Research shows low chance of sudden cardiac arrest after sex

A small percentage of sudden cardiac arrest events are related to sexual activity, but survival rates in those cases remain low, according to a research letter published today in the Journal of the American College of Cardiology and presented at the American Heart Association's Scientific Sessions 2017. Despite these sexual activity related SCA events being witnessed by a partner, bystander CPR was performed in only one-third of cases.

13 nov 2017--Sudden cardiac arrest (SCA) is when the heart suddenly stops beating; it usually occurs without warning. If not treated immediately it can lead to sudden cardiac death, which results in around 350,000 deaths annually in the United States. It is known that sexual activity may trigger non-fatal cardiac events such as myocardial infarction, but researchers in this study sought to determine if sexual activity is a potential trigger for SCA in the general population.
The researchers looked at the community-based Oregon Sudden Unexpected Death Study (Oregon SUDS) database from 2002 to 2015 to discover the frequency to which SCA occurred during or within one hour after sexual activity for all persons over the age of 18. All reported cases of SCA were based on emergency medical service reports containing detailed information regarding cause of the cardiac arrest event.
In total, the researchers identified 4,557 SCAs in Portland during the 13-year study period. Of these, 34 (0.7 percent) of SCAs were linked to sexual activity. On average, these patients were more likely to be male, middle-aged, African-American and have a history of cardiovascular disease, with a majority taking cardiovascular medication. Patients who experienced SCA related to sexual activity also had a higher rate of ventricular fibrillation/tachycardia than those who did not.
Only one-third of these SCA cases received bystander CPR. The researchers determined that the low bystander CPR rate accounted for the less than 20 percent of patients who survived to hospital discharge.
"Even though SCA during sexual activity was witnessed by a partner, bystander CPR was performed in only one-third of the cases," said Sumeet Chugh, MD, senior study author and associate director of the Cedars-Sinai Heart Institute. "These findings highlight the importance of continued efforts to educate the public on the importance of bystander CPR for SCA, irrespective of the circumstance."
Limitations to the study included unknown information surrounding the frequency of sexual activity, so researchers could not determine relative risk compared to rest and physical activity.
Overall, the study authors said they found a relatively low burden of SCA in relation to sexual activity. The majority of cases were men with a previous history of cardiovascular disease. The researchers also noted that some cases of SCA after sexual activity may also involve medications, stimulants and alcohol use.

More information: Aapo L. Aro et al, Sexual Activity as a Trigger for Sudden Cardiac Arrest, Journal of the American College of Cardiology (2017). DOI: 10.1016/j.jacc.2017.09.025 , dx.doi.org/10.1016/j.jacc.2017.09.025


Provided by American College of Cardiology

What sex is safe for heart patients: A new approach using the KiTOMI model

Heart Disease Patients: Decision-Tree to Sexual Activity. Credit: Canadian Journal of Cardiology

Changes in sexual satisfaction and decreases in sexual activity are often reported by heart patients. Both patients and partners may have misconceptions about the perceived dangers of sexual activities and commonly restrict their activities. However, in a new study in the Canadian Journal of Cardiology, researchers provide a comprehensive and updated review of the relevant literature and offer evidence- and expert-based practical recommendations regarding sexual activity in heart patients.

07 nov 2015--"Our extensive literature review enabled us to dismiss several myths regarding the advisability of sexual activity in heart patients," commented lead author Ricardo Stein, MD, DSc, of the Cardiology Division of the Federal University of Rio Grande do Sul, Brazil. "Overall, the risk of death during sex is very low for most clinically stable heart patients, and interestingly, even much lower for the women."
Sexual activity, particularly coitus, is a major aspect of health-related quality of life and is often considered the most pleasant and rewarding form of exercise performed. Sexual activity is typically well-tolerated by most clinically stable heart patients, who are typically advised to participate in exercise programs as part of their recovery plan. Occurrence of sudden cardiac death is very rare, corresponding to less than 2% of all exercise-related deaths.
Counseling regarding how to gradually resume habitual sexual activity is critical for patients who have experienced a cardiac event or undergone a cardiac procedure. Sexual activity encompasses several behaviors such as kissing (Ki), touching (T), oral (O), masturbation (M) and vaginal/anal intercourse (I). The authors propose the acronym KiTOMI to represent these behaviors.
"Our KiTOMI model will allow healthcare professionals to provide very simple and objective advice to their patients," explained lead investigator Claudio Gil S. Araújo, MD, PhD, of the Heart Institute Edson Saad, Federal University of Rio de Janeiro, and the Exercise Medicine Clinic - CLINIMEX. "In almost every case some type of sexual activity would be permitted. For patients whose condition is more debilitated, KiT would be the best initial option, progressively advancing to KiTOM until all KiTOMI activities are allowed."

