Sexual health in older women.

Perspectives Populations around the world are rapidly ageing. Many challenges and opportunities arise from this demographic transition. 1 However, the sexual health of the older members of these aging populations is often overlooked in academic and media discourse. The subject of sexuality in older people remains largely taboo in many cultures, yet older women the world over are known to have sexual desire and to engage in sexual activity (Fig. 1). 2 Although some aspects of sexual functioning decline with age, the extent of this decline depends to a large extent on how this is defined. 3 Indeed, in a recent large study of older adults in the United States of America in which a broad definition was applied, women between the ages of 57 and 74 showed no decline in sexual activity and self-rated physical health was found to be more strongly associated than age with reported sexual functioning. 4 Physical intimacy and sexual functioning are significant predictors of older women's degree of satisfaction with their long-term committed relationships (although the association is likely to be bi-directional). 5 Yet the degree to which sexuality is expressed in older age is also dependent on sociocultural context. 3 In some cultures, older women may feel that they have to conceal their sexuality to fit social norms. Population ageing has triggered a re-examination of many ageist stereotypes , notably the assumption that older people invariably abandon more active social roles. 1 In the future, this reassessment of social norms is likely to extend to the sphere of sexuality in older age and to be reinforced by medical advances such as improved treatments for erectile dysfunction. 6 Changing age structures also interact with other social trends. For example, over the past 50 years the proportion of older people living as part of multigenerational families has fallen. Since women tend to live longer than men, an increasing proportion of older women live alone. In Europe, it has been estimated that around 40% of women over the age of 65 years now live by themselves. 7 Although current social norms may lead single women in this age group to repress their sexual drive, broader cultural acceptance of sexual activity in older single women may lead to more overt expression of sexuality in this group in the future. Regardless of their marital status, women of all ages have a right to sexual health, defined by the …