Sex and concepts of sexuality influence sexual problems and help-seeking behaviours of older people

Abstract

In this study, we aimed to examine the prevalence, associated factors, and management of sexual problems in older people at a primary care unit. We recruited people aged 60 years old and over, who visited the Primary Care Unit of Songklanagarind Hospital, a tertiary-care and referral centre in Southern Thailand, between June and August 2021, and used a self-administered questionnaire on sexuality, sexual problems, help-seeking behaviours, and clinical consultations for sexual problems in older people. There were 190 participants in this study (120 women, 70 men, mean age = 68.3). One hundred and five (55.3%) participants reported having sexual problems. Compared to their female counterparts, males were more likely to have sexual problems (adjusted OR = 3.11; 95% CI = 1.52,6.34; p-value = 0.001). The majority (77.3%) considered non-penetrative sexual activities (outercourse) when discussing sexuality in later life, and they had lower odds of having sexual problems compared to those who relied purely on sexual intercourse (adjusted OR = 0.27 for only outercourse and 0.30 for both intercourse and outercourse; p-value = 0.016). Only 2.1% (4/190) of participants reported that a physician had asked them about sexual problems. Participants reporting sexual problems (N = 105) often consulted their partners (25.7%) and friends (10.5%) or searched information from the internet (18.1%). According to this study, sexual problems in older people are common in primary care settings, but they tend to be poorly managed. Clinical discussions and interventions that are sensitive to gender differences and acknowledge the broadened concepts of sexuality in later life, e.g., encouragement to practice outercourse, may help improve sexual problems and well-being among older people.

Keywords:

• Ageing
• general practitioner
• multi-comorbidity
• older adults
• sexual dysfunction

Acknowledgements

The authors would like to thank the participants for their time and contribution. We would also like to acknowledge the invaluable contribution of Nisan Werachattawan and Kittisak Choomalee, who helped analyse and interpret the data. We thank Edmond Subashi, an English advisor at the International Affairs Office, Faculty of Medicine, Prince of Songkla University, for proofreading the manuscript. The ideas and opinions expressed herein are those of the authors alone, and endorsement by the authors’ institutions is not intended and should not be inferred.

Authors’ contributions

K.A. designed the study, supervised the data collection, analysed and interpreted the data, and wrote the manuscript. B.B. conceived and designed the study, recruited participants, acquired the data, and analysed and interpreted the data. T.A. designed the study, supervised the data collection and analysis, and contributed to the interpretation of the data. All authors revised and approved the final version of the manuscript to be published.

Availability of data and materials

All data generated or analysed during this study are included in this published article.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

This study was funded by the Faculty of Medicine, Prince of Songkla University, Thailand. The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.