Sexual Activity vs Walking: Comparing Efforts. Credit: Canadian Journal of Cardiology

Co-investigator, Aline Sardinha, PhD, also of the Federal University of Rio de Janeiro, noted that "Cardiac anxiety, the fear of cardiac-related stimuli and sensations, which are perceived as negative or dangerous, is common in heart patients and surely interfere with the resumption of a normal and regular sexual life." The authors emphasize the importance of sexual counseling to provide reassurance and reliable information for patients and their partners, including the proper use of medications to treat erectile dysfunction.
Recommendations resulting from this study are summarized in the following Decision Tree, which evaluates the patient's heart condition according to widely-accepted definitions, places the patient in one of three risk groups, and defines the advisable sexual activities for each group.
Putting these recommendations into perspective, the researchers equated various sexual activities with walking at different speeds, noting for example that orgasm is equivalent to a brisk walk across a street.
"Professional sexual activity advice should be offered similar to advice regarding the return to work and enrollment in an exercise program," emphasized Dr. Araújo. "KiT activities should be a component of positive sexual behavior toward a healthier sexual life and should be recommended for virtually all heart patients regardless of sexual orientation. Often considered 'taboo,' an objective discussion of sexual behavior in heart disease has often been put aside. Healthcare providers must break this vicious cycle."
More information: Ricardo Stein et al. Sexual Activity and Heart Patients: A Contemporary Perspective, Canadian Journal of Cardiology (2015). DOI: 10.1016/j.cjca.2015.10.010


Provided by Elsevier

New study reveals active sex lives of the over 70s

Older people are continuing to enjoy active sex lives well into their seventies and eighties, according to new research from The University of Manchester and NatCen Social Research.

28 jan 2015--More than half (54%) of men and almost a third (31%) of women over the age of 70 reported they were still sexually active, with a third of these men and women having frequent sex – meaning at least twice a month – according to data from the latest wave of the English Longitudinal Study of Ageing (ELSA).

The paper, lead authored by Dr. David Lee, an Age UK Research Fellow at The University of Manchester's School of Social Sciences and entitled "Sexual health and wellbeing among older men and women in England," is published in the American academic journal Archives of Sexual Behavior.

It is the first study on sexual health of its kind to include people over the age of 80 and uncovers a detailed picture of the sex lives of older men and women in England, finding that a sizeable minority remain sexually active in their old age.

Contrary to popular misconceptions, it finds that overall health and conflicting partnership factors were more closely linked to decreasing sexual activity and functioning, rather than simply increasing age.

Of the more than 7000 people who responded to the questionnaire, very few (less than 3%) declined to answer direct questions about their sexual activities and problems.

Dr Lee said: "This is the first nationally-representative study to include people over the age of 80 when asking older men and women in England about their sexual health.

"We hope our findings improve public health by countering stereotypes and misconceptions about late-life sexuality, and offer older people a reference against which they may relate their own experiences and expectations.

"Our ongoing research is also highlighting the diversity of late-life sexualities, and trying to impose youthful norms of sexual health on older people would be over-simplistic and even unhelpful.

"It is however important that health professionals act on this and are more open about discussing sexual health with older people – it can't simply be assumed to be an irrelevance."

Problems most frequently reported by sexually active women related to becoming sexually aroused (32%) and achieving orgasm (27%), while for men it was erectile difficulties (39%). Chronic health conditions and poor self-rated health seemed to have more obvious negative impacts on the sexual health of men compared to women.

Men were more concerned about their sexual activities and function than women and, with increasing age, these concerns tended to become more common. Sexually active women were less dissatisfied with their overall sex lives than men, and also reported decreasing levels of dissatisfaction with increasing age.

