By KBC Associate 
When it comes to older people having sex, the conversation is often swept under the rug—like passion and pleasure are reserved only for the under-40 crowd. That couldn’t be further from the truth.
The reality is, older adults are still having sex—and want to keep having it. Maintaining a healthy sex life as we age doesn’t just support connection and confidence, it also plays a key role in physical and emotional well-being.
We spoke to Dr. Martina Ambardjieva, MD, urologist, and PhD graduate, to break down the facts around sexual health for the aging population—and how to keep things sizzling, no matter what birthday you’re celebrating next.
Older People Having Sex: What Physical Changes Come with Age—And How to Navigate Them
Let’s face it: bodies change with age, and sex changes along with them; however, that doesn’t mean it disappears. In fact, understanding those changes is the first step to working with them—not against them.
“The first group of causes includes pathological conditions that affect blood vessels, such as diabetes, atherosclerotic plaque, inflammatory diseases, and thrombosis,” says Dr. Ambardjieva. Keeping these conditions under control with proper medication, healthy eating, and regular physical activity can help maintain sexual function and confidence.
Hormonal shifts are another key factor—particularly testosterone levels in men and estrogen levels in women. “In such cases, testosterone replacement therapy may be beneficial,” she adds. Women experiencing vaginal dryness from decreased estrogen can turn to gels, tablets, and lubricants to ease discomfort.
For men recovering from prostate surgery, nerve damage can take time to heal, but options like Kegel exercises, vacuum erection devices (VEDs), or even intracavernosal injections may help. “In some cases, a penile implant may be necessary,” Dr. Ambardjieva explains.
Plus, let’s not ignore psychological factors. Stress, anxiety, and performance pressure can all mess with libido, which is why regular movement and professional mental health support can be game changers.