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Nervenheilkunde 2021; 40(12): 1001-1006
DOI: 10.1055/a-1467-7131
Schwerpunkt

Sexualität im Alter

Sexuality in older age
Friederike Schröck∗
1   Abteilung für neurodegenerative Erkrankungen und geriatrische Psychiatrie, Universitätsklinik Bonn
,
Kai-Uwe Kühn∗
2   Klinik für Psychiatrie, Psychotherapie und Psychosomatische Medizin, Abteilung Gerontopsychiatrie der LVR Klinik Bonn
,
Birgitta Sträter∗
3   Katholische Hochschule Nordrhein-Westfalen, Köln
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ZUSAMMENFASSUNG

Hintergrund Sexualität spielt auch im höheren Lebensalter eine wichtige Rolle und ist mit der Lebensqualität verknüpft, doch wird dieser Zusammenhang weiterhin tabuisiert.

Methoden Selektive Literaturübersicht ergänzt durch eigene klinische Erfahrungen zu Bedeutung, Einflussfaktoren und Stigmatisierung von Sexualität im Alter.

Ergebnisse Körperliche und psychische Erkrankungen sowie Medikation haben Einfluss auf die Sexualität. Während die sexuelle Aktivität im hohen Lebensalter abnimmt, bleibt die sexuelle Zufriedenheit weiterhin bestehen. Doch haben sich aus objektiven, altersbedingt zunehmenden Einschränkungen Stigmata entwickelt, die das Bild von sexueller Gesundheit im Alter prägen. Neben der öffentlichen Stigmatisierung spielt auch die institutionelle Stigmatisierung eine wichtige Rolle; so fehlt meist ein offenes Ansprechen des sexuellen Erlebens im Arzt-Patienten-Kontakt.

Fazit Die medizinischen Bedingungen für eine erfüllte Alterssexualität sind besser denn je. Medizinisches Personal sollte nicht nur mögliche Erkrankungen sowie Polypharmazie als Risikofaktoren für Beeinträchtigung im Blick haben, sondern auch die sexuelle Gesundheit ihrer Patienten in jedem Lebensalter unterstützen.

ABSTRACT

Background Sexuality plays an important role in old age and is linked to quality of life, but this connection is still a taboo topic.

Methods Selective literature review supplemented by own clinical experience on the importance, influencing factors and stigmatization of sexuality in old age.

Results Physical and mental illnesses as well as medication have an impact on sexuality. While sexual activity decreases in old age, sexual satisfaction persists. But stigmata have developed from objective, age-related restrictions that shape the image of sexual health in old age. In addition to public stigmatization, institutional stigmatization also plays an important role; so, there is usually no open addressing of the sexual experience in doctor-patient contact.

Conclusion The medical conditions for fulfilling sexuality in older age are better than ever. Medical staff should not only keep an eye on possible diseases and polypharmacy as risk factors for impairment, but also support the sexual health of their patients at all ages.

Schlüsselwörter

Sexualität - Alter - Stigma

Key words

Sexuality - aged - stigma


Publication History

Article published online:
06 December 2021

© 2021. Thieme. All rights reserved.