The study also found that many septuagenarians and octogenarians were still affectionate towards their partners, with 31% of men and 20% of women reporting frequent kissing or petting. Among those who reported any sexual activity in the past three months, 1% of men and 10% of women reported they felt obligated to have sex.

Caroline Abrahams, Charity Director at Age UK, said: "The fact this is the first time that people over 80 years old have been included in this kind of research highlights how often the public health needs of older people, including sexual health, are ignored or overlooked.

"With an ageing population it is important that providers of sexual health services understand the needs of older people in both clinical settings and when developing information and advice. These recent findings now need to be used to improve sexual health advice and information for older people."

Provided by University of Manchester

62 percent of men and 37 percent of women over the age of 65 are sexually active: Spanish study

There are gender differences among those older than 65, with less sexual activity in women compared to men. Credit: Jose Javier

A study based on the National Health and Sexuality Survey, involving nearly 2000 people, describes the sexual practices of senior citizens in Spain. The most common are kisses, caresses and vaginal penetration. The main causes of sexual inactivity are physical illness and widowerhood.

06 april 2012--A new study published in one of the world's biggest sexuality journals the Journal of Sexual Medicine analyses the factors that influence sexual activity amongst elderly people in Spain.

"This research lets us know the reality of a social phenomenon which is not tackled enough in Spain: sexuality and the elderly", Domingo Palacios, a researcher at the Rey Juan Carlos University in Madrid and main author of this study, explained to SINC.

The results, based on the National Health and Sexuality Survey, in which 1,939 heterosexual elderly people participated in 2009, show that 62.3% of men and 37.4% of women are sexually active. The most common practices are kisses, caressing and vaginal penetration. On the other hand, the least practised are masturbation and oral sex.

Furthermore, there are other factors that limit sexual activity in both sexes: being older than 75, not having a partner, having a low level of education, a poor perception of their own health and sexuality, suffering from two or more chronic illnesses and taking two or more types of medication.

"This can be applied to preventing illnesses and promoting health and healthy sexual practices", Palacios states. He highlights widowerhood and physical illness amongst reasons why the older Spanish population do not have sexual intercourse.

The authors note gender differences among those older than 65, with less sexual activity in women compared to men. They also note age differences, with better results for those aged between 65 and 74 than those older than 75.

The results support previous studies

This is not the first time that sexual health amongst the elderly has been measured. In 2006, a study published during the XXVI Spanish Family and Community Medicine Society (SEMFYC) Conference showed that 60% of people over the age of 65 said they had sex on average four times a month.

In that project, which was carried out with over 100 people by family doctors in Catalonia, the majority said that although their sexual intercourse had changed as a result of age, they were not "less satisfying".

Furthermore, new data backs up a survey carried out in the USA and published in 'New England Journal of Medicine' in 2008, in which 73% of Americans between 57 and 64 years of age had sex. The number dropped to 53% for those aged between 65 and 75, and dropped to 26% for those aged 85.

More information: Domingo Palacios-Ceña; Pilar Carrasco-Garrido; Valentín Hernández-Barrera; Cristina Alonso-Blanco; César Fernández-de-las-Peñas; Rodrigo Jiménez-García. "Sexual Behaviors among Older Adults in Spain: Results from a Population-Based National Sexual Health Survey". J Sex Med; 9:121-129, Jan 2012.

Provided by FECYT - Spanish Foundation for Science and Technology

Sexual activity is safe for most heart, stroke patients

If you have stable cardiovascular disease, it is more than likely that you can safely engage in sexual activity, according to an American Heart Association scientific statement.

21 jan 2012--The statement, published online in Circulation: Journal of the American Heart Association, contains recommendations by experts from various fields, including heart disease, exercise physiology and sexual counseling.

"Sexual activity is a major quality of life issue for men and women with cardiovascular disease and their partners," said Glenn N. Levine, M.D., lead author of the statement and a professor of medicine at Baylor College of Medicine in Houston, Texas. "Unfortunately, discussions about sexual activity rarely take place in the clinical context."

