Doctors urged to recognize post-antidepressant sexual dysfunction

by SAGE Publications

Credit: CC0 Public Domain

A psychiatrist specialising in sexual dysfunction caused by antidepressants is calling for greater recognition of the problems that can endure after treatment stops. Professor David Healy, writing in the Journal of the Royal Society of Medicine, said problems may begin after only a few doses and leave someone affected for life, or a relatively mild dysfunction can worsen dramatically when the person stops treatment.

01 feb 2020--Called Post-SSRI Sexual Dysfunction (PSSD), the core features of the condition are genital numbing, loss or muting of orgasm and loss of libido. According to Professor Healy many patients are just as concerned by additional features like emotional numbing or derealisation. Both sexes, all ages and every ethnic group can be affected.

Professor Healy, of Bangor University, said: "10% of people of sexually active years in developed countries are on antidepressants chronically. Nearly 20% of the population, therefore, may not be able to make love the way they want. In some deprived areas, the figure may be much higher. Some likely comfort themselves with the thought that once they stop treatment, they will get back to normal, when in fact they may be even less able to function."

In June 2019, in response to a petition lodged by Professor Healy and colleagues in 2018, the European Medicines Agency asked pharmaceutical companies to warn that sexual dysfunction can endure after antidepressant treatment stops.

Professor Healy said: "There is a great need to recognise these treatment-related enduring sexual dysfunctions and pinpoint how they arise and might be treated."

More information: David Healy, Antidepressants and sexual dysfunction: a history, Journal of the Royal Society of Medicine (2020). DOI: 10.1177/0141076819899299

Journal information: Journal of the Royal Society of Medicine 

Provided by SAGE Publications

Sexual satisfaction among older people about more than just health

by University of Glasgow

Communication and being in a happy relationship, along with health, are important for sexual satisfaction among older people, according to new research published in PLOS ONE.

02 april 2019--Sexual expression is increasingly recognised as important throughout the life course, in maintaining relationships, promoting self-esteem and contributing to health and well-being. Although health care professionalsare being urged to be more proactive in helping older patients achieve a satisfying sex life, there is a distinct lack of evidence to help guide practitioners.

Led by the London School of Hygiene & Tropical Medicine (LSHTM), the University of Glasgow and UCL, the study is one of the first to look at how health, lifestyle and relationship factors can affect sexual activity and satisfaction in later life, and examine how people respond and deal with the consequences.

The researchers carried out a mixed methods study combining survey data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) and in-depth interviews with older men and women. Out of nearly 3,500 people aged between 55-74, the survey found that one in four men and one in six women reported having a health problem that affected their sex life. Among this group, women were less likely than men to be sexually active in the previous six months (54 percent vs 62 percent) but just as likely to be satisfied with their sex life (42 percent vs 42 percent).

Follow up interviews with a sample of participants revealed that older people found it difficult to separate the effects of declining health from those of increasing age. Ill health impacted sexual activity in many ways but most crucially it influenced whether individuals had a partner with whom to have sex. Some older people were more accepting of not having a sex life than others.

For those in a relationship, sexual satisfaction was strongly associated with both the quality of communication with their partner and contentment with their relationship. The impact of health issues was not always negative; some men and women found themselves having to experiment with new ways of being sexually active and their sex lives improved as a result.

Natsal-3 is the largest scientific study of sexual health and lifestyles in Britain. Conducted by LSHTM, UCL and NatCen Social Research, the studies have been carried out every 10 years since 1990, and have involved interviews with more than 45,000 people to date.

Bob Erens, lead author and Associate Professor at LSHTM, said: "Looking at the impact of health on sexual activity and satisfaction as we age is important, however few studies have examined the relationship between the two.

"Health can affect an individual's sex life in various ways, from having or finding a partner, to physical and psychological limitations on sexual expression.

"We identified that not many people who reported experiencing problems or lack of satisfaction sought help. Although this could be an individual choice or because of a perceived lack of support, it is vital that individuals feel able to make enquiries with health care professionals. In particular, discussing problems can often lead to identification of underlying medical conditions."

Although some individuals the research team spoke to were not affected by not being sexually active, it seemed to be important that health professionals make sensitive enquiries for patients who might want to access help, which can lead to significant improvements in their wellbeing and quality of life.