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  • Literatur

  • 1 Dekker A, Matthiesen S, Cerwenka S. et al Health, sexual activity, and sexual satisfaction—selected results from the German Health and Sexuality Survey (GeSiD). Dtsch Arztebl Int 2020; 117: 645-52
    CrossrefPubMedSearch in Google Scholar
  • 2 Gott CM.. Sexual activity and risk-taking in later life. Health and Social Care in the Community. 2001; 09: 72-78
    CrossrefPubMedSearch in Google Scholar
  • 3 Nicolosi A, Laumann EO, Glasser DB. et al Sexual behavior and sexual dysfunctions after age 40: The global study of sexual attitudes and behaviors. Urology 2004; 64 (05) 991-7
    CrossrefPubMedSearch in Google Scholar
  • 4 Lindau ST, Schumm LP, Laumann EO. et al A Study of Sexuality and Health among Older Adults in the United States. N Engl J Med 2007; 357: 762-774
    CrossrefSearch in Google Scholar
  • 5 Lindau ST, Gavrilova N. Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ 2010: 340-c810
    CrossrefPubMedSearch in Google Scholar
  • 6 Baumeister RF, Catanese KR, Vohs KD. Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence. Personality and Social Psychology Review 2001; 05 (03) 242-273
    CrossrefSearch in Google Scholar
  • 7 Campbell JM, Huff MS.. Sexuality in the older woman. Gerontol Geriatr Educ. 1995; 16 (01) 71-81
    CrossrefSearch in Google Scholar
  • 8 Kandeel FR, Koussa VKT, Swerdloff RS. Male sexual function and its disorders: Physiology, pathophysiology, clinical investigation, and treatment. Endocr Rev 2001; 22 (03) 342-88
    CrossrefPubMedSearch in Google Scholar
  • 9 Hartmann U, Philippsohn S, Heiser K. et al Low sexual desire in midlife and older women: personality factors, psychosocial development, present sexuality. Menopause 2004; 11: 726-40
    CrossrefPubMedSearch in Google Scholar
  • 10 Waite LJ, Laumann EO, Das A. et al Sexuality: measures of partnerships, practices, attitudes, and problems in the National Social Life, Health, and Aging Study. J Gerontol B Psychol Sci Soc Sci 2009; 64 (Suppl. 01) 56-66
    CrossrefPubMedSearch in Google Scholar
  • 11 Field N, Mercer CH, Sonnenberg P. et al Associations between health and sexual lifestyles in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet 2013; 382 9907 1830-44
    CrossrefPubMedSearch in Google Scholar
  • 12 Mulligan T, Retchin SM, Chinchilli VM. et al The role of aging and chronic disease in sexual dysfunction. J Am Geriatr Soc 1988; 36 (06) 520-4
    CrossrefPubMedSearch in Google Scholar
  • 13 Wierman ME. Advances in the diagnosis and management of impotence. Dis Mon 1999; 45 (01) 1-20
    CrossrefPubMedSearch in Google Scholar
  • 14 Lewis R, Hatzichristou D, Laumann E. et al Epidemiology and natural history of erectile dysfunction: risk factors including iatrogenic and aging. In: Jardin A, et al. (eds). Erectile Dysfunction. Plymouth: Plymbridge Distributors Ltd 2000: 19-51
    PubMedSearch in Google Scholar
  • 15 Chew KK, Bremner A, Stuckey B. et al Sex life after 65: How does erectile dysfunction affect ageing and elderly men?. Aging Male 2009; 12 2–3 41-46
    CrossrefPubMedSearch in Google Scholar
  • 16 Helgason AR, Fredrikson M, Adolfsson J. et al Decreased sexual capacity after external radiation therapy for prostate cancer impairs quality of life. Int J Radiat Oncol Biol Phys 1995; 32 (01) 33-9
    CrossrefPubMedSearch in Google Scholar
  • 17 Marien T, Sankin A, Lepor H. Factors predicting preservation of erectile function in men undergoing open radical retropubic prostatectomy. J Urol 2009; 181: 1817-22
    CrossrefPubMedSearch in Google Scholar
  • 18 Walsh KE, Berman JR. Sexual dysfunction in the older woman: An overview of the current understanding and management. Drugs Aging 2004; 21 (10) 655-75
    CrossrefPubMedSearch in Google Scholar