The recommendations include:

• After a diagnosis of cardiovascular disease, it is reasonable for patients to be evaluated by their physician or healthcare provider before resuming sexual activity.
• Cardiac rehabilitation and regular physical activity can reduce the risk of cardiovascular complications related to sexual activity in people who have had heart failure or a heart attack.
• Women with cardiovascular disease should be counseled on the safety and advisability of contraceptive methods and pregnancy based on their patient profile.
• Patients with severe heart disease who have symptoms with minimal activity or while at rest should not be sexually active until their cardiovascular disease symptoms are stabilized with appropriate treatment.
• Patients should be assessed to see if their sexual dysfunction is related to underlying vascular or cardiac disease, anxiety, depression or other factors.
• Drugs that can improve cardiovascular symptoms or survival should not be withheld due to concerns that such drugs may impact sexual function.
• Drugs to treat erectile dysfunction are generally safe for men who have stable cardiovascular disease. These drugs should not be used in patients receiving nitrate therapy for chest pains due to coronary artery disease (blockages in the arteries that supply the heart with blood), and nitrates should not be administered to patients within 24-48 hours of using an erectile dysfunction drug (depending on the drug used).
• It is reasonable for post-menopausal women with cardiovascular disease to use estrogen that's topically or vaginally inserted for the treatment of painful intercourse.

Decreased sexual activity and function — common in men and women with cardiovascular diseases — is often related to anxiety and depression.

The absolute rate of cardiovascular events during sexual activity, such as heart attacks or chest pain caused by heart disease, is miniscule because sexual activity is usually for a short time.

"Some patients will postpone sexual activity when it is actually relatively safe for them to engage in it," said Levine, who is also director of the Cardiac Care Unit at the Michael E. DeBakey Medical Center in Houston. "On the other hand, there are some patients for whom it may be reasonable to defer sexual activity until they're assessed and stabilized."

Provided by American Heart Association

Men likelier than women to enjoy sex in old age

PARIS , 10 mar 2010– Men are more than twice as likely as women to be sexually active in old age but good health is the key for both to feeling naughty, says a study published Wednesday by the British Medical Journal.

Doctors looked over two big probes into the health of the American population.

One survey covered 3,000 people aged 25-74 who filled in questionnaires in the mid-1990s as part of an investigation into midlife.

The other survey, focussing on old age, was carried out a decade later among a similar number of volunteers aged 57-85.

At the age of 55, men have on average almost 15 years of sexually active life ahead of them, and women 10-and-a-half years, the researchers found.

They also discovered a major gap between the genders on sex lives.

"Overall, men were more likely than women to be sexually active, report a good-quality sex life and be interested in sex. These gender differences increased with age," according to the paper online.

The biggest gap was among 75- to 85-year-olds, where 38.9 percent of men said they were sexually active, compared with 16.8 percent of women.

Another 41.2 per cent of the men were interested in sex, compared with 11.4 percent of the women.

Within the "sexually active" group of the 75- to 85-year-olds, 70.8 percent of men rated their sex life as of good quality, compared with 50.9 percent among women.

Why such a difference?

It could be partly explained by opportunity, say the investigators.

Around three-quarters of men across all age groups said they had a partner.

Among women, though, only two-thirds of respondents between 25 and 54 had a partner. For women aged 75 and beyond, fewer than four in 10 had a partner -- a figure reflecting women's longer lifespan and the tendency of men to marry younger women.

Good health, too, was vital for sexual wellbeing, said the study.

An individual in sound health is almost twice as likely to be interested in sex and can expect to enjoy around six more years of sexual activity compared to a peer in poor health.

Authors Stacy Tessler Lindau and Natalia Gavrilova, from the University of Chicago hope the findings will help end a taboo.

"Doctors rarely address sexual concerns in older adults, particularly in women," they say.

In a commentary, Patricia Goodson, a professor at Texas A&M University, said the news that US adults can enjoy "many years of sexual activity beyond age 55" was good news.

But there were also intriguing questions, she said.

If the study's measure of "sexually active life expectancy" ia credible, American men generally stop having sex around the age of 70, about eight or nine years before their death, according to demographic life expectancy.

For women, "sexually active life expectancy" would ended around 65, yet their demographic life expectancy was around 82 or 83.

"The measure sheds no light on the intriguing -- and still poorly understood -- question of why, even though they enjoy fewer years of a sexually active life, many women do not perceive this as a 'problem'," said Goodson.

"Neither does the measure provide details on how women and men manage, attempt to enhance, or deal meaningfully (and uniquely) with their ageing sexuality."

