Does sex get better as you age? Most people over 45 think so. They say they are either somewhat or extremely satisfied with their sex life. Thirty-one percent are neither satisfied nor dissatisfied. And 23% of men and 14% of women say they are dissatisfied.

Why are things so good? Experts say the sex lives of older people often benefit from more experience and sexual confidence, and from relationships that have matured to a greater level of trust and intimacy.

As people age, their sexual desire usually decreases. This is true for men and women, although women are two to three times more likely than men to see their sex drive decline. You can blame lower hormones for some of these changes. But issues or conflicts with their partner, medical problems, and cultural issues also play a role. As long as someone is healthy, then it’s really only a problem if it bothers them.

Yes, sexual activity does decline as you get older. But many seniors stay sexually active. According to the Kinsey Institute, 25% of men over 50 say they have sexual intercourse a few times a month, and 10% say they have intercourse two or three times a week. For women, 20% say they have sex a few times a month and 7% say they have sex two or three times a week.

As you age, your sexual response time gets slower. That doesn’t mean you’re out of the game -- just that your warm-up takes longer! Lubricants and hormone creams may help older women. If erectile dysfunction is a problem for older men, there are treatments that can help.  Couples also can change their sexual behavior -- focusing more on longer foreplay, for instance.

Most older people who use medications, hormones, and other treatments were satisfied with the results. About two-thirds say these treatments helped them be more satisfied or enjoy sex more. And that helped couples, too -- about half the people with a regular partner said treatments for sexual problems had a good effect on their relationship.

Actually it’s the opposite: Frequent sex may lessen the risk of heart attack for many men.  Although there may be a slight risk of triggering a heart attack for very sedentary men, one British study found that overall, frequent sexual intercourse offers some protection from heart attack.

Older people with a history of heart trouble should check with their doctors.

ED is surprisingly common. Nearly 75% of men have had erectile dysfunction at some point by the time they're 70. It can be caused by serious health problems, so men who have ED should see their health care provider to rule out conditions such as heart disease or diabetes, or medications that might be causing the problem. In many cases there are effective solutions, including drugs such as Cialis, Levitra, or Viagra.

Don’t assume ED is due to age. Many common medications can cause ED, including antidepressants, antihistamines, and blood pressure medications. Painkillers, antipsychotics, chemotherapy drugs, alcohol, marijuana, and even some over-the-counter heartburn drugs can also cause problems getting an erection.

If you’re taking medication and have ED, ask your doctor what can be done.

Estrogen isn’t the only hormone that goes down after menopause. Lower levels of estrogen and progesterone may cause a woman’s sex drive to be lower, too. Other changes may include vaginal dryness or lower levels of vaginal lubrication, reduced sexual sensation, fewer and weaker orgasms, and painful intercourse. But not all women have these problems, and there are solutions for those who do.

A woman's level of testosterone also goes down as she gets older, though it's not tied directly to menopause. Researchers aren't sure what effect it has, but it may play a role reducing sexual desire in some women.

One reason is that men are more likely than women to have a partner in later life, because there are more women than men at older ages. Men also are more likely to marry a younger partner.

Studies have shown that as many as half of postmenopausal women have lower sex drive. But many women who report a lack of desire are not troubled by it. For those who do find it to be a problem, hormonal therapy and other drug treatments can help.

Although the sex drive of men and women declines with age, it’s not normal for healthy older men to have NO interest at all in sex. Low testosterone is frequently to blame for lost sex drive in older men. Testosterone levels go down gradually with age. In some men, testosterone can get too low, causing less interest in sex, erection problems, low energy, depression, and other issues.

Low testosterone is sometimes treated with testosterone replacement therapy.  This treatment is not for everyone, however -- your doctor can help you weigh the risks and benefits.

Surprised? Older people are not immune to sexually transmitted diseases. In fact, experts say older people are at greater jeopardy for STDs because they don't know as much about the risks and are less likely than younger people to talk about their sex lives or STDs. They also may mistake symptoms of an STD for the normal aches and pains of aging.

The most common types of sexually transmitted diseases in older adults are chlamydia, gonorrhea, and syphilis.

Sex is a very healthy form of exercise for most older people.  Studies suggest it can burn fat, boost metabolism, reduce stress, improve heart health, and strengthen bones, muscles, and the immune system. Overall, studies suggest sex can help you live a longer and healthier life.