Healthy sexual aging

Status: Completed

A Mixed-Method Study of Sexual Function and Sexual Well-Being in Older European Adults – Principal Investigator Professor Bente Træen.

About the project

In Europe, older adults are a growing group of citizens that is thought to have more sexual difficulties with increasing age. While sexuality is long believed to be unimportant for older men and women, there are reasons - due to for instance cultural changes - to believe that current and future older adults will value their sexual health more than those from previous generations. Health authorities in European countries are gradually realizing that a growing number of older adults will regard their sexual health and sexual well-being as an important issue, even as a human right. Currently, there is a lack of empirical data about how older adults experience and cope with the physical, psychological, and relational changes that affect their sexual health.

Outcomes

The project aims to provide in culture-specific knowledge that will enable policy makers and health professionals to better react to the challenges associated with older adults' sexual health and well-being. In addition, we propose to design evidence-based education and intervention programs for: (a) health professionals in geriatric care; and (b) older individuals and couples struggling with sexual health related issues. It is known that European countries differ in terms of sexual cultures and the social organization of sexuality, and these differences are historically rooted. For example, North- and South European countries strongly differ in sexual norms, attitudes and behaviours based on sociocultural differences in terms of gender roles and gender equality.

Preliminary data from Norway can tell us something about how sexually active the older adults are. In the recently conducted survey, we used a broad definition of sexuality, and asked a representative sample of 60-75 year old Norwegians if they had had some form of sexual activity last year. As much as 91% men and 74% women answered yes to the question. The gender difference is explained by the fact that more women than men in this age group live alone.

Results

The project findings were in published in international, peer-reviewed scientific journals.

Participants

Nantje Fischer University of Oslo
Ingela Lundin Kvalem University of Oslo
Sidsel Louise Schaller
Aleksandar Stulhofer
Cynthia Graham
Sharron Hinchliff
Gert Martin Hald
Erik Lykke Mortensen
Ana Alexandra Carvalheira
Erick Janssen
Paul Enzlin
Britt Slagsvold
Lauren Towler
Matija Sinković