The survey carried out in 1995-6 defined sexual activity as having had sex with at least one partner in previous six months, whereas the survey from 2005-6 defined it as having sex with at least one partner in the previous 12 months.

Respondents who had sex two or three times a month or more were defined in both surveys as having sex regularly. Between 95.0 and 97.8 of respondents described themselves as heterosexual.

Sex no longer a taboo subject at nursing homes

By MARGARET STAFFORD
KANSAS CITY, 23 dec 2008– When Kansas State University sent researchers into nursing homes to find out how the topic of sex was being addressed, they initially found silence.

"Nobody was talking about it; it was a really hush-hush subject," said Gayle Doll, director of the university's Center on Aging. "I guess it's hard enough for people to think about their parents having sex, let alone their grandparents."

In response, the researchers have produced seminars and training aids to encourage nursing home caregivers to discuss and accommodate sexual desires.

The effort brings Kansas into a national discussion that advocates say will only grow as baby boomers age and take their beliefs about sexual freedom and civil rights into the nation's nursing homes.

One of the first Kansas seminars was held at Schowalter Villa in Hesston, where many staff first reacted with, "We're going to talk about WHAT?" said Lillian Claassen, vice president of health services at the villa.

Claassen said residents' sexuality had always been a difficult subject for nursing homes and the Kansas State training affirmed her earlier efforts to address the topic.

"It wasn't like we hadn't cared for these needs in the past, but it was liberating to some folks to have an open discussion with university researchers," Claassen said. "It empowered people to think about how they could help folks."

Doll said the training focuses on explaining what sexuality means for older adults, identifying barriers to fulfilling the sexual needs, finding strategies to help residents and how to discern appropriate from inappropriate sexual behaviors.

Solutions can be as simple as providing "do not disturb" signs or making sure staffers don't barge into residents' rooms without knocking. Claassen said her nursing home provides a discreet room for residents and has staff work through possible scenarios they may encounter.

Sometimes, it's as simple as arranging a bed for someone who needs physical therapy in a way that also allows that patient to be with his or her companion, she said.

"My greatest interest is to promote dignity in a situation that can be very challenging," Claassen said. "We all need touch, kindness and companionship. We try to enable that in this setting, which can be very public but where there is still a need for privacy."

Sexuality doesn't always mean intercourse. Many lonely or depressed residents are simply looking for ways to relieve loneliness and depression, Doll said.

For example, she told of one resident who had asked for pornography but dropped the request when the staff started spending more time with him.

"The staff can help with the loneliness and need for connection that residents often have," Doll said. "Some sexual expressions that might be seen as inappropriate will go away when they simply get the attention they deserve."

When the need does include sexual activity, the issue becomes more difficult if one of the residents is suffering from dementia, advocates say. That can manifest itself in a resident making passes at a staff member.

Claassen said her staff is trained to respond politely and to understand that the impaired resident may be mistaking the staff member for a spouse or reacting as he or she has in the past, which is often more vivid than the present for those suffering from dementia.

If a resident with dementia becomes involved with another resident, the issue becomes determining if the sexual activity is consensual, said Robin Dessel, a national expert on dementia who is the director of memory care at Hebrew Home in Riverdale, N.Y.

Dessel said people with dementia, even those who can no longer speak, have wants and desires and the ability to express them. It takes a trained and educated staff to recognize if a sexual overture or relationship involves abuse or is borne of real need, she said.

Dessel said she has seen a growing awareness that the aging do not forfeit their rights as they become infirm, and that includes the right to express sexuality. She expects that trend to increase as baby boomers, with more liberal attitudes toward sex than their parents, continue to age.

"No matter what we see, even if someone needs total care or is incontinent, they still feel," Dessel said. "If there's a bonding with someone else, I think it's a time of celebration at that point that there's something left, something good and pleasurable for that person."

To meet that challenge, clinicians and providers need some standardized parameters to use to assess patients' consent, Dessel said.

The Kansas State researchers say federal guidelines should be developed to help nursing homes deal with sexuality in a positive way.

"Nursing homes are the second most regulated industry in the country, behind nuclear power plants," Doll said. "But none of those regulations address sexuality. So, consequently, no one knows how to handle it."

