How Do Older Adults Perceive Sexual Unwellness? A Cross-National Qualitative Study with Mexican and Portuguese Older Adults

Abstract

Objectives: Perspectives on sexual unwellness (SU), referring to difficulties in achieving sexual satisfaction and maintaining sexual relationships, may vary across different cultural contexts. Understanding how cultural factors such as social norms, religion, family values, and help-seeking behaviors influence SU is crucial. This cross-cultural study aims to explore Mexican and Portuguese older adults’ perspectives on SU in the context of aging in different cultures. Methods: A total of 166 heterosexual older participants living in the community (range = 65 to 98 years of age; mean = 71.54 ± 5.0 years of age) took part. Semi-structured interviews were conducted, and interview data were content analyzed. Results: Six SU themes emerged: poor sexual experiences; feeling alone; religious values; medication; not feeling attractive; and feeling pain or physical restrictions. Cross-cultural differences were evident in this study. Older Portuguese participants most often spoke of ‘poor sexual experiences’ (25.5%), ‘religious values’ (18.2%), ‘medication’ (17.3%), ‘feeling alone’ (15.5%), and ‘not feeling attractive’ (15.5%). Older Mexican participants identified most with ‘feeling alone’ (13.7%), followed by ‘poor sexual experiences’ (7.4%) and ‘feeling pain or physical restrictions’ (5.6%). Conclusions: A diversity of experiences of older adults in relation to SU was highlighted in this study. Moreover, cross-cultural research on the construct of SU is essential to understanding the cultural differences in the conceptualization of the construct and how these themes may influence sexual life in old age. Research into older adults’ SU is still scarce; hence, these findings are pertinent for outlining guidelines and health interventions by considering elements that affect SU and by focusing on the sexuality of older people with a deep cultural and ethnic sensitivity.