Štulhofer, Aleksandar; Fischer, Nantje; Hansen, Thomas; Graham, Cynthia A. & Træen, Bente (2025). Positive Sexual Aging: A Novel Concept and Bi-Country Development of a Brief Measure. Archives of Sexual Behavior. ISSN 0004-0002. 54, p. 2185–2198. doi: 10.1007/s10508-025-03158-7. Full text in Research Archive
Træen, Bente; Hansen, Thomas & Stulhofer, Aleksandar (2021). Silencing the sexual self and relational and individual well-being in later life: a gendered analysis of North versus South of Europe. Sexual and Relationship Therapy. ISSN 1468-1994. 35(4). doi: 10.1080/14681994.2021.1883579. Full text in Research Archive Show summary
Aim: This study explores the European North-South differences in older partnered individuals’ silencing of the sexual self and its links to relational and individual well-being. Methods: A web survey was conducted among partnered individuals aged 65 years or above in Norway and Croatia. There were 368 (women: 37.8%, response rate: 22%) and 359 (women: 34.5%, response rate: 27%) individuals who participated in Norway and Croatia, respectively. A range of relational (sexual satisfaction, relationship quality) and individual well-being (anxiety, depression, and life satisfaction) indicators was considered. Results: Sexual self-silencing had significant impacts across outcomes, gender, and countries. Furthermore, contrary to what might be expected, we observed no differences in self-silencing between the two countries; and in both countries, men were more self-silenced than women. Conclusion: Findings suggest that sexual self-silencing can compromise relationship quality and psychological well-being in later life. Health and clinical practice toward older individuals and couples should thus probe about and aim to improve the expression of sexual desires and needs.
Fischer, Nantje; Graham, Cynthia A.; Træen, Bente & Hald, Gert Martin (2021). Prevalence of Masturbation and Associated Factors Among Older Adults in Four European Countries. Archives of Sexual Behavior. ISSN 0004-0002. doi: 10.1007/s10508-021-02071-z. Full text in Research Archive Show summary
Abstract Solitary sexual activity is a free, safe, and accessible way to experience sexual pleasure. Despite these advantages, research on masturbation in later life is highly understudied. Using data from a cross-sectional probability-based survey of 3816 European adults (mean age 67 years; range 60–75 years), we explored several sociodemographic, health, attitudinal, and sexual behavioral factors associated with reported masturbation frequency. Across all countries, between 41% and 65% of men and 27% and 40% of women reported any masturbation in the preceding month. Satisfaction with sexual activity and attitudes related to disapproval of sex without love were significant predictors of reported masturbation in almost all countries and in both genders. Age, education, self-perceived health, and depression were for the most part predictive of men’s reported masturbation, but not women’s. Generally, those believing sex is beneficial to older people were more likely to masturbate, while less permissive attitudes decreased the likelihood of reporting masturbation. To improve healthy sexual aging, misinformation about masturbation and sexual attitudes in older people need to be addressed.
Træen, Bente; Hald, Gert Martin; Fischer, Nantje & Janssen, Erick (2020). European older adults’ use of lubricants and medications to enhance erectile function. International Journal of Sexual Health. ISSN 1931-7611. 32(2), p. 81–93. doi: 10.1080/19317611.2020.1749210. Full text in Research Archive Show summary
What is the prevalence of using lubricants and medication to enhance erectile function among older adults, and what predicts such use? Survey data were collected in probability samples among 60–75 year-olds in Norway, Denmark, Belgium, and Portugal. In men, use of medication was highest in Norway (26%) and lowest in Portugal (12%). In women, use of lubricants was highest in Norway (31%), and lowest in Belgium (3%). Compared to those who had no sexual difficulties, use of medication/lubricants were higher in individuals with sexual difficulties. The findings contribute to an increased attention to the sexual health of older adults.
Fischer, Nantje; Stulhofer, Aleksandar; Hald, Gert Martin; Carvalheira, Ana & Træen, Bente (2020). Sexual Satisfaction in Older Heterosexual Couples From Four European Countries: Exploring the Roles of Actual and Perceived Discrepancy in Sexual Interest. Journal of Sex Research. ISSN 0022-4499. doi: 10.1080/00224499.2020.1809615. Full text in Research Archive Show summary
Even though sexual activity frequently takes place with another person, research rarely focuses on how partners influence each other’s sexual lives. This study used the sexual dyad to compare the concept of actual versus perceived discrepancy in sexual interest and explored how each is related to older partnered individuals’ sexual satisfaction. Further, the study assessed the robustness of the association between sexual interest discrepancy and sexual satisfaction, if any, by controlling for emotional intimacy. The actor–partner interdependence model (APIM) using structural equation modeling (SEM) was applied to examine 677 heterosexual couples ages 60 to 75 in Norway, Denmark, Belgium, and Portugal. Although a couple’s actual discrepancy in sexual interest was not predictive of female and male partners’ sexual satisfaction, perceived discrepancy was negatively associated with sexual satisfaction in both partners after controlling for emotional intimacy. This indicates that the subjective feelings of being sexually dissimilar seem to be more important to sexual satisfaction than the actual mismatch among partners in older heterosexual couples. Moreover, the finding that emotional intimacy is linked with sexual satisfaction underscores the importance of a broader perspective on sexuality among older adults.
Rossow, Ingeborg Margrete & Træen, Bente (2020). Alcohol use among older adults: a comparative study across four European countries. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 37(6), p. 526–543. doi: 10.1177/1455072520954335. Full text in Research Archive Show summary
Aims: (i) To examine whether mean consumption and prevalence of at-risk drinking are highly correlated across samples of older adults, and (ii) to explore whether sociodemographic and health characteristics of alcohol use differ across countries. Method: Cross-sectional surveys were conducted in four European countries, Norway, Denmark, Belgium, and Portugal, applying identical data collection methods and survey instruments in general population samples of older adults aged 60 to 75 years. Alcohol consumption was measured as units of alcohol per week, which provided the basis for categorising the two outcome measures: abstention (0 units/week) and at-risk drinking (8+ units/week). Cross-tabulations and logistic regression models were estimated to examine associations between sociodemographic and health characteristics on the one hand and alcohol abstention and at-risk drinking on the other. Results: Prevalence of abstention was highest in Portugal and lowest in Denmark, whereas at-risk drinking was more prevalent in Denmark and Belgium compared to Norway and Portugal. Among country- and gender-specific samples of drinkers, there was a strong positive correlation between mean consumption and prevalence of at-risk drinkers. Female gender characterised abstention, whereas male gender characterised at-risk drinking in all four countries. Other sociodemographic characteristics and indicators of health and wellbeing were differently associated with abstention and at-risk drinking across the four countries. Conclusions: A strong regularity in the distribution of alcohol consumption was observed in the samples of older adults. Gender was the only common factor associated with drinking behaviour across the four countries.
Graham, Cynthia; Stulhofer, Aleksandar; Lange, Theis; Hald, Gert Martin; Carvalheira, Ana & Enzlin, Paul [Show all 7 contributors for this article] (2020). Prevalence of sexual problems and associated distress in aging women across four European countries. Archives of Sexual Behavior. ISSN 0004-0002. doi: 10.1007/s10508-020-01742-7. Full text in Research Archive Show summary
There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60–75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties—vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex—and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.
Hald, Gert Martin; Graham, Cynthia; Stulhofer, Aleksandar; Carvalheira, Ana; Janssen, Erick & Træen, Bente (2019). Prevalence of sexual problems and Associated distress in aging men across four European countries. Journal of Sexual Medicine. ISSN 1743-6095. 16(8), p. 1212–1225. doi: 10.1016/j.jsxm.2019.04.017. Full text in Research Archive

View all works in NVA

Træen, Bente & Villar, Feliciano (2020). SEXUAL WELL-BEING IS PART OF AGEING WELL. European Journal of Ageing. ISSN 1613-9372. 17(2), p. 135–138. doi: 10.1007/s10433-020-00551-0. Full text in Research Archive
Fischer, Nantje & Træen, Bente (2020). Sexual satisfaction in older couples from four European countries: exploring the effects of actual and perceived discrepancy in sexual interest, physical affection, and emotional intimacy. Full text in Research Archive

View all works in NVA

Funding

The project is financed by the Research Council of Norway (FRIHUMSAM - Researcher Project) 2016 - 2020.

Collaborators

The research project is a collaboration between the Department of Psychology and partners at University of Zagreb, University of Southampton, University of Sheffield, University of Copenhagen, University of Leuven, ISPA-University Institute Portugal and The Centre for Welfare and Labour Research, Norway.

Norwegian version of this page

Published Apr. 28, 2025 1:23 PM - Last modified May 8, 2025 12:46 AM