Older Adults’ Coping Strategies With Changes in Sexual Functioning: Results From Qualitative Research

Abstract

Introduction Research has consistently documented changes in sexual functioning as people age. Aim To examine the ways older men and women cope with changes in sexual functioning. Methods In-depth interviews with 47 Israelis over the age of 60 were conducted and analyzed thematically. Main Outcome Measure The main outcomes of interest in this study were the coping strategies employed by older men and women to address changes in their sexuality. Results 7 coping strategies that were differentially employed by men and women were identified. These strategies were classified along a continuum of internal (involving only the person being affected by the change) vs external (involving others) strategies. External strategies involved other people and services, such as a primary care provider or a counselor, whereas internal strategies were confined to intrapsychic experiences, such as an acceptance of the fact that sex was no longer part of life. Other strategies, such as sexual fantasies about having an affair or the use of pornography to stimulate desire, were classified along the 2 poles. Most individuals used >1 strategy. Differences by gender are noted. Clinical Implications The techniques identified reflect to some degree the medicalization and marketization of sexuality among older adults, but potentially also allude to somewhat more liberal views of sexuality in contemporary society. Strength & Limitations The subjective nature of this study and the open-ended perspective employed in the analysis allow for better appreciation of the coping strategies used by older adults. There is potentially a selection bias with those individuals who feel more comfortable discussing sexuality, participating in the study, and others refraining from such a discussion. Conclusion The older adults interviewed in this study tended to equate sexual functioning with sexual intercourse.

Factors Conditioning Sexual Behavior in Older Adults: A Systematic Review of Qualitative Studies

“…A total of 226 studies was selected for full-text peer review, of which 208 references were removed after applying the proposed exclusion criteria [(1) not qualitative studies ( n = 44); (2) not scientific studies ( n = 21); (3) different topic ( n = 98); and (4) qualitative studies with samples younger than middle-aged adults ( n = 45)]. Finally, 18 studies [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ] were included in the narrative and thematic synthesis of this systematic review of qualitative studies.…”

“…In general, the methodological quality of the articles included in the thematic synthesis was Moderate (mean quality = 5.66). Seven articles exhibited High quality [58,61,64,68,69,71,74], which represents 38.89% of the total of studies; eight studies presented Moderate quality [59,60,62,63,65,70,72,75], which represents 44.44% of the total; and only three studies showed Low quality [66,67,73], which represents 16.67% of the total. Discrepant scores were shown in Items 3 and 6.…”

“…Discrepant scores were shown in Items 3 and 6. Item 3 refers to the adequacy of the research design with respect to its objectives, and 15 studies [58,59,61,62,[64][65][66][67][68][70][71][72][73][74][75] were inadequate as regards this criterion. Only one study [64] adequately met the requirements of Item 6, which deals with considerations in the relationship between researchers and participants.…”

“…In the following section, we provide an overview of the main findings of our review. The studies included in our review [58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] identified three main thematic areas related to the impact of different sexual conditioning factors in older adults. Table 5 shows the main findings of our review.…”

“…Low-income, uneducated women are disproportionately taught to believe that they have an "obligation" to care for and meet the sexual needs of their husbands, and their sexual notions are often strongly influenced by religious teachings that stigmatize sex. A reduction in sexual desire has been observed in women owing to these gender stereotypes, [58,63,67] which affect their sexuality and entail a dual danger, as they induce them to discriminate based on age and gender, thereby undermining the development of their intimate relationships [66]. Indicative is the story from a sample of a Turkish woman in her 60s [74]: "We haven't had sexual intercourse for the last 20 years.…”