Dysfunctional or differently functional? Distressing sexual experiences among older adults in the United States

The Surgeon General's Call to Action to Promote Sexual Health describes sexual dysfunction as an important public health problem. Although a few sexual experiences identified as dysfunctions have been the focus of substantial pharmaceutical research, there is limited evidence about the extent to which individuals regard these experiences as problematic. Using data from the 2005-2006 National Social Life Health and Aging Project, this study examines the prevalence and correlates of being bothered by one's own or one's partner's sexual difficulties, among adults 57-85 who had sex in the past year (N=1,352). For most of the seven specified outcomes, less than 25% of respondents indicated that the experience bothered them “a lot”, and more than 33% indicated that it did not bother them “at all.” The problem most likely to bother men (55.8% somewhat, 34.4% a lot) was erectile difficulty and the problem most likely to bother women (66.6% somewhat, 30% a lot) was physical pain during intercourse, Nearly a fifth of women reported pain during sex, 82.3% of whom reported vaginal pain, while only 2.3% of men reported any pain during sex. Vaginal pain during sex very strongly predicted being bothered by lubrication difficulties. Among those whose partner lacked interest in sex, men had four times the odds of being bothered by it, compared to women ( OR 4.0, 95% CI:2.3, 6.0). A public health approach focused on communication skills and behavior change may be more effective than a medical approach in addressing the sexual problems of older couples.