New research by Štulhofer and colleagues (2025) presents the novel construct of positive sexual aging and explains their measure of sexuality for older adults.
Background
Although sexuality is linked with health and well-being in older adults, we often experience declines in both sexual frequency and sexual health as we age. Štulhofer et al. emphasize that positive sexual aging should include adapting to the new circumstances and challenges which we may face as older adults.
According to Štulhofer et al., healthy aging involves maintaining physical health, cognitive activity, and social well-being, highlighting the three facets of physical, psychological, and social vigor. Their model of positive sexual health emphasizes that while sexuality is important for older adults, we must be willing to modify our behaviors and expectations in order to accommodate changes to our health, sexual functioning, or relationships. The researchers suggest that while sexual function may change, these changes do not necessarily need to cause distress. Finding new ways to experience pleasure if dysfunctions arise as well as adopting a broad definition of sexual behavior can help to maintain positive sexual experiences throughout the lifespan. Interestingly, the authors advise that positive sexual aging need not require sexual activity. Couples who freely choose and feel content with sexual inactivity can also be categorized as aging positively.
Measure
The authors developed a new measure called the Brief Positive Sexual Aging Scale (BIPAS). After a multi-year project, the researchers identified four components which contribute to positive sexual aging. Sexual agency is setting goals for sexual behaviors and accomplishing those goals. Adaptation involves the perception that adults have responded in a healthy way to changes in their sexual abilities or functioning. (Conversely, unsuccessful aging might include feeling dissatisfied or depressed with one’s sexuality and circumstances because of changes in sexual function or desire.) The third component is acceptance of body changes, which involves accepting the aging process, emphasizing physical capabilities, and acknowledging the reality of changes to one’s physical appearance. The last component is opportunity for sexual expression. This factor may involve responding to a partner’s physical health challenges or finding time for sex amidst other demands.
More than 700 participants aged 65 and older from Norway and Croatia completed this new scale measuring positive sexual aging. Sample items included “should you have a sexual need these days, how likely is it that you would be able to fulfill it?” and “so far, I have adapted well to changes in my sexuality that are due to aging.” The researchers also measured loneliness, depression and anxiety symptoms, distress over sexual difficulties, relationship satisfaction, sexual communication, sexual satisfaction, and life satisfaction. They found that those who scored high on the BIPAS also had high scores on measures of sexual communication, sexual activity, relationship satisfaction, and mental health. However, there were differences in positive sexual aging for men and women.
Gender Similarities and Differences
The researchers found that having opportunities to express their sexuality played a pivotal role in feelings of positive sexual aging for both men and women. Interestingly, sexual function or dysfunction seemed to impact women’s feelings of positive sexual aging more than men’s. Conversely, sexual agency, or feeling in control of one’s sexuality seemed to impact men’s sexual aging more than women’s. The researchers also found that perceptions of one’s facial and body attractiveness were a more important aspect of sexual aging for women than men.
For both men and women, the construct of positive sexual aging (encompassing all four factors) was positively correlated with sexual satisfaction, life satisfaction, and relationship satisfaction. It was also strongly positively correlated with communicating about sex with one’s partner. Better physical health was also positively related to positive sexual aging. The authors underscored that positive sexual aging need not include continuing to engage in intercourse at older ages. They state that “retiring from sex” may indicate that an individual is successfully modifying their expectations to match their life circumstances.
Limitations
The authors note that although this new scale has only been tested in individuals from Croatia and Norway, these two cultures differ from one another in both gender equality and sexual conservativeness. Therefore, they expect this new measure to be useful for measuring successful sexual aging across a range of cultures. Although participants were randomly invited to respond, more men than women responded to this survey, suggesting that this topic might be more personally relevant for men than for women. The authors also noted that responses to this survey were gathered during the COVID-19 Pandemic, which may have impacted the way participants responded. For the initial scale development, the authors excluded non-heterosexual individuals, so future research will be required to test the efficacy of this measure for participants who identify with other sexual orientations.
