AARP recently published a survey on sex, romance, and relationships in midlife and older adults (age 45 and older). One of the key findings was the answer to the question, what does a happy sexual relationship look like? Those who are the most satisfied tend to have the following:

  1. A sexual partner (but not necessarily a spouse)
  2. Frequent sexual intercourse (more than once a week, but not necessarily daily)
  3. Good health (self and partner)
  4. Low levels of stress
  5. Absence of financial worries


Marriage does not necessarily increase sexual frequency or satisfaction. In fact, 48 percent of those who are single and dating say they have intercourse at least once a week, compared to 36 percent of those who are married, and 60 percent of dating singles are satisfied with their sex lives, compared to only 52 percent of those who are married.

The study also noted a dramatic change in sexual attitudes in the older set. The percentage of those who agree that people should not have a sexual relationship if they are not married has dropped precipitously, from 41 percent ten years ago to 34 percent five years ago to 22 percent today.

Surprisingly, about 20 percent of the people surveyed in this age group engage in self-stimulation at least once a week. The presence or absence of a sexual partner is not a factor, as virtually the same percentage of those with sexual partners say they engage in self-stimulation at least once a week as well.

Not surprising, the men and women surveyed have different sex attitudes, regardless of age. For instance, sex is far more important to the overall quality of life and more critical to a good relationship for men than it is for women. In addition, nearly twice as many men as women admit to having had a sexual relationship outside their long-term relationship.

Ethnicity also makes a difference. Hispanics in this older age group are more sexually active and satisfied than the general population. And regardless of gender or ethnicity, those with a regular sexual partner have a more positive outlook on life, both present and future, than those without a regular partner do.

Good health is always a critical factor that affects sexuality and performance, particularly in this older population. High blood pressure and high cholesterol are the most common adverse medical conditions reported by this group, followed by arthritis or rheumatism, back problems, diabetes, and depression.

Fantasies are not just for the young. About 25 percent of the AARP population surveyed has sexual thoughts, fantasies, or erotic dreams at least once a day. The most common fantasies include the following:

  1. Having sex with a stranger (38 percent)
  2. Having sex with more than one person at a time (21 percent)
  3. Having sex with a celebrity (19 percent)
  4. Having sex in public (11 percent)
  5. Having sex with someone of the same sex (9 percent)

In addition, men are significantly more likely to report fantasies of having sex with a stranger or having sex with more than one person at a time than women are.

And what about romance? To keep romance in their relationship, the most common practice (cited by nearly two in three men and women of all ages) is telling each other, “I love you.” Second, and very close, is recognizing special occasions, like birthdays and anniversaries. On the other end of the spectrum, less than 20 percent of men responded, “Romance? What’s that?”

Better health and less stress top the list of changes that would improve current sexual satisfaction for both men and women in this age group. However, men are nearly twice as likely as women to say that better personal health would improve sexual satisfaction. Men are also more likely to cite a better financial situation as a helpful improvement, along with a partner who initiates sex more often, a more adventurous partner, and a younger partner. Women, on the other hand, are nearly twice as likely as men to say that no change is needed.

In the end, sex, romance, and relationship attitudes in the AARP age group (45 and older) are not much different from the attitudes of the younger, healthier, stronger, and more sexually active youthful group. Things may slow down a bit with age, but in the end, relationships can be just as rewarding and meaningful and emotional, proving once again that “romance has no boundaries.”

Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).

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