As people are living longer, the 65-plus age group is forming an increasingly large proportion of the population, and, fortunately, societal attitudes towards sexual functioning for ageing adults are gradually changing.

People who were sexually active younger people in the relatively sexually liberated 1960s and 1970s are now in or entering their retirement years, and are taking with them their established patterns of sexual attitudes and behaviour.

Studies indicate that about half of people over 60 enjoy sexual activity at least once a month, and many would prefer to have sex more often than this. But many older people have internalised society's anxieties and misconceptions about how ageing may affect sexual desire and ability.

Although the normal ageing process does produce sexual changes, these are not as extreme as they are often believed to be, and many older couples adjust successfully to these changes by slightly modifying their love-making practices.

Health problems that can affect sexuality do increase in later life, but even the most serious conditions shouldn't stop you from having a satisfying sex life. It is important to understand and know what to expect about how ageing affects your sexuality in order to dispel unwarranted fears and learn to deal with them.

Older men and sexual changes
Changes in sexual physiology that you can expect with ageing can affect both erectile function and ejaculation. These changes don't mean you have to stop having sex, however.

It will probably take you longer to attain a full erection or the erection may not be as firm or as large as in earlier years, and you may need more direct manual stimulation from your partner to become fully aroused and erect.

Try incorporating a lubricated hand massage into foreplay. If you're not fully erect enough to enter your partner, have your partner manually guide your penis. You may not experience as much warning time before ejaculation, and when you do ejaculate, you will probably release less sperm less forcefully. The loss of erection after orgasm may be more rapid or it may take longer before an erection is again possible.

The majority of men with erectile dysfunction (impotence) are over 65, but the condition is not caused by ageing itself. More often, erectile dysfunction is caused by health conditions such as vascular, endocrine or neurological disorders, prostate problems or diabetes. Effective treatments for this condition do exist and should be discussed with your doctor.

Certain kinds of surgery and medication may also interfere with sexual function. Many medications that older people use, such as antihypertensives, tranquilizers, and antidepressants, can adversely affect erectile function and libido. Don't resign yourself to adverse affects – many can be alleviated. Consult your doctor for advice.

Older women and sexual changes
In women, the physiological effects of ageing on sexual function are primarily caused by post-menopausal hormonal changes. This usually does not mean decreased desire and ability to become aroused, however. And for many women, post-menopausal changes are offset by the freedom to enjoy sex without worrying pregnancy.

The rate and amount of vaginal lubrication decreases in most women, and vaginal tissue may become thinner and less elastic. The associated discomfort that you may experience during intercourse might reduce your sexual desire. Consult your gynaecologist about vaginal pain.

Treatment may simply involve using an over-the-counter vaginal lubricant. Water-based lubricants like KY jelly can also be applied to your partner's penis to ease penetration. Discuss the possibilty of hormone replacement therapy with your doctor: this may improve your general health in addition to relieving bothersome post-menopausal sexual symptoms.

You may also experience a reduction in the size of the clitoris, vulva, and labia as a result of thinning fatty tissue. If the 'hood' that covers the clitoris thins, the clitoris may become overly sensitive to pressure that was previously experienced as pleasurable. Discuss this with your partner. A simple lessening of pressure or less direct and prolonged stimulation may solve the problem.

So it's very much a case of "Oud, maar nie koud nie!"