Kirstin Mitchell, co-author and Senior Research Fellow in Social Relationships and Health Improvement at the University of Glasgow, said: "We're seeing numerous, interconnected factors influencing sexual activity in older people. Not being in good health can influence mood, mobility and whether a person has a partner, which in turn impact on sexual activity. Medication taken for health conditions often compounds the problem.

"The study findings suggest that pharmacological approaches, like Viagra, do not always help to resolve sexual difficulties, which need to be seen in the wider context of older people's lives."

The authors acknowledge the limitations of the study, including that Natsal had an upper age limit of 74 years, and so the study is unable to describe the sexual health and wellbeing of people at older ages.

Natsal-3 is the largest and most comprehensive study of sexual attitudes and lifestyles in the world, and is a major source of data informing sexual and reproductive health policy in Britain.

More information: Bob Erens et al. Health status, sexual activity and satisfaction among older people in Britain: A mixed methods study, PLOS ONE (2019). DOI: 10.1371/journal.pone.0213835

Journal information: PLoS ONE 

Provided by University of Glasgow 

Removing the stigma surrounding the sex lives of the over 60s will help improve sexual health

by University of Sheffield

Credit: CC0 Public Domain

The stigma surrounding the sex lives of older adults is being tackled with a pioneering website which aims to improve sexual health in the over 60s.

17 feb 2019--Age, Sex and You is the first website in the UK dedicated solely to providing advice about sex and intimate relationships for older peoplewho feel reluctant to talk to their doctor or get advice from family and friends.

The website has been launched by researchers from the University of Sheffield who, in a recent study, found the prejudice and discrimination that older people face when seeking support for their sexual needs significantly affects their health and wellbeing.

Sexually transmitted infection (STI) diagnosis in people aged between 50 and 70 has risen by a third in recent years. However, the Sheffield study found that age-related stereotypes and embarrassment can prevent older adults from getting appropriate care for a sexual concern or advice about practising safe sex.

Dr. Sharron Hinchliff from the University of Sheffield's School of Nursing and Midwifery led the study and the creation of the pioneering website.

"A third of over-70s have sex at least twice a month but they face huge barriers particularly when it comes to seeking advice about sexual health," said Dr. Hinchliff.

"We know that many older adults enjoy sex and intimacy, and both are important factors in their quality of life," said Dr. Hinchliff.

"Our bodies change as we get older, which can lead to sexual changes, and it is really important to understand what changes are common with age, but importantly when to seek professional help.

"Erectile dysfunction affects around 30 per cent of men aged 65-74 and uncomfortable vaginal dryness affects 20 per cent of women in the same age group, however many are too embarrassed to go to the doctor. This can impact on your psychological wellbeing and cause stress, anxiety or relationship difficulties.

"We are now living well, for longer, so it is increasingly important that we tackle the stigma surrounding the sex lives of older people. We hope the website will become a vital resource for people looking for evidence—based advice they can trust."

Dr. Hinchliff is a Reader in Psychology and Health and the founder of #SexRightsAge, a national campaign to recognise the sexual rights of older adults. She leads a programme of research which explores ageing, sexual health, intimate relationshipsand psychological factors of health, in order to improve patient quality of life and inform healthcare practice.

For more information about Age, Sex and You please visit: www.agesexandyou.com

Sex after 65: Poll finds links to health, gender differences, lack of communication

Key findings from the May 2018 National Poll on Healthy Aging report, on sexual health after age 65. Credit: University of Michigan

A new poll busts stereotypes about the sex lives of older Americans—and reveals gender and health-related divides on key aspects of sexual health, while highlighting the need for more people to talk with their health providers about sexual issues.

04 may 2018--Forty percent of people between the ages of 65 and 80 are sexually active, according to the new findings from the National Poll on Healthy Aging. Nearly three-quarters of people in this age range have a romantic partner and 54 percent of those with a partner are sexually active.
Whether or not they have an active sex life, nearly two-thirds of older adults say they're interested in sex, and more than half say sex is important to their quality of life.
And when asked if they are satisfied with their current sex life, 73 percent of the nationally representative sample of 1,002 people polled said they were. The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, U-M's academic medical center.
The poll explored how older adults might seek help or advice for sexual problems, and if they've talked with their doctors about their sexual health.
In all, 18 percent of older men and 3 percent of older women say they've taken medications or supplements to improve sexual function in the past two years. But only 17 percent of older adults said they have talked with their doctor or other health care provider about sexual health in the past two years. Most who had engaged in such discussions said they brought the topic up, suggesting the need for more proactive conversations by clinicians with their older patients.
"Sexual health among older adults doesn't get much attention but is linked closely to quality of life, health and well-being," says U-M's Erica Solway, Ph.D., co-associate director of the poll. "It's important for older adults and the clinicians who care for them to talk about these issues and about how age-related changes in physical health, relationships, lifestyles and responsibilities such as caregiving, affect them."

