Geriatric sexuality

Abstract

The older population of the United States aged 65 years is expected to rise significantly to almost 55 million by 2020. Several studies have shown that a large percentage of men and women are sexually active into their 70s and 80s even though more than 50% of them have at least 1 bothersome symptom. Despite these issues, sexuality is rarely addressed in the health care setting: according to a major healthcare survey, only 38% of elderly men and 22% of women have had discussions about sex with a physician since age 50. Major contributors to this barrier to adequate diagnosis and treatment of sexual disorders in older adults are the perpetual myths regarding sex in aging individuals (i.e., erectile dysfunction is a normal part of aging). In this chapter, we hope to provide essential information to urologists and primary care physicians to correct this gap. We present an epidemiologic overview to allow clinicians to appreciate the extent of the problem and its consequences on a geriatric health. We also provide valuable clinical pearls to help physicians more comfortably address sexual dysfunctions in their office. Lastly, we summarize the literature behind a multitude of treatment options currently available. It is our hope that clinicians can integrate this knowledge and provide the best individualized care for their patients’ needs.