For many older adults, sex continues well past 60. A nationally representative US study in 2007 of 3005 adults aged 57 to 85 found that 73% of those aged 57 to 64 and 26% of those aged 75 to 85 were sexually active, so about one in four in the oldest group. The practical question is therefore not whether sex is possible at this age but which positions suit a particular back and hips, and how to talk about it with a partner and a doctor.
This article is about adapting intimacy to a body that has changed, treating the research on position, pain and desire as a general guide.
Yes, for a meaningful minority, and the proportion falls steadily with age. A nationally representative US study in 2007 of 3005 adults aged 57 to 85 (1550 women and 1455 men) found that sexual activity was reported by fewer people in each successive age band.
A couple side-lying with a pillow under the hip: adapting the position to the body is a practical way to keep intimacy going. — Image: AI-generated / Gemini 3.1 Flash via OpenRouter
The figures were 73% at ages 57 to 64, 53% at 65 to 74 and 26% at 75 to 85, so about 1 in 4 people in the oldest group was sexually active.
Women were less likely than men to report sexual activity at every age, and less likely to have a spouse or intimate partner. The study measured association at one point in time and did not test cause.
Why Does Position Choice Depend on the Back and Joints?
Because coital positions differ in how much the lumbar spine bends and arches. A 2014 biomechanics study from a Canadian university studied 10 healthy volunteers (men and women) in 5 common coital positions with lumbar spine motion capture and found distinct patterns of flexion and extension.
In men, most lumbar motion in all 5 positions was flexion, or forward bending; the all-fours variants had a faster cycle than side-lying and the face-to-face variants.
For a man who cannot tolerate forward bending, the authors ranked the 5 positions from least to most recommended: side-lying, face-to-face with more hip and knee flexion, the second all-fours variant, the first face-to-face variant, and the first all-fours variant.
In women, both all-fours variants used a significantly greater range of lumbar motion than the face-to-face position with more hip and knee flexion. Outside the face-to-face variants, most of a woman’s lumbar motion was extension. The ranking for a woman who cannot tolerate forward bending ran from face-to-face with more hip and knee flexion, then face-to-face with less, then all-fours resting on elbows, then side-lying, then all-fours resting on hands; those recommendations would be contraindicated for someone who cannot tolerate back extension.
In the clinical experience of sex therapists, many couples over sixty are less troubled by sexual ability than by fear of pain and the difficulty of telling a partner about it.
[Further verification needed: the biomechanics research was done on healthy adult volunteers, and we have no direct data for older adults with arthritis or osteoporosis.]
Which Positions Put Less Strain on the Body?
Less strain comes from matching the position to the movement that hurts. The first question is whether bending forward or arching back is the problem, because the order of the recommendations shifts with the type of pain and with sex.
If fast jolting hurts, side-lying and face-to-face positions had slower movement cycles than the all-fours variants.
For women, the face-to-face position with more flexed hips and knees used the smallest range of lumbar motion.
The authors of the male-spine study also developed recommendations on movement strategies and on the role of the partner for men with low back pain; those details are written for back-pain patients.
A pillow under the painful area, or sitting on the edge of a bed or a sturdy chair, are options used in clinical practice rather than research findings.
These suggestions come from research on healthy adult volunteers, and each body needs testing with a physician’s or physiotherapist’s advice.
The editorial position of this site is clear: age is not the barrier; the barrier is not knowing simple adaptations and silence between two partners.
What If Desire, Lubrication or Erections Fade?
A medical conversation comes first, because these problems are common and worth assessing. In the 2007 study, about half of sexually active men and women reported at least 1 bothersome sexual problem.
Among women, the most common reports were low desire at 43%, difficulty with lubrication at 39% and inability to climax at 34%. Among men, erectile difficulty was reported by 37%, and 14% had used medication or supplements.
People who rated their health as poor were less likely to be sexually active and more likely to report problems. Only 38% of men and 22% of women had discussed sex with a physician since age 50.
General measures often suggested, outside the cited studies, include water-based or silicone lubricants, longer foreplay, non-penetrative intimacy, and a review of current medicines with a clinician.
Sexual activity in the 2007 study was reported by 26% of adults aged 75 to 85, so it is neither universal nor absent at that age. About 1 in 4 people in that age band remained sexually active.
Why are older women less sexually active than older men?
In the 2007 study, women were less likely than men to report sexual activity at every age, and less likely to have a spouse or an intimate partner. The study documented the difference without testing what produces it.
Does back pain mean giving up sex?
No. The biomechanics data show that positions differ in how much the lumbar spine bends or arches, so changing position is a practical option. A clinician or physiotherapist can help match it to your body.
How do I talk to my doctor about a sexual problem?
Directly, and early in the visit. In the 2007 study, only 38% of men and 22% of women had discussed sex with a physician since age 50. Naming the specific problem gives the clinician something to assess.
Sex in Later Life: Adapt, Do Not Abandon
Adaptation, not abandonment, is the reasonable response when the body changes. Position, pace, lubrication and an open conversation can keep intimacy available.
In the 2007 study, 26% of adults aged 75 to 85 were still sexually active, which is a substantial minority rather than a rarity. For those who adapt, intimacy remains within reach.
Looking for professional support with your relationship or mental health?
Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762-774. PMID: 17715410. DOI: 10.1056/NEJMoa067423
Sidorkewicz N, McGill SM. Male spine motion during coitus: implications for the low back pain patient. Spine. 2014;39(20):1633-1639. PMID: 25208042. DOI: 10.1097/BRS.0000000000000518
Sidorkewicz N, McGill SM. Documenting female spine motion during coitus with a commentary on the implications for the low back pain patient. Eur Spine J. 2015;24(3):513-520 (published online 2014). PMID: 25341806. DOI: 10.1007/s00586-014-3626-y
