Blame it on Netflix, smartphones, your children or your high-pressured job — if you don’t think your sex life is up to scratch, at least you’re not alone. Health conditions and medications, body confidence, relationship issues and life changes can all take their toll.
Read on to find out what can make sex better for each decade of your life…
Though we’re at our physical peak, sex in your 20s can be hampered by anxieties over body image and “getting it right”. It’s made all the worse for today’s generation by social media and internet porn, says Ammanda Major, a sex therapist and head of clinical practice at Relate. “It’s all about communication and learning to speak to each other sexually so you can share your needs and wants,” she says.
One in 10 women aged 16 to 24 report feeling pain as a result of sex. “It may be that they’re not aroused enough or it can be related to contraceptives — condoms or the hormonal methods may lead to dryness and pain,” says Cynthia Graham, professor of sexual and reproductive health at the Centre for Sexual Health Research at the University of Southampton. Talking to a GP is a good idea, she adds.
This is the age when children often come along, and pregnancy, birth, breastfeeding and sleep deprivation can all take their toll on a couple’s sex life. “It may help to have conversations about how things may change, before baby arrives,” says Major. “And be flexible. Sex might have to happen at different times now.”
After pregnancy and childbirth, incontinence and prolapse can have an effect on a woman’s sex life, both due to impact on sensation and body confidence, says Dr Elise Dallas, clinical lead of women’s health at private GP service Babylon. Kegel exercises, during pregnancy and after birth, are key, but if you have any concerns see your GP or a physiotherapist.
Anniki Sommerville, co-author of More Orgasms Please: Why Female Pleasure Matters, advises couples to keep up physical contact, even when full-on sex is off the cards.
“After kids you can forget to kiss for kissing’s sake, but it’s when you need affection the most and can help a couple stay close.”
Erectile dysfunction can happen at any age but studies show an increase in prevalence from 40 onwards, says David Goldmeier, a leading consultant in sexual health based at Imperial College London. “In the younger man, it’s usually related to performance anxiety, but in older groups it’s caused by all the same conditions that predispose to heart problems and strokes: high blood pressure and cholesterol, diabetes, being overweight.
“So anyone experiencing a persistent sexual problem should go to their doctor.” Treating these problems through lifestyle changes such as exercise, diet and giving up smoking, can improve erectile dysfunction.
“Once all the underlying causes have been looked at, you can use any of the PDE5 inhibitors such as sildenafil [Viagra].”
Stress over work, children and caring for elderly parents can leave people in their 40s exhausted and time-poor.
“Couples go to therapy and say there’s a problem with the sex, but when you start to talk it’s because there are problems in the relationship. People are so busy, there’s no time to talk about it,” says Major.
Another mistake people make is having sex when they’re too tired, she says. “They end up feeling resentful, frustrated and used, and the experience is almost ‘by rote’.”
Try changing your habits — especially tech habits — and make time not just for sex, but for talking, touching and reconnecting. Remember, too, that a loss of interest in sex can be an early sign of depression. “This can be more obvious to see in men than in women,” says Dr Dallas. “However, men are not so great at coming forward.” For mild to moderate depression, a GP can refer you for cognitive behavioural therapy (CBT), she says, adding that the picture can be complex because anti-depressants can cause sexual problems of their own.
If vaginal dryness is an issue, consider whether you need to switch contraceptive, says GP Dr Dallas. “People in their 40s are often wanting a longer-lasting form, such as the coil — but it can cause dryness and affect libido.”
The menopause can have profound effects on a woman’s sexual relationship. Along with vaginal dryness — which affects around 70pc of women — hormonal changes often result in reduced libido, says Louise Newson, a GP who specialises in the menopause. “So many women tell me they love their husbands, but just don’t feel interested. They stay downstairs and wait for their husband to fall asleep.
“Also, a lot of menopausal women just feel rubbish — they put on weight because of metabolic changes, they’re tired, they comfort eat — they just don’t feel as sexy.” Hormone replacement therapy (HRT) can help with all these symptoms, she says, and the addition of testosterone is particularly effective for libido. Local vaginal oestrogen, applied as a pessary, cream or ring, improves vaginal dryness, and is safe for those who can’t use HRT.
Partners can find it hard to manage these changes, too. Newson says it’s helpful to remind yourselves that sex doesn’t always have to mean intercourse: for many couples, caressing is just as satisfying.
Not everyone experiences the menopause as a negative stage — some have no symptoms and feel liberated by the end of periods.
“Some women describe the sex in their 50s and 60s as the best they’ve ever had; they know their bodies, they know what they want and they know how to ask for it,” says Ammanda Major. “So ignore generalisations.” Prof Graham adds that some see the menopause “as the chance to give up sex, because they’ve never really enjoyed it.”
For some, the seventh decade of life can bring the start of a new chapter. “After divorce or death, people may find themselves dating again after being out of the game for a long time,” says Major. “Meeting someone new can be a great joy, but don’t feel rushed, or pressurised into doing anything you don’t want to do.”
She advises talking to trusted friends who can share their experiences of starting new relationships, and seeking information from reliable sources online.
Older people can be unaware of the importance of contraception, a factor that has been blamed for a sharp rise in STIs among this age group.
“If you’re in a new partnership, don’t be afraid to ask about sexual history or any issues you might need to know about. And if you have the slightest worry — discharge, bleeding, lumps or bumps — see your GP.”
For men, erectile problems will become more common with age, and can also start as a result of health problems such as diabetes and enlarged prostate, and medications such as anti-hypertensive drugs.
“There are things that can help, but also be kind to yourself and bear in mind that there are other ways to pleasure each other,” says Major.
“Men talk about being less focused on erections at this stage, and sometimes they have to be,” adds Prof Graham.
Seventies and beyond
Along with changes in sexual appetite and function, age brings changes in our physical appearance and problems with body confidence.
“Accepting the ageing process can be difficult,” says Major. “We tend to compare ourselves with other people, but it’s a good idea to instead focus on the things we do like about our bodies and to do the same for your partner.”
Giving gushing compliments all the time can render them meaningless, she says. “Just let them know from time to time that you love that particular bit, or thing they’ve done.
“If you’re with somebody for a long time, good sex is about constant rediscovery, remaining curious and asking: how do things need to be now? That often helps people through difficult times.”
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