Sexuality is important for the well-being and quality of life of elderly people and, as such, should be understood and treated by health professionals. Almost all older people want and can enjoy an active sex life and satisfactory regular sexual activity helps to maintain sexual capacity. However, with the passage of time, people realize that their reactions become slower. This is part of the normal process of aging. When the changes occur gradually, the symptoms are commonly associated with the organic causes of sexual dysfunction related with aging.
In the case of women, the deterioration of sexual desire (decreased libido) or sexual arousal can have a hormonal cause: a decrease in the level of estrogen below normal. Decreased desire and/or sexual arousal may be attributable, in many cases, to a combination of psychological factors and clinical conditions. The typical symptoms of menopause (hot flashes, night sweats, insomnia) may compromise sexual desire, as well as vaginal discomfort and pain from inability to get an adequate response from lubrication and numbness during sexual intercourse. Social, cultural, ethnic and religious characteristics can also influence the expectations and attitudes of women regarding sexual performance.
In men, there is little or no motivation for sex. The patient does not take the initiative, but gets involved when stimulated. This condition can be attributed to a combination of psychological factors and clinical conditions, and occur associated with another dysfunction (eg, difficulty reaching orgasm). In older men, the decrease in sexual desire may be associated with decreased testosterone levels, fatigue or side effects of some medication. It is well known that SSRI antidepressants (among those that are fluoxetine, sertraline and paroxetine) can reduce libido in men. Depression and anxiety may be associated with the onset of the problem or be consequence of it.