Key findings from the May 2018 National Poll on Healthy Aging report, on sexual health after age 65. Credit: University of Michigan

Gender, age and health status divides
Solway notes that the poll finds some sharp differences along health, age and gender lines.
For instance, compared with the 45 percent of respondents with excellent, very good, or good health who reported they were sexually active, only 22 percent of those who said they are in fair or poor health were sexually active. Only 28 percent of those with fair or poor health said they were extremely or very satisfied with their sex lives.
There are also differences within age groups. Those between the ages of 65 and 70 were nearly twice as likely as those in their late 70s to be sexually active. One-third of those in their late 60s said they were extremely or very interested in sex, compared with 19 percent of those in their late 70s.
The gender gaps that emerged reveal some differences that may create challenges for relationships. For instance, women were less likely than men to be sexually active—31 percent overall, compared with 51 percent of men—but were more likely to be extremely or very satisfied with their sex lives. And while 84 percent of older men said sex was an important part of a romantic relationship, 69 percent of older women agreed with that statement.
But the biggest gender difference was the percentage of those who said they were extremely or very interested in sex. Half of men aged 65 to 80 said they had this level of interest, compared with just 12 percent of women in the same age range.
"This survey just confirms that the need for and interest in sexual intimacy doesn't stop at a certain age," says Alison Bryant, Ph.D., senior vice president of research for AARP. "Although most older adults say that they would talk with their doctor about sexual concerns, health care providers should routinely be asking all of their older patients about their sexual health and not assume that bringing up the issue will offend or embarrass them."
A key takeaway from the poll, Solway notes, is that there appears to be opportunity for more proactive conversations between providers and their older patients about sexual health.
In all, 62 percent of the older adults polled said that if they were having a problem with their sexual health, they would talk with their health provider about it, yet only 17 percent had actually done so in the past two years. The majority (88 percent) of those who had talked with their provider about their sexual health said they were comfortable doing so.
The poll results are based on answers from a nationally representative sample of 1,002 people ages 65 to 80. The poll respondents answered a wide range of questions online. Questions were written, and data interpreted and compiled, by the IHPI team. Laptops and Internet access were provided to poll respondents who did not already have it.

More information: A full report of the findings and methodology is available at www.healthyagingpoll.org , along with past National Poll on Healthy Aging reports.


Provided by University of Michigan

More frequent sexual activity can boost brain power in older adults, according to study

More frequent sexual activity has been linked to improved brain function in older adults, according to a study by the universities of Coventry and Oxford.

Researchers found that people who engaged in more regular sexual activity scored higher on tests that measured their verbal fluency and their ability to visually perceive objects and the spaces between them.

22 jun 2017--The study, published today in the Journals of Gerontology, Series B: Psychological and Social Sciences, involved 73 people aged between 50 and 83.
Participants filled in a questionnaire on how often, on average, they had engaged in sexual activity over the past 12 months - whether that was never, monthly or weekly - as well as answering questions about their general health and lifestyle.
The 28 men and 45 women also took part in a standardised test, which is typically used to measure different patterns of brain function in older adults, focussing on attention, memory, fluency, language and visuospatial ability.
This included verbal fluency tests in which participants had 60 seconds to name as many animals as possible, and then to say as many words beginning with F as they could - tests which reflect higher cognitive abilities.
They also took part in tests to determine their visuospatial ability which included copying a complex design and drawing a clock face from memory.
It was these two sets of tests where participants who engaged in weekly sexual activity scored the most highly, with the verbal fluency tests showing the strongest effect.
The results suggested that frequency of sexual activity was not linked to attention, memory or language. In these tests, the participants performed just as well regardless of whether they reported weekly, monthly or no sexual activity.
This study expanded on previous research from 2016, which found that older adults who were sexually active scored higher on cognitive tests than those who were not sexually active.
But this time the research looked more specifically at the impact of the frequency of sexual activity (i.e. does it make a difference how often you engage in sexual activity) and also used a broader range of tests to investigate different areas of cognitive function.
The academics say further research could look at how biological elements, such as dopamine and oxytocin, could influence the relationship between sexual activity and brain function to give a fuller explanation of their findings.
Lead researcher Dr Hayley Wright, from Coventry University's Centre for Research in Psychology, Behaviour and Achievement, said:
"We can only speculate whether this is driven by social or physical elements - but an area we would like to research further is the biological mechanisms that may influence this.
"Every time we do another piece of research we are getting a little bit closer to understanding why this association exists at all, what the underlying mechanisms are, and whether there is a 'cause and effect' relationship between sexual activity and cognitive function in older people.
"People don't like to think that older people have sex - but we need to challenge this conception at a societal level and look at what impact sexual activity can have on those aged 50 and over, beyond the known effects on sexual health and general wellbeing."

