Fears of the occurrence of heart attacks or strokes during sex frequently lead to older couples abstaining from such activities regardless of medical advice to the contrary. Female longevity creates another barrier to sexual activity in later years. Women tend to outlive their male counterparts by seven or more years, thus leaving many women without sexual partners in the later years. Society has condoned the relationships of older men and younger women, but tends to ostracize older women who establish relationships with younger men. The number of available men as sexual partners for older women is further limited by the lower numbers of eligible older males.
Extramarital affairs are taboo for many elderly both religiously and morally.
Masturbation, although increasingly more acceptable, is still considered shameful or harmful for many elderly. Research has accumulated on the sexuality of the elderly, which generally supports the view that sexual capacity has been underestimated except where illness or lack of a sexual partner is a factor. Changes that occur in elderly men are often misinterpreted as impotence. Older men generally take longer to obtain erections, but can remain erect and make love longer before attaining orgasm. Older men are usually able to continue some form of sexual activity well into their eighties and even beyond.