Regardless of our age, we would all love to have a thriving sex life. Men and women reach their sexual peaks between their late teens and early 20s, before it slowly starts to decline with age. Typically, sex is a sign of health, but if we stop having it on the regular, can we really lose it if we don’t use it?

The short answer is “yes.”

Sex is like a muscle; if you don’t exercise it, it’s gone. As April Masini, relationship expert and author, explains, the incidence and frequency of sex revives our sexual health.

"The more often you have sex, the more confident you become about having it — both your own ability and the ability of the relationships in which you’re having the sex," she told Medical Daily in an email. So, in a way, that confidence and the strength of the relationship will make it so that sex can "take care of itself."

Men: When Sex Needs A Tune-Up

Erections are key when it comes to preserving male sexual function. A 2008 study published in the American Journal of Medicine found men who reported having sexual intercourse once a week were half as likely to develop erectile dysfunction (ED) as men who had sex less frequently. The study tracked over 900 men in their 50s, 60s, and 70s for five years and showed regular sexual activity preserved potency in the same fashion as exercise preserved the body’s capacity. 

Dr. Fran Walfish, Beverly Hills psychotherapist, author of The Self-Aware Parent, and expert panelist on WE TV’s Sex Box emphasizes the importance of stimulation to keep things functioning. Age, she says, can put men at risk for performing sexually, such as premature ejaculation and erectile dysfunction. Erections help maintain the health of the nerves of the penis, and this habit can ward off erectile dysfunction, a condition marked by occasional erections, not lasting long enough for sex, or the inability to achieve one at all.

So, what's a man to do if he does develop ED? Walfish suggests sexually active men and women engage in alternative excitation practices, such as oral sex, manual touching, and the use of sex toys, among many others.

“When they do age, if by chance they suddenly come face to face with 'use it or lose it,' they are well prepared for other ways to pleasure each other,” she said.

That's not to say that ED's psychological effects aren't a barrier. Men with cardiovascular disease, for example, may become nervous and experience performance anxiety, making erectile dysfunction worse. So, it's important for couples to search for safe, healthy ways to practice stimulation.

Women: When Sex Takes A Backseat

Similar to men, women benefit from regularly engaging in sexual intercourse. A healthy vagina, when sexually aroused, self-lubricates and the vulva engorges. First, the muscles of the vagina begin to relax, and the bartholin glands in the vagina produce the vaginal fluid which makes the inside extra wet, says the Mayo Clinic. This fluid was once part of the blood that flows to the genitals and the pelvic area during arousal.

“Sex is the best aphrodisiac [for arousal],” Dr. Tammy Nelson, expert in sex therapy in Ridgefield and New Haven, Conn. told Medical Daily in an email.  So, “when a woman stops having sex, over a period of time, her body will decide to decrease the amount of hormones and therefore tell her that she is not aroused nor does she have the desire for sex.”

A "do not disturb" sign on open door into office. Photo courtesy of Shutterstock

This prompts some women to manage their “unacceptable” impulses by channeling them into acceptable behaviors. For example, these women may direct their sex drive toward their career. Women who are driven with ambition to reach the top, says Walfish, have sexual libido driving that energy. These women are putting out less in the bedroom and more at the office.

“This defense mechanism is known as sublimation. Women are sublimating sexuality into work,” Walfish said.

This unhealthy sublimation can lead to loneliness and reckless abandonment of our personal life. This puts all aspects of our life outside of work on hold — including sex. Soon, a month without sex turns into three months and three months turn into a year.

Before long, we begin to wonder: Where did our sex life go?

Sexual Dry Spell: A Woman And A Man’s Problem, Too

“Going through a dry spell” often gets labeled as a “woman’s problem.” The term is popularly used to describe a “sexless state” and isn’t given the best connotation. But these phases of celibacy, which could be months at a time, are actually normal.

A 2010 National Survey of Sexual Health and Behavior from The Kinsey Institute found these droughts are common in partnered and unmarried women in their 30s. More than 28 percent of these women reported having intercourse somewhere between once a month and not at all, with the frequency being slightly lower for married women. This is known as “double income, no sex” for married couples in a sex-starved marriage.

