Experts Offer Adapted Sex Positions and Tips to Help People Over 60 Have More Comfortable, Satisfying Sex

Sex experts say people in their 60s and beyond can maintain satisfying sex lives by adjusting positions, pacing and expectations to match changing bodies and abilities.

Clinical sexologist Lawrence Siegel, sex therapist Jesse Kahn and author and therapist Nan Wise told HuffPost that pain, stiffness and fatigue often prompt older adults to avoid sex — but simple modifications and open communication can make sex more comfortable and pleasurable.

Experts stressed that aging does not mean the end of sexual expression, but rather an opportunity to find positions and rhythms better suited to current bodies. "Getting older is not about trying to be able to do the same sexual activities you’ve always done before," Siegel told HuffPost. "It's to find positions and paces that are more comfortable and make the sexual act more enjoyable." Nan Wise said people who maintain sexual enjoyment over time emphasize being present in their bodies rather than focusing on how their bodies look.

Therapists offered several position modifications and non‑penetrative options intended to reduce strain on joints, hips and backs while preserving intimacy and pleasure. One recommended variation is a modified missionary in which the receiving partner lies on their back with legs elevated and a pillow beneath the lower back. Kahn said that having the penetrating partner stand at the edge of the bed can shift effort away from the hips and allow more support for the partner on top.

For partners seeking reduced joint stress during oral sex, Kahn suggested the sideways 69. Lying on the side facing one another removes the need to hold the body up, lowering pressure on hands, knees and hips compared with the traditional over‑and‑under position.

The position known as the "speed bump" or supported rear entry uses a pillow or wedge under the receiving partner’s hips while they lie on their stomach. Siegel said this configuration lets the bottom partner control depth and angle of penetration and can make it easier to stimulate the G‑spot. He also noted that the position can be adapted for non‑penetrative play by having the top partner lie across the lower back to allow body‑against‑body grinding or to facilitate strap‑on play where desired.

Doggy‑style can be useful for people with lower mobility or hip pain, Kahn said, because the receiving partner remains on hands and knees with support available, such as a wedge or pillow under the pelvis. However, therapists cautioned that it may exacerbate certain types of back pain and that partners should modify leg position or surface support accordingly.

Spooning — where both partners lie on their sides with one partner’s back against the other’s front — was described as particularly low‑effort and versatile. Siegel said spooning allows partners to explore a range of stimulation, from breast and genital touch to shallow intercourse, without exerting significant upper‑body strength or straining knees and backs. For many older adults, he added, sexual encounters focused on affection and shared intimacy can be as satisfying as penetrative sex.

Experts emphasized practical tools and habits that reduce discomfort: using soft surfaces, pillows or specially shaped sex wedges to support the pelvis or spine; changing angles to avoid putting pressure on painful joints; and adjusting tempo and depth to prioritize comfort. Siegel recommended exploring clitoral stimulation, grinding against bolsters, or massage with oils as alternatives to penetration that preserve intimacy and sexual pleasure.

Therapists also highlighted communication and body awareness as key elements. "People who enjoy sex over their lifespan all report being able to enjoy first and foremost being in their bodies," Wise said. Open conversations about pain, preferences and expectations help couples find solutions and avoid disappointment that can lead to avoidance.

Medical evaluation is appropriate when pain is new or severe. Clinicians can check for treatable conditions — including vaginal dryness, pelvic floor dysfunction, arthritis and other causes of pain — and recommend topical treatments, pelvic‑floor therapy or other interventions. Sex therapists or counselors can assist couples in navigating changes in desire, function and role expectations.

As bodies change with age, experts said, flexibility in approach and a willingness to try adaptations can sustain sexual wellbeing. The recommended positions and strategies are intended to reduce pain and increase control, not to prescribe a single "right" way to have sex. For many older adults, the goal is shared pleasure and intimacy, achieved by prioritizing comfort, communication and mutual consent.