Both societal and internalized ageism negatively impacts sexual health in older adults across five domains: stigmatizing sexuality in aging populations, neglecting intimate environments, decreased sexual pleasure, overlooked sexual health concerns, and underestimation of sexual violence.
Key Findings
Results
Ageism stigmatizes sexuality in the aging population, contributing to the broader negative impact on older adults' sexual health.
Societal ageism perpetuates the view that sexuality is inappropriate or nonexistent in older adults
Internalized ageism leads older adults themselves to adopt negative beliefs about their own sexuality
This stigmatization was identified as one of five major thematic impacts of ageism on sexual health
The finding emerged from synthesis of 29 included studies using the constant comparison method
Results
Ageism contributes to the neglect of intimate and private environments for older adults, particularly in care settings.
This was identified as one of five key thematic findings from the integrative review
Neglect of private environments was linked to both societal and institutional forms of ageism
The theme reflects how care environments fail to accommodate the sexual and intimate needs of older residents or patients
Evidence was synthesized from 29 studies across multiple databases including PubMed, Scopus, Web of Science, and EBSCOhost
Results
Ageism is associated with decreased experience of sexual pleasure among older adults.
Decreased sexual pleasure was identified as one of five major themes in the review
Both societal and internalized ageism were implicated in reducing older adults' experience of sexual pleasure
This finding reflects how ageist attitudes can directly affect subjective sexual experience in later life
Quality of included studies was evaluated using the Mixed Methods Appraisal Tool and Gough's weight of evidence framework
Results
Sexual health concerns of older adults are frequently overlooked, in part due to ageist attitudes among healthcare providers and society.
Overlooked sexual health concerns in later life was identified as one of five thematic findings
Ageism contributes to healthcare providers failing to address or screen for sexual health issues in older patients
The review notes that sexual health remains understudied in older adults due to ageism
This theme was derived from 29 studies identified from an initial pool of 634 records
Results
Sexual violence against older adults is underestimated, and ageism contributes to this underrecognition.
Underestimation of sexual violence against older adults was identified as one of five key thematic findings
Both societal ageism and internalized ageism were implicated in the underrecognition and underreporting of sexual violence in this population
This finding highlights a significant gap in awareness, reporting, and intervention for sexual violence in later life
The theme was synthesized using the constant comparison method across the 29 included studies
Methods
The integrative review included 29 studies identified through a systematic search of multiple databases using Whittemore and Knafl's five-step integrative review method.
A total of 634 records were initially identified before screening; 29 studies were ultimately included
Databases searched included PubMed, Scopus, Web of Science, and EBSCOhost, with publications up to January 2025
Search terms combined keywords related to ageism, sexual health, and older adults
A reference list search of all included publications was conducted to identify additional studies
Quality appraisal used the Mixed Methods Appraisal Tool; evidence levels were assessed using Gough's weight of evidence framework
Background
Sexual health is identified as essential to older adults' quality of life but remains understudied due to ageism.
The authors frame ageism as a root cause of the research gap in older adult sexual health
The review explicitly states that sexual health 'remains understudied due to ageism'
The review calls for enhanced sexual health awareness in older adults through mitigation of ageism
What This Means
This research suggests that ageism — both from society at large and from older adults who have internalized negative views about aging — has a broad and damaging effect on the sexual health of older people. Researchers reviewed 29 studies published before 2025 and found five main ways ageism harms sexual health in later life: it stigmatizes the idea that older adults are sexual beings, fails to provide private and intimate spaces (especially in care facilities), reduces older adults' enjoyment of sexual activity, causes healthcare providers and others to ignore sexual health needs in this age group, and leads to sexual violence against older adults being seriously underrecognized and underreported.
This research suggests that many of the sexual health challenges faced by older adults are not simply a natural consequence of aging, but are shaped by cultural and societal attitudes that dismiss or demean older adults' sexuality. When healthcare providers hold ageist views, they may skip conversations about sexual health with older patients, miss important diagnoses, or fail to offer appropriate care. When older adults internalize these ageist messages, they may feel shame or believe their sexual needs don't matter, reducing their wellbeing.
The practical implication of this review is that improving sexual health outcomes for older adults requires addressing ageism directly — in healthcare training, care facility policies, public awareness, and the attitudes that older adults hold about themselves. The authors call for greater awareness of older adults' sexual health needs as a key step toward more equitable and complete care for this population.
Cao S, Gordon J, Nian W, Johnson K. (2026). The impact of ageism on sexual health in older adults: an integrative review.. The Gerontologist. https://doi.org/10.1093/geront/gnaf304