This first ICSM position paper on sexual health in older adults finds that despite extensive literature on prevalence and risk of sexual challenges in adults over 65, there is limited evidence regarding quality of treatment modalities, particularly scant data on women, and recommends a comprehensive, non-judgmental, couple-centered approach that accounts for multifactorial challenges.
Key Findings
Results
There is extensive literature on the prevalence and risk of sexual challenges in adults over age 65, but limited evidence regarding the quality of treatment modalities.
The review was conducted as the first ICSM position paper specifically addressing sexual health in older adults
A comprehensive literature search was conducted using PsycInfo, PubMed, Medline, and Google Scholar
Recommendations were formulated using a modified Delphi method by a multidisciplinary international expert panel
The panel included specialists in urology, gynecology, psychiatry, sexual medicine, social work, and sex therapy
Results
Data on sexual health treatment modalities in older women is particularly scarce compared to data on older men.
The paper explicitly notes 'scant data on women in this age group' (adults over 65)
This gap was identified as a notable limitation in the existing evidence base
The finding highlights a sex-based disparity in sexual medicine research for older populations
Background
Physical, cognitive, and psychosocial factors create a unique and multifactorial set of challenges related to sexuality in older adults.
Factors examined included physiological aspects of aging, state of health, psychological factors, relationship-related factors, and sociocultural factors
Cognitive decline was identified as requiring special attention as a distinct challenge in this population
The multifactorial nature of sexual challenges in this group points to the need for a comprehensive approach to care
Conclusions
Healthcare providers must be aware of ageist biases that may prevent them from providing appropriate sexual healthcare to older adults.
Ageist biases among healthcare providers were identified as a specific barrier to appropriate care
The paper recommends that any approach to sexual health in older adults endorse the full spectrum of sexual expression in a non-judgmental way
Provider bias was highlighted as a distinct concern separate from patient-level or system-level barriers
Conclusions
A couple-centered approach to sexual health care is recommended for older adults who are in a relationship.
The recommendation specifies that 'individuals in a relationship should be offered a couple-centered approach'
This recommendation was developed through a modified Delphi consensus process among international experts
The couple-centered framing reflects the relational context in which older adult sexuality commonly occurs
Conclusions
Individuals experiencing cognitive decline require special attention in the context of sexual health care.
Cognitive decline was specifically called out as requiring heightened attention beyond the general older adult recommendations
This finding reflects the intersection of neurological health and sexual expression in aging populations
The paper does not specify particular treatment modalities for this subgroup, consistent with the identified evidence gap
What This Means
This research represents the first official position paper from the International Consultation on Sexual Medicine (ICSM) focused specifically on the sexual health of older adults (those 65 and over). A team of international experts from multiple medical and therapeutic fields reviewed existing scientific literature and used a structured consensus process to develop recommendations. They found that while there is a substantial body of research documenting how common sexual difficulties are in older adults and what puts people at risk, there is surprisingly little high-quality evidence about how well different treatments actually work — and this gap is especially pronounced for older women.
The research suggests that sexual health in older adults is shaped by a complex mix of physical changes from aging, health conditions, mental health, relationship dynamics, and social and cultural attitudes. Healthcare providers were found to be at risk of holding ageist assumptions that can lead them to overlook or dismiss sexual concerns in older patients. The experts recommend that care be comprehensive, non-judgmental, and respectful of the full range of ways people express their sexuality — and that for people in relationships, treatment should involve both partners when possible.
This research matters because it highlights that sexuality remains an important part of well-being throughout life, yet older adults are often underserved by healthcare systems when it comes to sexual health. The findings point to a need for better-designed studies — especially involving older women — and for healthcare providers to actively address their own biases so that older patients feel comfortable raising sexual health concerns and receive evidence-based care in return.
Luria M, Park K, Gewirtz-Meydan A, Arbanas G, Ho C, Da Ros C, et al.. (2026). Sexuality and sexual health in older adults-recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).. Sexual medicine reviews. https://doi.org/10.1093/sxmrev/qeaf069