More information: Hayley Wright et al, Frequent Sexual Activity Predicts Specific Cognitive Abilities in Older Adults, The Journals of Gerontology: Series B (2017). DOI: 10.1093/geronb/gbx065


Provided by Coventry University

When it comes to older people and sex, doctors put their heads in the sand

Then we did it in this position.

The sex lives of older people have received a lot of attention recently. From the Netflix sitcom Grace and Frankie, which stars Jane Fonda and Lily Tomlin (both in their 70s) and does not shy away from the issue of sex, tothe Channel 4 series that focused on "love and sex when we're over 60", it seems there is no escaping the message that older adults have and enjoy sex.

27 jun 2015--Indeed, five years ago the World Health Organisation declared sexual health to be important across the lifespan. And since the early 2000s governing bodies have promoted sexual activity as good for the health and well-being of older adults. The UK's largest sexual health study, the National Survey of Sexual Attitudes and Lifestyles (NATSAL), has, for the very first time in its 25-year history, included adults aged 60 and older. And the English Longitudinal Study of Ageing (ELSA) which began in 2002 has, also for the first time, included questions about sex. These studies follow the growing number of international studies that have explored the frequency of sexual activity among older adults, including, for exampleSpain, North America, Australia and Sweden.

Clearly, there has been a societal shift in attitudes towards sexuality and ageing which, in my view, is a step in the right direction. It enables us to move away from the taboo that surrounds sex after the age of 60 and the negative stereotyping of the sexuality of older adults. But, in spite of this increased recognition and visibility, there is consistent evidence that older adults tend not to seek help when they have a concern about sex and also that doctors are unlikely to ask their older patients about it.

Don't ask, don't tell

In our research we found that doctors were unlikely to be proactive when it came to the sexual needs of their older patients, leaving it instead for the patient to raise the issue. This related to a number of factors, including having limited knowledge of later-life sexuality issues, receiving "inadequate" training at medical school and thinking that sexuality and intimacy were private topics for older adults and that raising them would cause offence.

Opening up the conversation. Credit: Shutterstock

There was also evidence that doctors assumed sex was less important to older patients than it was to younger patients, which might explain why they were less likely to mention that medications could affect sexual function when the patient was older.

Similar barriers have been identified in relation to the aftercare of health conditions that are known to impact sexual function. For example, one study found that health professionals who worked in stroke care rarely raised the topic of sexual well-being with their patients. This was due to a lack of motivation on their part and difficulties with their own communication skills and confidence. Another, in the area of spinal care, found that while the majority of neurosurgeons saw discussing sexual matters with patients as part of their role, 73% reported that they didn't do this.

Expecting the patient to be the one to raise the issue of sex if she or he has a concern should be viewed alongside the research finding that older adults tend to prefer it if the health professional initiates a discussion about sex. That research also identified the reasons older adults may not ask for help; these included viewing the sexual problem as a "normal" part of getting old and thinking that the doctor would not be able to help because sex is a specialist area.

Other reasons included internalised ageism, evidenced by older adults reporting concern about what the health professional would think when they knew that they were sexually active "at their age". A fear of being judged negatively for having an interest in sex forms a clear barrier – and other researchers have identified that the perceived attitude of the doctor can influence whether or not older adults seek help. For example, a study of middle aged and older women with diabetes also found that characteristics of the doctors, including their attitude towards sex and ageing, influenced whether or not the women were willing to discuss sexual matters with them.