  • 19 Amin SH, Kuhle CL, Fitzpatrick LA. Comprehensive evaluation of the older woman. Mayo Clin Proc 2003; 78: 1157-1185
    CrossrefPubMedSearch in Google Scholar
  • 20 Stead ML, Brown JM, Fallowfield L. et al Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Br J Cancer 2003; 88 (05) 666-71
    CrossrefPubMedSearch in Google Scholar
  • 21 Grossman DC, Curry SJ, Owens DK. et al Hormone Therapy for the primary prevention of chronic conditions in postmenopausal women US preventive services task force recommendation statement. JAMA 2017; 318: 2224-2233
    CrossrefPubMedSearch in Google Scholar
  • 22 Bak E, Marcisz C, Krzeminska S. et al Does Type 1 Diabetes Modify Sexuality and Mood of Women and Men?. Int J Environ Res Public Health 2018; 15 (05) 958
    CrossrefPubMedSearch in Google Scholar
  • 23 Braun M, Wassmer G, Klotz T. et al Epidemiology of erectile dysfunction: Results of the “Cologne Male Survey.”. Int J Impot Res 2000; 12: 303-11
    CrossrefPubMedSearch in Google Scholar
  • 24 Bak E, Marcisz C, Krzeminska S. et al Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus. Int J Environ Res Public Health 2017; 14 (09) 1073
    CrossrefPubMedSearch in Google Scholar
  • 25 Corona G, Lee DM, Forti G. et al Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med 2010; 07: 1362-80
    CrossrefPubMedSearch in Google Scholar
  • 26 Matthias RE, Lubben JE, Atchison KA. et al Sexual activity and satisfaction among very old adults: results from a community-dwelling Medicare population survey. Gerontologist 1997; 37 (01) 6-14
    CrossrefPubMedSearch in Google Scholar
  • 27 Bacon CG, Mittleman MA, Kawachi I. et al Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med 2003; 139 (03) 161-8
    CrossrefPubMedSearch in Google Scholar
  • 28 Rosen R, Altwein J, Boyle P. et al Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2000; 44 (06) 637-49
    CrossrefPubMedSearch in Google Scholar
  • 29 Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med 2007; 120 (02) 151-7
    CrossrefPubMedSearch in Google Scholar
  • 30 Addis IB, Ireland CC, Vittinghoff E. et al Sexual activity and function in postmenopausal women with heart disease. Obstet Gynecol 2000; 106 (01) 121-7
    CrossrefSearch in Google Scholar
  • 31 Wagner G, Mulhall J. Pathophysiology and diagnosis of male erectile dysfunction. BJU Int 2001; 88 (Suppl. 03) 3-10
    CrossrefPubMedSearch in Google Scholar
  • 32 Feldman HA, Goldstein I, Hatzichristou DG. et al Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151 (01) 54-61
    CrossrefPubMedSearch in Google Scholar
  • 33 Valadares AL, Pinto-Neto AM, Osis MJ. et al Prevalence of sexual dysfunction and its associated factors in women aged 40–65 years with 11 years or more of formal education: a population-based household survey. Clinics (Sao Paulo) 2008; 63 (06) 775-782
    CrossrefPubMedSearch in Google Scholar
  • 34 Lindau ST, Surawska H, Paice J. et al Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers. Psychooncology 2011; 20 (02) 179-85
    CrossrefPubMedSearch in Google Scholar
  • 35 Helgason ÁR, Adolfsson J, Dickman P. et al Sexual desire, erection, orgasm and ejaculatory functions and their importance to elderly Swedish men: A population-based study. Age and Ageing 1996; 25 (04) 285-91
    CrossrefPubMedSearch in Google Scholar
  • 36 Chapman KR, Spitznagel MB. Measurement of sexual disinhibition in dementia: A systematic review. Int J Geriatr Psychiatry 2019; 34 (12) 1747-1757
    CrossrefPubMedSearch in Google Scholar
  • 37 Montejo-González AL, Llorca G, Izquierdo JA. et al SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther 1997; 23 (03) 176-94
    CrossrefPubMedSearch in Google Scholar
  • 38 Zajecka J, Mitchell S, Fawcett J. Treatment-emergent changes in sexual function with selective serotonin reuptake inhibitors as measured with the Rush Sexual Inventory. Psychopharmacol Bull 1997; 33 (04) 755-60
