The first comprehensive, nationally representative survey on the prevalence of sexual activity among older Americans is in - and they are having a lot of sex.

Americans ages 57 to 85 are sexually active and view intimacy as an important part of life, despite a high rate of “bothersome” sexual problems, according to a new report in The New England Journal of Medicine.

Stacy Tessler Lindau, M.D., who conducted the study with Linda Waite, Ph.D., and others at the University of Chicago, expects the study to help open a dialogue between older patients and their doctors as older Americans were very receptive to the survey and its questions. This openness suggests that, when asked, many older people want to talk about this part of their lives.

“We found, despite the high prevalence of problems, that most older adults have never discussed sex with a physician. From a medical and a public health perspective, we have an opportunity and an obligation to do better patient education and counseling about health-related and potentially preventable and treatable sexual problems,” Dr. Lindau said.

The researchers gathered information from a nationally representative sample of 3,005 men and women ages 57 to 85 years, asking about each person’s marital or other relationship status, frequency and types of sexual activity during the past 12 months, physical health, and communication with a physician about sex. They also queried sexually active respondents about the presence of sexual problems.

The study found that many older adults are sexually active, but about half of the men and women surveyed reported at least one sexual problem and about a third report at least two problems. Specifically:

• In general, older adults are sexually active. A large portion of respondents said they were sexually active in the preceding 12 months, but the percentage declined with age—from 73 percent of those age 57 to 64, to 53 percent of those age 65 to 74, to 26 percent of those age 75 to 85. Older women, however, were significantly less likely to report sexual activity than older men and less likely to be in intimate relationships, due in part to women’s status as widows and the earlier mortality, on average, of men.
• Healthier people are more likely to report being sexually active. Eighty-one percent of men and 51 percent of women reporting excellent or very good health said they had been sexually active in the past 12 months. Of those in fair or poor health, a considerably lower percentage (47 percent of men and 26 percent of women) reported activity in the previous year. Diabetes and hypertension were strongly associated with some sexual concerns.
• About half of sexually active older adults report at least one “bothersome” sexual problem. Thirty-seven percent of sexually active men said they had erectile difficulties. Women most often reported low desire (43 percent), difficulty with vaginal lubrication (39 percent), and inability to climax (34 percent).
• Most older adults have not discussed sex with their doctors. Despite the high prevalence of sexual problems, only 38 percent of men and 22 percent of women said they had discussed sex with a physician since age 50.

“Despite the aging of the population, little had been known about the intimate lives of older adults,” said NIA Director Richard J. Hodes, M.D. “This study expands our knowledge by reporting, on a national scale, data about sexual functioning and health among older adults.”

"A national study of sexuality and health among older adults in the U.S.", Lindau, S.T., et al. New England Journal of Medicine (2007), 357(8):762-774.