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It is now well established that the world’s population is ageing, and has been doing so rapidly in the last century. According to the United Nations, as of 1950, there were an estimated 205 million people aged 60 years or over living in the world. More recently, that number had almost quintupled, with the 2017 estimate put at 962 million [1, 2]. Two-thirds of the older population aged 60 years or over live in lowand middle-income countries, where their rate of growth has been faster compared to high-income countries. Put together, the number of people aged 60 years or older is expected to keep increasing globally, with a further doubling projected by the year 2050, at 2.1 billion, by which point this elderly cohort would have outstripped adolescents, who are expected to number 2.0 billion [1]. Ageing will have a significant impact on health and social policies, and the older people (both men and women) will likely be among the policy-making priorities in the next few decades. Indeed, there have been several areas of health of the elderly that are increasingly receiving attention including physical health, primarily focused on non-communicable diseases, and mental health, mainly dementia and depression [3, 4]. However, sexual and reproductive health and rights (SRHR) issues in older adults remain a “taboo” among individuals and in many societies at large, a “topic of minimal interest” for health professionals and researchers; and a “blind spot” in the broader policy dialogue [4, 5]. This minimal focus remains despite the global call for the need to implement a lifecourse approach, from pre-pregnancy to post-reproductive years, in tackling SRHR issues [6, 7]. There are undoubtedly several SRHR issues relevant to the older population. For older women, a sharp decline in oestrogen and progesterone levels leads to declining ovarian function and then to several physical and psychological changes experienced as part of the peri-menopausal syndrome, including reduced libido, lack of energy, osteoporosis, irritability and mood swings. In some cultures, women perceive menopause as a positive experience, choosing to focus more on their freedom from menstruation; others see menopause as a phenomenon requiring medical intervention [8, 9]. Older men, on the other hand, have reductions in their testosterone levels and sperm production gradually becomes lower. While they also experience some similar physical and psychological symptoms, as a result of these low levels, there are a few differences including a decrease in lean body mass, decrease in body hair, skin alterations, erectile dysfunction, and increase in visceral fat and obesity. Besides, the development of symptoms is a lot more gradual compared to menopause that women experience [10]. For both men and women, there is also the impact of non-communicable diseases and medications that older people typically take, and their impact on libido, erectile dysfunction and energy levels. Non-communicable diseases at older age are exacerbated in women as a result of the cumulative impact of pregnancy and childbearing during the reproductive age. For older people, there is a general perception that they do not have any sexual desires and even if they do, in many cultures, they are not expected to speak about such matters [11]. However, available evidence suggests

reproductive health

“Leaving no one behind” also includes taking the elderly along concerning their sexual and reproductive health and rights: a new focus for Reproductive Health