TheJournalof Sex Research Vol. 27, No. 2, pp.

289-295 May, 1990

SEXUAL EXPRESSION AMONG 60-80-YEAR-OLDMEN AND WOMEN:

A SAMPLE FROM STOCKHOLM,SWEDEN

MAJ-BRIHT BERGSTROM-WALAN, Ph.D.,

AND
HELLE H. NIELSEN, Ph.D.
Swedish Institute for Sexual Research

A questionnaire concerning physical and mental health, religion, loneli-

ness, sexual interest and activity (masturbation,sexual intercourse)was
sent by post to 1,574 randomly chosen persons, between 60-80 years of
age, in the larger Stockholm area. The main findings from this survey
were: sexual interest and activity are present even in older ages (i.e.,
sixty-one percent of the total group express their sexuality through
intercourse, mutual sexual stimulation (other than intercourse), and
masturbation). Also, men are significantly more sexual than women, in
all ages and in all respects. However, sexual interest and activity
decrease significantly in the higher ages (75-80 years), even though
among married couples, almost one quarter of the subjects have inter-
course at least sometime each month. Finally, in general, the religious
respondents do not differ from the nonreligiousrespondents, either with
respect to sexual interest, masturbation, or feelings of attraction to the
same sex.

KEY WORDS: masturbation, elderly sex, sexual intercourse.

Sexual Expression Among 60-80-Year-OldMen and Women:

A Random Sample from Stockholm, Sweden
A numberof recent Scandinavianstudies have reportedsexual activity at an
advanced age. For example, a Finnish study of elderly people (Kiveli, Pahkala,
& Honkakoski, 1986) indicated that two-thirds of the men above 60, but only
one-fourthof the women above 60, sometimes experienced sexual desire. Also,
half of the men and about 20% of the women still had sexual intercourse. In a
Danish representative study of women aged 70, 22%replied that they still had
intercourse "now and then" (Lundeet al., 1986). Finally, a large Swedish longi-
tudinal study of elderly people (Skoog, 1988) reported that half of the married
men and one-third of the married women were still sexually active, 30% and
15%respectively, at age 75.
In a longitudinal study of aging conducted in the United States, data on
sexual behavior showed that between 60 and 70 years of age, about half of the
subjects had intercourse "with some frequency," while in the group 78 years
and over, only 10-20%were still sexually active (Pfeiffer,Verwoerdt,& Wang,

Requests for reprints should be sent to Maj-Briht Bergstrom-Walan,Swedish Insti-

tute for Sexual Research, Lastmakargatan 14-16, S-111 44, Stockholm, Sweden.
289
290 BRIEFREPORTS

1968). Also, men were more sexually active than women, whose sexual activity
was heavily dependent on the availability of a functionally capable male part-
ner. When asked for reasons for stopping sexual intercourse, both men and
women reportedthat the male partnerwas responsible for the cessation of sex-
ual intercourse. This observation has been confirmed in more recent studies
(George & Weiler, 1981; Skoog, 1988). Additionally, in another United States
investigation with more than 4,000 respondents (the largest geriatric sample
assembled for a sexuality study), a very large proportion of the respondents
reportedbeing sexually active and highly enjoying sex, even at 70 years of age
and over (75% men and 61% women) (Brecher, 1984). However, similar to
previous studies, this researchalso indicated that men were considerablymore
sexually active than women in younger, as well as in older, ages and with
respect to all varieties of sexual behavior (intercourse, masturbation, fre-
quency of orgasm and other measures).
The present study, drawn from Stockholm, Sweden, was designed to extend
our knowledge of elderly people's sexuality in regard to gender differences,
masturbation habits, and religiosity.
Method and Material
A questionnaire was mailed to a random selection of men and women aged
60-80 years, residing in the larger Stockholm area. This survey was made dur-
ing the autumn of 1987 by the Swedish Institute for Sexual Researchin Stock-
holm in collaborationwith the Swedish Institute for OpinionResearch(SIFO).
Complete anonymity of the respondents was assured. Also, a letter was
attached in which we stressed the importanceof frankness and asked that the
form be completed without discussion with other individuals. The letter
expressed the opinion that "people of every age are entitled to a sex life, but
also equally entitled not to have one." Finally, a week after the mailing, a
reminderwas sent to all subjects.
The questionnaire comprised 29 items and included background data, such
as sex, age, civil status, school education and further education, profession or
occupation. Furthermore, items were included about physical and mental
health, religiosity, loneliness, and several questions about sexual interest and
behavior.
The completed questionnaires were returned directly to SIFO in postage-
paid envelopes. Of the 1,574 questionnaires sent out, 509 were returned. This
yielded a 32.3%reply rate (i.e., approximatelyevery third person participated
in the study). An analysis of the reply group indicated that a few more men
than women replied, while the age distribution was consistent with the geo-
graphic region. Thus, apart from the slight gender difference in return rate,
the reply group may be considered representative, at least in age and sex, to
the population of this region.
Results
In general, this group of elderly people viewed themselves as relatively
healthy, physically as well as mentally. As many as 83%judged their physical
health as good, and more than 70%stated that they hardly ever felt depressed.
A majority (87%)have one or more close friends evenly distributed over the
 BRIEFREPORTS 291

