor sleep quality, affecting almost all areas of sexual function.
Likewise, another study – The Impact of Sleep on Female Sexual Response and Behavior: A Pilot Study (2015, https://onlinelibrary.wiley.com/doi/abs/10.1111/jsm.12858) – attempted at filling a gap in the research: the long-time overlooked connection between sleep problems and sexual difficulties. So far, research had shown that poor sleep quality and shorter sleep can negatively affect women’s sexual responses. However, most studies had been one-time snapshots, and the effect of sleep on sexual function over time has not been thoroughly explored. The study aimed to examine how nightly sleep duration, quality of sleep, and the time it takes to fall asleep impact women’s daily sexual response and activity. It followed 171 women in the United States who were not on antidepressants and had stable internet access. After completing initial tests in a laboratory, participants filled out online surveys each morning for 14 days. These surveys measured sexual desire, arousal, orgasm, and whether they had any sexual activity with a partner or through self-stimulation. The results showed that getting more sleep was linked to higher sexual desire the next day. For every extra hour of sleep, the chances of engaging in sexual activity with a partner increased by 14%. However, longer sleep was also linked to lower genital arousal the next day. Despite this, women who generally slept longer over the 14 days reported better overall genital arousal than those who slept less. In conclusion, getting enough sleep is important for boosting sexual desire, genital response, and the likelihood of having partnered sexual activity. These findings were consistent regardless of mood or fatigue during the day, and future research could explore whether sleep disorders contribute to sexual problems.
Notably and naturally, simply avoiding or at least reducing stressful activities can have a positive effect on one’s sex life.
Spiritual factors
Relaxation, observing the thoughts and emotions and paying attention to the sensations in such procedures as meditation and the resulting activation of the senses as well as those of one’s partner seem to improve both the sexual and the romantic relationship. In one study – The role of sexual mindfulness in sexual wellbeing, relational wellbeing, and self-esteem (2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640099/) –, the researchers looked at how being mindful during sexual experiences affects sexual satisfaction, relationship satisfaction, and self-esteem. The research involved 194 married, heterosexual men and women in the U.S. (50.7% women, mostly Caucasian, aged 35–60), who took an online survey. The findings revealed that people who were more mindful during sex generally had higher self-esteem, were happier with their relationships, and, especially in women, were more satisfied with their sex lives. These connections were present even when accounted for overall mindfulness, and the insights could help researchers and therapists improve individuals’ sexual and relationship well-being by teaching sexual mindfulness techniques.
Conclusion
Age should not – may not – be an impediment to being healthy, strong and having an active sexual life: evidence-based study scientific studies prove this fact. Just like in the Swedish study, which shows that over 70% of people between the ages of 60 are sexually active, with 10% keeping their sexuality dynamic even after turning 90, by taking care of ourselves holistically, we can keep on living fulfilling happy lives until the inevitable end. This perspective gives us all great hope that we can wholeheartedly enjoy the essential activities and sensations of youth even as we inexorably and naturally age, with the added benefits of wisdom and benevolence brought forth by a life well lived: nonetheless, we must take care of our body, mind and spirit in order to be able to love in old age as much as we did in our youth – or maybe even more!