___

On the Net:

http://www.humec.k-state.edu/aging

Gait may be associated with orgasmic ability

Paisley, Scotland – 05 sept 2008 - A new study found that trained sexologists could infer a woman's history of vaginal orgasm by observing the way she walks. The study is published in the September 2008 issue of The Journal of Sexual Medicine, the official journal of the International Society for Sexual Medicine and the International Society for the Study of Women's Sexual Health.
Led by Stuart Brody of the University of the West of Scotland in collaboration with colleagues in Belgium, the study involved 16 female Belgian university students. Subjects completed a questionnaire on their sexual behavior and were then videotaped from a distance while walking in a public place. The videotapes were rated by two professors of sexology and two research assistants trained in the functional-sexological approach to sexology, who were not aware of the women's orgasmic history.
The results showed that the appropriately trained sexologists were able to correctly infer vaginal orgasm through watching the way the women walked over 80 percent of the time. Further analysis revealed that the sum of stride length and vertebral rotation was greater for the vaginally orgasmic women. "This could reflect the free, unblocked energetic flow from the legs through the pelvis to the spine," the authors note.
There are several plausible explanations for the results shown by this study. One possibility is that a woman's anatomical features may predispose her to greater or lesser tendency to experience vaginal orgasm. According to Brody, "Blocked pelvic muscles, which might be associated with psychosexual impairments, could both impair vaginal orgasmic response and gait." In addition, vaginally orgasmic women may feel more confident about their sexuality, which might be reflected in their gait. "Such confidence might also be related to the relationship(s) that a woman has had, given the finding that specifically penile-vaginal orgasm is associated with indices of better relationship quality," the authors state. Research has linked vaginal orgasm to better mental health.
The study provides some support for assumptions of a link between muscle blocks and sexual function, according to the authors. They conclude that it may lend credibility to the idea of incorporating training in movement, breathing and muscle patterns into the treatment of sexual dysfunction.
"Women with orgasmic dysfunction should be treated in a multi-disciplinary manner" says Irwin Goldstein, Editor-in-Chief of The Journal of Sexual Medicine."Although small, this study highlights the potential for multiple therapies such as expressive arts therapy incorporating movement and physical therapy focusing on the pelvic floor."
###
This study is published in the September 2008 issue of The Journal of Sexual Medicine. Media wishing to receive a PDF copy may contact medicalnews@bos.blackwellpublishing.net.
Stuart Brody, Ph.D., is a professor in the Division of Psychology, School of Social Sciences at the University of the West of Scotland. He can be reached for questions at stuartbrody@hotmail.com.
Irwin Goldstein, MD is Director of Sexual Medicine, Alvarado Hospital San Diego and Clinical Professor of Surgery at University of California San Diego. He can be reached at San Diego Sexual Medicine 619-265-8865.
Article: "A Woman's History of Vaginal Orgasm is Discernible from Her Walk," Aurelie Nicholas, Stuart Brody, Pascal De Sutter, François de Carufel, Journal of Sexual Medicine, September 2008.
The Journal of Sexual Medicine is a peer-reviewed publication founded in 2004 and is the official journal of the International Society for Sexual Medicine, its five regional affiliated societies and the International Society for the Study of Women's Sexual Health. It publishes multi-disciplinary basic science and clinical research to define and understand the scientific basis of male and female sexual function and dysfunction. The Journal carries an Impact Factor of 6.199 and is ranked by the Thomson ISI Journal Citation Reports as the #1 urology publication in the Urology/Nephrology category worldwide. For more info, please visit www.jsm.issm.info.
The International Society for Sexual Medicine (ISSM) was founded in 1982 for the purpose of promoting, throughout the international scientific community, research and knowledge in sexual medicine, considered as the subspecialty area of medicine that embraces the study, diagnosis and treatment of the sexual health concerns of men and women. The society has over 2700 members worldwide, with five regional societies that are affiliated with ISSM: the Africa Gulf Society for Sexual Medicine, Asia Pacific Society for Sexual Medicine, European Society for Sexual Medicine, Latin American Society for Sexual Medicine, and Sexual Medicine Society of North America. For more information please visit www.issm.info.