Unmet need

If doctors leave it to older adults to ask about their sexual concerns, and older adults leave it to their doctors to raise the issue, then a clear unmet need exists. This impasse has implications for the sexual well-being of older adults, particularly as many studies – including NATSAL and ELSA – report that sexual problems are more likely to occur the older a person gets. For some older adults, sexual problems can be a cause for concern.

It is imperative to address this issue, as a growing number of industrialised countries have an increasing older population. And those born in the 1950s and subsequent decades, will have specific expectations about health care and are thusless likely than previous generations to keep quiet about their sexual health needs as they become older themselves.

Source: The Conversation

Sexual satisfaction in women increases with age

A new study of sexually active older women has found that sexual satisfaction in women increases with age and those not engaging in sex are satisfied with their sex lives. A majority of study participants report frequent arousal and orgasm that continue into old age, despite low sexual desire. The study appears in the January issue of the American Journal of Medicine.

08 jan 2012--Researchers from the University of California, San Diego School of Medicine and the Veterans Affairs San Diego Healthcare System evaluated sexual activity and satisfaction as reported by 806 older women who are part of the Rancho Bernardo Study (RBS) cohort, a group of women who live in a planned community near San Diego and whose health has been tracked for medical research for 40 years. The study measured the prevalence of current sexual activity; the characteristics associated with sexual activity including demographics, health, and hormone use; frequency of arousal, lubrication, orgasm, and pain during sexual intercourse; and sexual desire and satisfaction in older women.

The median age in the study was 67 years and 63% were postmenopausal. Half the respondents who reported having a partner had been sexually active in the last 4 weeks. The likelihood of sexual activity declined with increasing age. The majority of the sexually active women, 67.1%, achieved orgasm most of the time or always. The youngest and oldest women in the study reported the highest frequency of orgasm satisfaction.

40% of all women stated that they never or almost never felt sexual desire, and one third of the sexually active women reported low sexual desire. Lead investigator Elizabeth Barrett-Connor, MD, Distinguished Professor and Chief, Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, comments, "Despite a correlation between sexual desire and other sexual function domains, only 1 in 5 sexually active women reported high sexual desire. Approximately half of the women aged 80 years or more reported arousal, lubrication, and orgasm most of the time, but rarely reported sexual desire. In contrast with traditional linear model in which desire precedes sex, these results suggest that women engage in sexual activity for multiple reasons, which may include affirmation or sustenance of a relationship."

Regardless of partner status or sexual activity, 61% of all women in this cohort were satisfied with their overall sex life. Although older age has been described as a significant predictor of low sexual satisfaction, the percentage of RBS sexually satisfied women actually increased with age, with approximately half of the women over 80 years old reporting sexual satisfaction almost always or always. Not only were the oldest women in this study the most satisfied overall, those who were recently sexually active experienced orgasm satisfaction rates similar to the youngest participants. "In this study, sexual activity was not always necessary for sexual satisfaction. Those who were not sexually active may have achieved sexual satisfaction through touching, caressing, or other intimacies developed over the course of a long relationship," says first author Susan Trompeter, MD, Associate Clinical Professor of Medicine. Division of General Internal Medicine, Department of Medicine at the University of California, San Diego School of Medicine and Staff Physician at the VA San Diego Healthcare System.

"Emotional and physical closeness to the partner may be more important than experiencing orgasm. A more positive approach to female sexual health focusing on sexual satisfaction may be more beneficial to women than a focus limited to female sexual activity or dysfunction," Trompeter concludes.

More information: The article is "Sexual Activity and Satisfaction in Healthy Community-Dwelling Older Women," by Susan E. Trompeter, MD, Ricki Bettencourt, MS, and Elizabeth Barrett-Connor, MD. It appears in the American Journal of Medicine, Volume 125, Issue 1 (January 2012)

Provided by Elsevier

Study finds sex a significant predictor of happiness among married seniors

The more often older married individuals engage in sexual activity, the more likely they are to be happy with both their lives and marriages, according to new research presented in Boston at The Gerontological Society of America's (GSA) 64th Annual Scientific Meeting.

21 nov 2011--This finding is based on the 2004-2006 General Social Surveys, a public opinion poll conducted on a nationally representative sample of non-institutionalized English and Spanish-speaking person 18 years of age or older living in the U.S. The data analysis was conducted by Adrienne Jackson, PT, PhD, MPA, an assistant professor at Florida Agricultural and Mechanical University.