sexes, and two-thirds are members of one or more associations or clubs. Final-
ly, only 6% often feel lonely, yet every fifth person is religious.
Concerningsexuality, there was a great difference between men and women
-a difference noticeable throughout life. The majority of the men (86%)indi-
cated that when they were young, their sexuality was "very or fairly strong,"
compared to only 50% of the women (p < .05). As far as how important their
sexuality was now, 54% of the men answered that it was very or fairly impor-
tant, compared to only 16% of the women (p < .05) (see Table 1).

Table1
How important is sexuality to you? (N = 509)
Men Women
Veryimportant 8% 1%
Fairlyimportant 46% 15%
Not very important 32% 34%
Not important at all 12% 44%
No reply 2% 6%

Not surprisingly, the importanceof sexuality decreases with age, e.g., about
50% of the younger elderly (60-64years old, both sexes) estimate sexuality as
fairly important, compared to 16%of the older elderly (75-79years old). How-
ever, when comparingtheir present interest in sexuality to their interest at the
age of 40, 35% of the men and 15%of the women consider it as strong as then
(p < .05). It is also worth noting that 5% of the women estimate their sexual
interest as stronger now than when they were 40 (comparedto 1%of the men).

Sexual Behavior
The present study asked the question: "In what way do you get sexual satis-
faction?" The alternatives included: through dreams, erotic pictures, mastur-
bation, mutual sexual stimulation (without intercourse),and intercourse. The
results show that 29% of the women did not experience sexual satisfaction at
all, comparedto 12% of the men (p < .05). Intercourse was given as the most
usual way of satisfaction by 55% of the men and 23% of the women (p < .05).
Fifteen percent of the women and 11%of the men indicated that their primary
sexual satisfaction was through mutual sexual stimulation without inter-
course.
The questionnaire also asked about masturbation. The results indicate that
men masturbate much more frequently than women (p < .05). It is notable,
though, that almost every third elderly woman masturbates at least a few
times a year. Also, as might be expected, the older elderly (70-79 years old)
masturbated less often than the younger elderly (60-69 years old). Masturba-
tion occurredat least a few times a year with 49% of both the 60-64-year-olds
and the 65-69-year-olds.The corresponding figure for the 70-74-year-oldsis
30%, and for the oldest group (75-79 years old) it is 21%.
292 BRIEF REPORTS

Table 2
Do you ever masturbate? (N = 509)
Men Women
Once a day 0% 0%
About once a week 12% 0%
About once a month 16% 5%
A few times a year 23% 25%
Never 45% 58%
No reply 4% 11%

Married People Or Couples Living Together

Married couples or nonmarried couples living together were asked, "Do you
(still) have intercourse with your partner?" As is evident in Table 3, men
showed greater coital activity, but the difference between the sexes is not
statistically significant. Just over 50% of the men, but only one-third of the
women, had intercourse every month. Also, more than every fourth man had
intercourse every week.

Table 3
Do you (still) have intercourse with your partner? (N = 320)

Age
Men Women 60-64 65-69 70-74 75-79
Once a day 2% 2% 5% 0% 1% 0%
About once a week 27% 14% 30% 24% 13% 8%
About once a month 24% 22% 23% 24% 22% 15%
A few times a year 14% 19% 17% 18% 16% 18%
Never 29% 39% 21% 33% 39% 52%
No reply 4% 5% 4% 1% 8% 7%

As expected, we also observed a definite decrease in intercourse frequency

with increasing age. In the age group 60-64 years (both sexes), 58% stated that
they had intercourse at least every month. In the age group 65-69 years, the
corresponding percentage is 48%; in the group 70-74, it is 36%; and in the
75-79-year-old group, it is 23%.

Table 4
Do you reach orgasm with your partner? (N = 320)
Men Women
Always 44% 12%
Often 12% 9%
Sometimes 5% 24%
Seldom 8% 13%
Never 22% 26%
No reply 9% 16%
 BRIEFREPORTS 293

We also assessed how often couples experienced orgasm together (see Table
4). Here, too, we discovered a large gender difference.Forty-fourpercent of the
men always reached orgasm, compared to 12% of the women (p < .05). Also,
we asked couples: "How important is sexuality to your partner?"The results
indicated that men showed significantly higher uncertainty regarding their
partner's sexual needs than vice versa (p < .05).

Religion
A little over 20% of the total group (N = 509) declaredthemselves deeply or
fairly religious. However, there were no significant differences between
religious and nonreligiousindividuals in terms of sexual relations or masturba-
tion. Thus, as far as the present results are concerned, the impact of religion
had not influenced the sexuality of these elderly people in a negative direction.