Surprisingly, women aren’t the only ones refusing sex in marriages. In a study conducted by Dr. Denise Donnelly of Georgia State University, she found out of 75 married people in sexually inactive marriages, in 60 percent of the cases, it was the man who stopped having sex first. Reasons for the couples’ dry spell included extramarital affairs and demanding jobs. Low frequency of sex in marriages is not a problem unless the partner perceives it as a problem. But how much sex is healthy for a happy couple?

“Couples of all ages who are either married or cohabitating should be having sex one to two times a week on average,” Walfish said. She believes when couples have sex less than once a week (excluding unexpected circumstances), this becomes a cause for concern. Sex and its frequency is usually reflective of communication, based on Walfish’s professional experience.

However, physiological changes in the body, like menopause for women, can impact the quantity and duration of sex.

Menopause: Moist In All The Wrong Places

Women will inevitably experience menopause between the ages of 45 and 50, with the average onset at age 51, according to the Mayo Clinic. This normal part of aging means the ovaries have stopped releasing eggs and making most of their estrogen. Symptoms of menopause include hot flashes, mood swings, and the dreaded vaginal dryness.

This is a different kind of “dry spell,” which close to one out of every three women experiences. The drop in estrogen levels reduces the amount of moisture available, making the vagina thinner and less elastic, which is known as vaginal atrophy. Although this dryness may seem like a small health issue, it severely impacts a woman’s sex life.

“When women go through menopause where vaginal dryness occurs, men can experience decreased sexual desire and some women can have a lower sense of themselves as sexual beings,” Walfish said.

Recently, though, Sprout Pharmaceuticals resubmitted the drug flibanserin to the Food and Drug Administration for approval for a third time. Flibanserin aims to treat hypoactive sexual desire disorder (HSDD) in women, defined as the persistent or recurrent deficiency or absence of sexual fantasies and a desire for sexual activity that causes distress or interpersonal difficulty, according to the press release. This drug is believed to help women, especially postmenopausal women who struggle to boost their sex drive.

Masturbation: A Cure-All To 'Use It Or Lose It?'

Women can prepare for the effects of menopause even before they reach their 40s, without relying on drugs. Masturbation can help women remain sexually active — and men, too. It helps protect the nerve fibers and blood vessels responsible for erectile function. However, Walfish advises men be careful with this because they can become fascinated or obsessed with masturbation and begin to turn to it more accessibly.

“It becomes easier to do it yourself than communication. The hard stuff becomes the talking,” she said.

A "sex in progress" sign on a laptop. Jean KOULEV, CC BY 2.0

Meanwhile for women, masturbation can be advantageous because it helps them identify for themselves which region feels best when stimulated, including the speed and pleasure. Walfish emphasizes for women to "learn what excites them and feels good for them and verbalize and communicate."

Remember, just like the body needs fitness and health, the erectile tissue for men and women need to get regular and maximal blood flow to keep the arteries and tissues healthy and functioning well.

Sex Beyond Your Prime

The misconception of sex after the prime of our lives is that it doesn’t exist, especially for senior citizens. When it comes to senior sex, we know issues like erectile dysfunction and menopause are common, but the truth is the elderly can still have “normal” sex lives. Studies have found people in their 70s and 80s are actually far more sexually active than we once thought.

A study published in the journal Archives of Sexual Behavior found people, up to 54 percent of men and 31 percent of women, between 50 to 90 years old, reported having sex at least twice a month. The findings suggest our level of overall activity remains high in the later years and breaks down the old-age sexuality barrier. Indeed, sex at old age is possible and extremely healthy.

Walfish has seen this in her clinical practice with two of her patients in their 90s who have active sex lives. The couple met in a senior facility in their later years and began to consummate their relationship.

“They are healthy, have sharp thinking capacity, and have Viagra prescribed by medical doctors,” she said.

So, despite the age-related physiological and psychological changes such as pain and discomfort or emotional issues, sex should be part of our lives at every age — whether we’re seniors, career-obsessed, or even disheartened. Getting creative, rediscovering foreplay, and fantasizing with a sexual partner are ways we can strive for a thriving sex life for years to come.