"This study will help open the lines of communication and spark interest in developing 'outside the box' approaches to dealing with resolvable issues that limit or prevent older adults from participating in sexual activity," said Jackson. "Highlighting the relationship between sex and happiness will help us in developing and organizing specific sexual health interventions for this growing segment of our population."

Based on the survey responses of 238 arried individuals age 65 years or older, Jackson discovered that frequency of sexual activity was a significant predictor of both general and marital happiness. The association even remained after accounting for factors such as age, gender, health status, and satisfaction with financial situation.

Whereas only 40 percent of individuals who reported no sexual activity in the last 12 months said they were very happy with life in general, almost 60 percent who engaged in sexual activity more than once a month said they were very happy. Similarly, while about 59 percent of individuals who reported no sexual activity in the last 12 months said they were very happy with their marriage, almost 80 percent who had sex more than once a month said they were very happy. To assess frequency of sexual activity, respondents were asked the following question: "About how many times did you have sex during the last 12 months? By 'sex' we mean vaginal, oral, or anal sex." To assess general happiness, respondents were asked the following question: "Taken all together, how would you say things are these days — would you say that you are very happy, pretty happy, or not too happy?" To assess marital happiness, respondents were asked the following question: "Taking things all together, how would you describe your marriage? Would you say that your marriage is very happy, pretty happy, or not too happy?"

GSA's meeting — the country's largest interdisciplinary conference in the field of aging — is taking place at the John B. Hynes Veterans Memorial Convention Center and Sheraton Boston Hotel from November 18 to 22.

Provided by The Gerontological Society of America

Frequent sex and masturbation in 20s and 30s linked to higher prostate cancer risk

But study also shows that risks diminish with age, particularly in a man's 50s

27 jan 2009--Men who are very sexually active in their twenties and thirties are more likely to develop prostate cancer, especially if they masturbate frequently, according to a study of more than 800 men published in the January issue of BJU International.

However the UK research team also found that frequent sexual activity in a man's forties appears to have little effect and even small levels of activity in a man's fifties could offer protection from the disease. Most of the differences were attributed to masturbation rather than sexual intercourse.

The study, led by the University of Nottingham, looked at the sexual practices of more than 431 men who had been diagnosed with prostate cancer before the age of 60, together with 409 controls.

Men who took part in the study were asked about all aspects of their sex life from their twenties onwards, including how old they were when they became sexually active, how often they masturbated and had intercourse, how many sexual partners they had had and whether they had had any sexually transmitted diseases.

"We were keen to look at the links between sexual activity and younger men as a lot of prostate cancer studies focus on older men as the disease is more prevalent in men over 50" says lead author Dr Polyxeni Dimitropoulou, who is now at the University of Cambridge.

"Hormones appear to play a key role in prostate cancer and it is very common to treat men with therapy to reduce the hormones thought to stimulate the cancer cells. A man's sex drive is also regulated by his hormone levels, so this study examined the theory that having a high sex drive affects the risk of prostate cancer."

The study participants, who were recruited by their family doctors, were asked to fill in a questionnaire about their sexual habits in each decade of their life since their twenties.

All the men with prostate cancer had been diagnosed in their fifties. Most of the men who took part in the study (97%) were white and the majority were currently married (84%) or widowed, separated or divorced (12%).

A number of interesting points came out of the study:

• 59% of the men in both groups said that they had engaged in sexual activity (intercourse or masturbation) 12 times a month or more in their twenties. This fell steadily as they got older, to 48% in their thirties, 28% in their forties and 13% in their fifties.
• 39% of the cancer group had had six female partners or more, compared with 31% of the control group.
• Men with prostate cancer were more likely to have had a sexually transmitted disease than those without prostate cancer.
• More men with prostate cancer fell into the highest frequency groups in each decade when it came to sexual activity (intercourse and masturbation) than men in the control group. 40% of men in the cancer group fell into the highest frequency category in their twenties (20 or more times a month) compared to 32% in the control group. Similar patterns were observed in the men's thirties and forties. By the fifties it had evened out, with 31% in each group falling into the most frequent category (ten or more times a month).
• Men with prostate cancer were also more likely to masturbate frequently than men in the control group, with the greatest difference in the twenties (34% versus 24%) and thirties (41% versus 31%). The differences were less pronounced in their forties (34% versus 28%) and by the fifties the cancer group was slightly lower (25% versus 26%).