Attraction To One's Own Sex

The present survey also asked subjects whether they had ever felt sexual at-
traction towards their own sex. The findings showed that 8% of the women
and 5% of the men experienced such feelings before they were 50 years old. In
the group divorced/widow (widower), the percentage was 11. Additionally,
every tenth religious person declared having felt attracted towards his/her
own sex. To the same question, although relating to the period of after 50
years of age, a positive answer was given by 4% (the same for both sexes); by
8%in the group divorced/widow(widower);and by 10%in the group "Lonely."

Health
Forty-three percent of all elderly people who reported being in "very good
health" stated that sexuality was important to them, a significant difference
from those who reported being in bad physical health, where the correspond-
ing figure was 15%.
On the other hand, the group that often (4%) or sometimes (22%) felt
depressed did not differ significantly from other individuals regarding sexual
interest and activity.

Education And Profession

Where education is concerned, it was evident that people with only an
elementary school education (45%)valued sexuality as significantly less im-
portant (p < .05) than people with more education (secondaryschool, college,
academic education).This finding is consistent with the data from Finland, as
among other countries.
Regardingoccupation,almost 60%were office employees, and just over 20%
were workers, the distribution between the sexes being fairly even. Ten per-
cent were self-employed people, where there were twice as many men as
women, and another 10% "housewives." This latter group valued their
sexuality as "unimportant" to a significantly higher extent than the rest of
the respondents. Apart from the "housewives," there was no apparent corres-
pondence between occupation and estimated importance of sexuality.
294 BRIEFREPORTS

Civil Status
An available partner is the obvious prerequisite for an interactive sex life.
Married couples and couples living together have greater access, to a larger
extent, than single people. This circumstance was also reflected in our
findings; married people and people living together had intercourse signifi-
cantly more often than single people (p < .05). Furthermore, significantly
more marriedor cohabiting people valued sexuality as important as compared
to those living without a partner. Regarding masturbation frequency, there
were no difference between the two groups.

Discussion
About five years ago, the present authors asked SIFO (Swedish Institute for
Opinion Research) to include a few questions about sexuality in a telephone
interview with senior citizens. This method proved unsuccessful, since
subjects refused to answer questions. Presumably, the lack of anonymity in
the telephone interview affected compliance.
In the present study, we used an anonymous questionnaire and received
approximately a one-thirdreturn rate. The low return rate reduces, of course,
the generalizability of our results. The findings indicate that the sample did
not have very high education (11% matriculated);their physical and mental
health was good; they had many social contacts, and few felt lonely; 20%were
religious, but most individuals had a liberal attitude toward sex.
The results of the present study suggest that in both sexes, sexual interest
and sexual activity (intercourse and masturbation) decrease with increasing
age. However, in a cross-sectional investigation like the present one, the dif-
ferences between age groups may reflect the effects of cohort- or generation-
related changes, besides age-related changes. This problem notwithstanding,
the results indicated that men were more sexual than women, in every respect.
Women reported lower interest in sexuality, as well as greater lack of sexual
satisfaction and lower orgasm frequency. These findings, however, do not
enable us to assess whether women's low sexual interest and sexual satisfac-
tion is primarilya sign of sexual frustration (i.e., whether sexual needs are un-
satisfied due to unfortunate circumstances and/or an uninterested partner)or
a function of a sexually repressive upbringing.
When these individuals grew up, religion was fairly important to the
Swedish population. The State Church,as well as the nonconformistchurches,
played a certain formative role regarding sexuality and explicitly condemned
premarital intercourse, masturbation, and especially homosexuality. Twenty
percent of our sample stated that they were deeply or fairly religious. The data
do not support, however, the presumption that religious individuals are less
sexual, either regarding interest, sexual activity, or experience of attraction to
their own sex. On the other hand, perhaps these subjects were more per-
missive than the average religious Swedish person. Conceivably,if this survey
had been conducted among elderly people living in more rural regions, dif-
ferences for religiosity may have emerged.
Undoubtedly, younger generations, especially women, are more sexually
liberated and more sexually conscious than older generations. However, as the
results herein suggest, elderly people remain sexually interested and sexually
 BRIEF REPORTS 295

active. It is hoped that further evidence of the sexual activities of elderly

people will contribute to increased tolerance and better understanding of sex-
uality throughout the life span.

References

E. M. (1984).Love, sex, and aging. Boston: Little, Brown.

BRECHER,
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KIVELA,S-L, PAHKALA, K., HONKAKOSKI, A. (1986). Sexual desire, intercourse, and
related factors among elderly Finns. Nord Sexol, 4, 18-27.
LUNDE, N. I., FOG, E., LARSEN,G. K., MADSEN,J., GARDE, K., KELSTRUP,J. (1986).
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PFEIFFER, E., VERWOERDT, A., & WANG,H.-S. (1968).Sexual behavior in aged men and
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