Seniors Today Having More Sex Than Those of 30 Years Ago

By Todd Neale

GOTHENBURG, Sweden, 10 july 2008-- Sexual activity is on the rise among 70-year-olds, a cross-sectional survey here revealed.
From 1971 through 2001, the proportion of 70-year-olds who reported having sex within the past year increased for both men and women, regardless of marital status (P=0.016), Ingmar Skoog, M.D., Ph.D., of the University of Gothenburg, and colleagues reported online in BMJ.
Women seemed to be deriving the most enjoyment from the increased activity, with a significantly greater percentage reporting that they had high satisfaction with their sex life (P=0.039) and that they always or usually had an orgasm (P=0.015), and a lower percentage saying they had low or no satisfaction (P<0.05).

Compared with those in the earlier cohorts, men and women in the later cohorts more often reported that sexuality had been a positive factor in their lives and that they had a positive attitude about sexuality (P<0.05 for both).
"Our study … shows that most elderly people consider sexual activity and associated feelings a natural part of later life," the researchers said. "It is thus important that sexuality is taken into consideration when dealing with elderly people."
According to the researchers, little is known about the normal sexual behavior of older persons.
So they surveyed four separate representative population samples of 70-year-olds living in Gothenburg in 1971-1972, 1976-1977, 1992-1993, and 2000-2001, totaling 1,560 participants (946 women and 560 men).
Each assessment included a physical and psychiatric examination, which included questions about sexual behavior.
Among both sexes, the percentage of participants who were divorced, cohabiting, or in a relationship but living apart increased from the first sample to the last (P<0.05 for all).
The percentage who were widowed or who had never been married decreased for both genders (P<0.05 for both).
In all subgroups, the percentage reporting sexual intercourse within the past year increased from the beginning of the study as follows:
Married men: 52% to 68%, P=0.002
Married women: 38% to 56%, P=0.001
Unmarried men: 30% to 54%, P=0.016
Unmarried women: 0.8% to 12%, P<0.001
Among those who were sexually active, a greater percentage of participants in the 2000-2001 cohort said they had sex at least once a week than in the 1971-1972 cohort for both men (31% versus 10%, P=0.006) and women (26% versus 9%, P=0.047).
In a logistic regression analysis of all participants, those born in the later cohorts had increased odds of being sexually active (OR 1.48, 95% CI 1.10 to 2.00), which was independent of several confounding variables.
In the later cohorts, the participants were more likely to report becoming sexually active before age 20 (52% to 77% for men and 19% to 64% for women, P<0.001 for both).
Participants in the 2000-2001 cohort were significantly more likely to report being in a happy relationship than those in the earliest cohort (57% versus 40% for men and 52% versus 35% for women, P<0.001 for both).
Among men, there were no significant changes in satisfaction with sex or in the occurrence of erectile or ejaculation dysfunction or premature ejaculation.
Men and women seemed to agree that, when intercourse was not occurring, it was the man's choice. The most frequently cited reason for lack of sex by both men and women was the man's illness or loss of desire and capability.
The authors acknowledged several limitations to the study: the low response rate, potential survival bias, the sensitive subject matter, differences in the examiners and data evaluators for each cohort, the self-reported data, the exclusion of questions about homosexual activity, and possible confounding by depression.
They also cautioned that "it is possible that our results reflect a more open-minded attitude in society to sexual matters rather than real changes in sexual behavior."
Nevertheless, in an accompanying editorial, Peggy Kleinplatz, Ph.D., of the University of Ottawa, wrote that the study "makes a welcome contribution to the limited literature on sexuality in older people."
The results have clinical implications, she said.
"Given that sex plays an increasingly valuable role in the lives of older men and women," she concluded, "[the] study reinforces the dictum that doctors should ask -- and be trained to ask -- every patient, regardless of age, 'Any sexual concerns?'"
The study was supported by the Swedish Council for Working Life and Social Research, the Alzheimer's Association Stephanie B. Overstreet Scholars, the Swedish Research Council, the Bank of Sweden Tercentary Foundation, Stiftelsen for Gamla Tjanarinnor, and Handlanden Hjalmar Svenssons Forskningsfond.
Neither the study authors nor the editorialist declared any competing interests.

Primary source: BMJSource reference:Beckman N, et al "Secular trends in self-reported sexual activity and satisfaction in Swedish 70-year-olds: cross-sectional survey of four populations, 1971-2001" BMJ 2008; DOI: 10.1136/bmj.a279.