"What makes our study stand out from previous research is that we focused on a younger age group than normal and included both intercourse and masturbation at various stages in the participants' lives" says Dr Dimitropoulou.

"Overall we found a significant association between prostate cancer and sexual activity in a man's twenties and between masturbation and prostate cancer in the twenties and thirties. However there was no significant association between sexual activity and prostate cancer in a man's forties.

"A possible explanation for the protective effect that men in their fifties appear to receive from overall sexual activity, and particularly masturbation, is that the release of accumulated toxins during sexual activity reduces the risk of developing cancer in the prostate area. This theory has, however, not been firmly established and further research is necessary."

###

Notes to editors

Sexual activity and prostate cancer risk in men diagnosed at a younger age. Dimitropoulou et al. BJU International. 103, pp 178-185. (January 2009).

Healthy Sex Life Can Extend Into 80s

By Serena Gordon

14 aug 2008 -- A satisfying sex life is possible as you age into your 70s and 80s, new research suggests.
Many older Americans are apparently taking advantage of that fact, because 68 percent of men between 57 and 85 reported having sex last year, as did 42 percent of women, according to the study's lead author, Edward Laumann, the George Herbert Mead Distinguished Service Professor of Sociology at the University of Chicago. And, Laumann added, more older women might have wanted to have sex, but there just aren't as many available older men for them to partner with.
"Healthy people can have reasonably satisfying sexual health for most of their lives," said Laumann. "There are challenges that arise, but it's not aging, per se, that's the issue. A decline in sexuality may be the canary in the mineshaft. Sexual problems may manifest before diabetes and high blood pressure."
The study findings were published in the current issue of The Journal of Sexual Medicine.
"It's definitely whether you're elderly or "wellderly" that makes a difference," said Dr. Virginia Sadock, director of the program of human sexuality at New York University Langone Medical Center in New York City. "Illness and medications make a difference in sex lives."
Other factors that can get in the way of a satisfying sex life later in life include having had a sexually transmitted disease, and having physical problems, mental health issues or relationship difficulties, the study found.
The study included information from 1,550 women and 1,455 men between the ages of 57 and 85. All participated in the National Social Life, Health and Aging Project.
Some highlights of the study include:
Having had a sexually transmitted disease (STD) in the past nearly quadrupled a woman's odds of having sexual pain, and it tripled the odds a woman would have lubrication problems.
In men, a history of STD was associated with five times the risk of finding sex unpleasant.
In both older men and women, a common factor in sexual dysfunction and a decreased interest in sex was urinary tract syndrome.
Both older men and older women reported that mental health issues affected their interest in sex.
For men, relationship troubles also contributed to a lack of interest in sex and the inability to achieve orgasm.
Drinking alcohol daily improved a women interest in and pleasure from sex. Alcohol didn't have that effect on men.
Hispanic women were twice as likely to report pain during intercourse.
Black men were twice as likely to say they weren't interested in sex and were more likely to report climaxing early.
"Sexual health is a harbinger of physical and mental health, and it plays an important role in the quality of life," Laumann said. "Older people don't just drop out of the picture. In general, if you're healthy, you can be sexually active."
Sadock added: "Don't assume that because you're older, your sex life has to be gone. If you're healthy and connected to someone, and you've had a pretty good sex life when you're younger, then you can have a pretty good sex life in old age."

