Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
PLoS One. 2019 Mar 27;14(3):e0213835. doi: 10.1371/journal.pone.0213835. eCollection 2019.
Men and women are increasingly likely to stay sexually active into later life, but research shows that sexual activity and satisfaction decrease with increasing age. Ill health and medical treatments may affect sexual activity but there is little research on why some older people with a health problem affecting their sexual activity are satisfied with their sex life, and others are not.
A mixed method study integrating data and analyses from the third British National Survey of Sexual Attitudes and Lifestyles (n = 3343 aged 55-74 years) and from follow-up in-depth interviews with 23 survey participants who reported having a health condition or taking medication affecting their sex life.
Overall, 26.9% of men and 17.1% of women aged 55-74 reported having a health condition that affected their sex life. Among this group, women were less likely than men to be sexually active in the previous 6 months (54.3% vs 62.0%) but just as likely to be satisfied with their sex life (41.9% vs 42.1%). In follow-up interviews, participants sometimes struggled to tease out the effects of ill health from those of advancing age. Where effects of ill health were identified, they tended to operate through the inclination and capacity to be sexually active, the practical possibilities for doing so and the limits placed on forms of sexual expression. In close relationships partners worked to establish compensatory mechanisms, but in less close relationships ill health provided an excuse to stop sex or deterred attempts to resolve difficulties. Most fundamentally, ill health may influence whether individuals have a partner with whom to have sex.
The data show complex interactions between health, lifestyle and relationship factors that affect sexual activity/satisfaction. When dealing with sexual problems in older people, practitioners need to take account of individual lifestyle, needs and preferences.
男性和女性越来越有可能在晚年保持活跃的性生活，但研究表明，随着年龄的增长，性活动和性满意度会下降。健康状况不佳和医疗治疗可能会影响性活动，但对于为什么一些有健康问题影响其性活动的老年人对性生活感到满意，而另一些则不然，研究甚少。
一项混合方法研究整合了第三次英国性态度和生活方式调查（n=3343 名 55-74 岁的年龄）的数据和分析，以及对 23 名报告有健康状况或服用影响性生活的药物的调查参与者的后续深入访谈。
总体而言，55-74 岁的男性中有 26.9%和女性中有 17.1%报告有健康状况影响他们的性生活。在这一组中，女性在过去 6 个月内的性活跃程度低于男性（54.3%比 62.0%），但对性生活的满意度相当（41.9%比 42.1%）。在后续访谈中，参与者有时难以将健康状况的影响与年龄的增长区分开来。在确定健康状况的影响时，它们往往通过性活跃的倾向和能力、实际进行性行为的可能性以及对性表达形式的限制来起作用。在亲密关系中，伴侣会努力建立补偿机制，但在不太亲密的关系中，健康状况不佳成为停止性行为的借口，或阻止了解决困难的尝试。最重要的是，健康状况不佳可能会影响个人是否有伴侣进行性行为。
数据显示，健康、生活方式和关系因素之间存在复杂的相互作用，这些因素会影响性活动/满意度。在处理老年人的性问题时，从业者需要考虑个人的生活方式、需求和偏好。
