Sex, intimacy, and the aging process.

The loss of sexuality is not an inevitable aspect of aging, and the majority of healthy people remain sexually active on a regular basis until advanced old age. However, the aging process does bring with it certain changes in the physiology of the male and the female sexual response, and these along with a number of medical problems that become more prevalent in the mature years, play a significant role in the pathogenesis of the sexual disorders of the elderly. The typical patient over 50 has only a partial degree of biological impairment, which has, however, been escalated into a total sexual disability by a variety of cultural, intrapsychic, and relationship stressors. Fortunately, these problems are frequently amenable to an integrated psychodynamically oriented sex therapy approach that emphasizes the improvement of the couple's intimacy, and the expansion of their sexual flexibility.