With Age, Sexuality Becomes Ember of Its Former Flame

CHICAGO, Aug. 22 -- For many older patients, sexual activity doesn't abate but it clearly begins to fade away.
Desire and performance dim with the passing years and with poor health, researchers here reported, yet older adults, especially men, are often sexually active, Stacy Tessler Lindau, M.D., of the University of Chicago, and colleagues, reported in the Aug. 23 issue of the New England Journal of Medicine.
A nationwide survey of 3,005 U.S. adults, ages 57 to 85, found that sexual activity may continue into the ninth decade of life, although the prevalence was uniformly lower among women and, not surprisingly, among those in poor health.
In addition, the researchers said that although sexual problems are frequent among older adults, these problems are rarely discussed with a physician. Clinicians should be aware that sexual problems may be a warning sign or a consequence of a serious underlying illness such as diabetes, infection, urogenital tract conditions, or cancer, the researchers added.
The findings came from a national probability sample of 1,550 community-dwelling women and 1,455 men. Interviews were in English and Spanish from July 2005 through March 2006.
The majority of this group are engaged in spousal or other intimate relationships and regard sexuality as an important part of life, the researchers said.
To be sure, the prevalence of those sexually active declined from 73% among respondents ages 57 to 64, to 53% among those ages 65 to 74, and to 26% among those ages 75 to 85.
However, even in the oldest group, 54% of sexually active persons reported having sex at least two to three times a month, and 23% reported having sex once a week or more.
Women were significantly less likely than men at all ages to report sexual activity, the researchers reported. In the subgroup of respondents age 75 to 85, 38.5% of men and 16.7% of women reported sexual activity with a partner in the previous 12 months.
The impact of age on the availability of a spouse or other intimate partner was particularly marked among women, the researchers noted. A total of 78% of men, age 75 to 85, compared with only 40% of women reported having such a relationship.
The age structure of the marital relationship and the earlier death rate of men compared with women may help explain the difference, the researchers said.
Among sexually active respondents, about half of both men and women reported at least one bothersome sexual problem.
The most prevalent sexual problems among women were low desire (43%), difficulty with vaginal lubrication (39%), and inability to climax (34%).
Among men, the most prevalent sexual problems were erectile difficulties (37%).
Fourteen percent of all men reported using medication or supplements in the previous 12 months to improve sexual function whereas only 1% of women did so. Nevertheless, only 38% of men and 22% of women reported having discussed sex with a physician since the age of 50.
Men and women who rated their health as poor were less likely to be sexually active, with poor health being even more important than age.
Compared with respondents who rated their health as good or excellent, those in fair or poor health had more sexual problems including difficulty with erection or lubrication, pain, or lack of pleasure. Also, women with diabetes were less likely to be sexually active.
The adjusted odds ratio for being sexually active among those who rated their health as "poor" or "fair" compared with those rating their health as "good" or "excellent," was 0.21 (95% CI 0.14-0.32) for men and 0.36 (CI 0.25-0.51) for women.
In discussing the study's limitations, the researchers said that because only specific sexual problems were assessed, the extent of sexual problems in older people may have been underestimated. Furthermore, this bias may increase with age as persons with sexual problems are likely to discontinue sexual activity.
As with most sexuality research, the data were self-reported, although the interview methods are well accepted as being valid, they noted.
In an accompanying editorial John H.J. Bancroft, M.D., of the Kinsey Institute at Indiana University in Bloomington, wrote that "until recently older adults tended to keep quiet about their sexuality because younger people assumed that they were not and should not be sexually active. Now the pendulum has swung, and the emphasis is increasingly on the provision of medical treatment to foster it."
Perhaps a middle ground is preferable, Dr. Bancroft said. For some older people sex is important in their relationship and well-being, and may benefit from counseling and medication.
Other couples, he said, choose to leave sex behind as they settle into later life. Often negotiation between partners is needed. "The medical profession," he wrote, "should encourage older patients to feel comfortable in discussing sexual problems and in choosing whichever of these two options suits them best."
This study was supported by grants from the National Institutes of Health, including the National Institute on Aging, the Office of Research on Women's Health, the Office of AIDS Research, and the Office of Behavioral and Social Sciences, and by NORC, which was responsible for the data collection. Donors of supplies include OraSure, Sunbeam, A&D Medical/LifeSource, Wilmer Eye Institute at the Johns Hopkins Bloomberg School of Public Health, Schleicher & Schuell Bioscience, BioMerieux, Roche Diagnostics, Digene, and Richard Williams.
Coauthor Edward O. Laumann, Ph.D., reported receiving research funding and support for a research assistant from Pfizer. Colm O'Muircheartaigh, Ph.D., reported serving as an expert witness on behalf of Johnson & Johnson. Linda J. Waite, Ph.D., reported serving on the eHarmony Research Laboratories Advisory Board and receiving a yearly honorarium. No other potential conflict of interest relevant to this article was reported.
Editorial writer John H.J. Bancroft, M.D., reported no potential conflict of interest relevant to this article. Primary source: New England Journal of MedicineSource reference: Lindau ST, et al "A Study of Sexuality and Health among Older Adults in the United States" N Engl J Med 2007; 357:762-774. Additional source: New England Journal of MedicineSource reference: Bancroft JHJ "Sex and Aging" N Engl J Med 2007; 357: 820-821.