Exploring Sexual Well-Being in Older Adulthood: Diversity in Experiences and Associated Factors
Creators: name: Bell, Suzanne
Publisher: name: Université d'Ottawa / University of Ottawa
Year: 2016
Subjects: Sexual well-being
Aging
Older adult
Sexual activity
Women's sexuality
Systematic review
Dual Control Model

description: For decades, sexual expression in older adulthood was a taboo topic in the public discourse and ignored in the empirical literature. As a result of several significant sociocultural changes and medical developments as well as an increasingly older population, however, perspectives are shifting and acceptance and interest in the sexual lives of older adults is growing. The purpose of this dissertation was to investigate sexual well-being in older adulthood and explore its diversity. Study 1 involved a systematic review of the literature on factors associated with the maintenance and cessation of sexual activity in adults 60 years of age and older. Data were extracted from a total of 57 studies and each was assessed for methodological quality. Surprisingly, only four factors (i.e., partner’s interest in sexual activity, past frequency of sexual activity, presence of erectile dysfunction, and partner-related illness) were consistently related, in more than one study, to whether or not older adults were sexually active. Significant variability in study results highlighted methodological caveats of the body of literature, but also the heterogeneity of older adults’ sexuality. Study 2 built upon the findings and recommendations of Study 1 and further examined diversity in sexual well-being. Sexual function and satisfaction, the absence of sexuality-related distress, breadth of sexual experience, and overall frequency of sexual activity were considered as indicators of sexual well-being. The Dual Control Model of Sexual Response (DCM) was used as the theoretical framework in this study of women 50 years of age and older. The DCM posits that sexual response depends on the relative activation of sexual excitatory and sexual inhibitory processes, two separate and independent systems. Study 2 results indicated that, independently, women’s propensities for sexual excitation and sexual inhibition were significantly associated with the majority of the indicators of sexual well-being and the directions of associations were consistent with the tenets of the DCM. The only association that proved not statistically significant was the relationship between sexual excitation and sexual distress. When examined together, sexual excitation and sexual inhibition factors significantly predicted sexual function, satisfaction, and frequency. Sexual distress was predicted more strongly by sexual inhibition factors and sexual breadth by sexual excitation factors. Partner physical and mental health and participant mental health were further identified as moderating variables of these associations. The results of Study 2 expand current knowledge regarding the DCM and its relevance to older women; sexual excitation and sexual inhibition appear to have heuristic value to better understand the variability in sexual activity and well-being in women aged 50 years and older. The results of this dissertation have important implications for the study of sexuality and ageing, perhaps most prominently in terms of highlighting the inter-individual variation in older adulthood and the conclusion that generalizations about “older adults” as a group may not be appropriate.