Sexual health


Good sex is about more than just having an orgasm. It contributes to relaxation, gives you pleasure, improves self-esteem. A healthy sex life can increase closeness and intimacy with your partner. Sexual activity contributes to a positive attitude toward life, increasing one’s happiness and optimism. These positive effects may in addition reduce coronary heart disease risk and the risk of mortality..

Sexual function changes for everyone as we age. These changes can add stress to a person’s life. These changes reflect decreases in sex hormones. This results in it taking longer to become aroused and achieve orgasm. In men it takes longer to get an erection. Women may have vaginal dryness. These changes can cause sex to be a challenge. Also, illnesses associated with aging can reduce one’s sexual activity. A clear example is arthritis which can make it difficult to get into sexual positions. Heart disease can make it tiring to have sex. The inability to maintaining an erection makes condom use difficult.

Sexual activity has many forms that include insertive sex, kissing, touch, intimacy and even just holding a person’s hand. The desire to have sex is continuous throughout life. This desire is best expressed by partnering, sharing the joys of sexual intimacy. The frequency of sexual activity, if it occurs at all, is a function of partner availability. Couples who are married or partnered have the highest rates of sexual activity. 

What to do with your doctor

Unfortunately, your doctors may not ask you about sex. This likely reflects the assumption that older adults do not have sex at all. Your physician may be reluctant to talk about sex and safer sex with someone of their parents’ age. The best advice is to not wait for your doctor to ask. Talk frankly about your sex life and any issues you have. With this proactive approach you will discover what you need to stay healthy and maintain a satisfying sex life. Addressing any issues early makes them more manageable before they become a serious problem.

Ask if your sexual problems may be a side effect from a drug or combination of drugs.

Some medications can reduce sexual desire or response. Ask if any of your meds can cause sexual problems, and if you can switch to ones with fewer side effects. Ask your 


doctor to evaluate whether you might have a hormone deficiency. Certain meds might help with sexual desire or erections. 


PrEP (Pre-Exposure Prophylaxis) is a medication for HIV-negative people that reduces the risk of getting HIV. It is close to 99% effective in preventing HIV if it is taken every day. But it does not prevent other STDs (Sexually Transmitted Diseases), and is meant to be used with condoms, not instead of them. Ask your doctor if PrEP might be right for you or your partner.

What you can do yourself


When your other conditions are not controlled, you may not feel well enough to enjoy sex. Take the right number of pills at the right time of day. This is especially important for PrEP, ART and all medications which must be taken every day to be effective. If this is difficult, use a pillbox or alarm to remind you.


Condoms protect you from STDs and prevent the spread of HIV. In HIV discordant couples maintain optimal ART use to prevent transmission. PrEP is designed to be used with condoms, since it does not protect against STDs.