    PubMedSearch in Google Scholar
  • 39 Rothmore J. Antidepressant-induced sexual dysfunction. Med J Aust 2020; 212 (07) 329-334
    CrossrefPubMedSearch in Google Scholar
  • 40 Laumann EO, Glasser DB, Neves R. et al A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America. Int J Impot Res 2009; 21: 171-178
    CrossrefPubMedSearch in Google Scholar
  • 41 Hartmann U. Sexuelle Funktionsstörungen. Psychosomatische Aspekte bei Erektionsstörungen. Dt Arztebl 2000; 97 (10) 615-619
    Search in Google Scholar
  • 42 Basson R, Gilks T. Women’s sexual dysfunction associated with psychiatric disorders and their treatment. Womens Health (Lond) 2018: 14
    CrossrefPubMedSearch in Google Scholar
  • 43 Büttner M. Trauma, Borderline und Sexualität. PPT 2019; 23 (02) 87-100
    Search in Google Scholar
  • 44 Bornefeld-Ettmann P, Steil R. Sexuelle Dysfunktionen bei Frauen mit Posttraumatischer Belastungsstörung – ein Übersichtsartikel. Verhaltenstherapie 2017; 27: 130-139
    CrossrefSearch in Google Scholar
  • 45 Csoka AB, Bahrick A, Mehtonen OP. Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors. J Sex Med 2008; 05 (01) 227-33
    CrossrefPubMedSearch in Google Scholar
  • 46 de Boer MK, Castelein S, Wiersma D. et al The facts about sexual (Dys)function in schizophrenia: an overview of clinically relevant findings. Schizophr Bull 2015; 41 (03) 674-86
    CrossrefPubMedSearch in Google Scholar
  • 47 Trudel G, Turgeon L, Piché L. Marital and sexual aspects of old age. Sexual and Relationship Therapy 2010; 25: 316-341
    CrossrefSearch in Google Scholar
  • 48 Smith LJ, Mulhall JP, Deveci S. et al Sex after seventy: A pilot study of sexual function in older persons. J Sex Med 2007; 04: 1247-1253
    CrossrefPubMedSearch in Google Scholar
  • 49 Childs JM. Aging and sexuality. Dialog 2019; 58: 269-276
    CrossrefSearch in Google Scholar
  • 50 Johnson BK. A correlational framework for understanding sexuality in women age 50 and older. Health Care Women Int 1998; 19 (06) 553-564
    CrossrefPubMedSearch in Google Scholar
  • 51 Lightner DJ. Female sexual dysfunction. Mayo Clin Proc 2002; 77 (07) 698-702
    CrossrefPubMedSearch in Google Scholar
  • 52 Lindau ST, Leitsch SA, Lundberg KL. et al Older women’s attitudes, behavior, and communication about sex and HIV: A community-based study. J Womens Health (Larchmt) 2006; 15 (06) 747-53
    CrossrefPubMedSearch in Google Scholar
  • 53 Gott M, Hinchliff S, Galena E. General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 2004; 58 (11) 2093-103
    CrossrefPubMedSearch in Google Scholar
  • 54 de Boer BJ, Bots ML, Lycklamaà Nijeholt AAB. et al The prevalence of bother, acceptance, and need for help in men with erectile dysfunction. J Sex Med 2005; 02: 445-450
    CrossrefPubMedSearch in Google Scholar
  • 55 Waterman EA. Reactions of College Students to the Sexuality of Older People. J Stud Research 2012; 01 (02) 46-50
    CrossrefSearch in Google Scholar
  • 56 Allen RS, Petro KN, Phillips LL. Factors influencing young adults’ attitudes and knowledge of late-life sexuality among older women. Aging Ment Health 2009; 13 (02) 238-45
    CrossrefPubMedSearch in Google Scholar
  • 57 Black B, Muralee S, Tampi RR. Inappropriate sexual behaviors in dementia. J Geriatr Psychiatry Neurol 2005; 18: 155-62
    CrossrefSearch in Google Scholar
  • 58 Stubbs B. Displays of inappropriate sexual behaviour by patients with progressive cognitive impairment: the forgotten form of challenging behaviour?. J Psychiatr Ment Health Nurs 2011; 18 (07) 602-7
    CrossrefPubMedSearch in Google Scholar
  • 59 Döring N. Sexualität in der Pflege. Zwischen Tabu, Grenzüberschreitung und Lebenslust. APuZ 2019; 69 33–34 24-30
    Search in Google Scholar
  • 60 Badeau D. Illness, disability and sex in aging. Sex Disabil 1995; 13: 219-237
    CrossrefSearch in Google Scholar