ATLANTA -As Americans age, many face an increase in the number of obstacles to romance and sex.

An illness, menopause, or surgery can be major setbacks in a couple's sex life. Occasionally, time goes by and their sex lives never really recover.

But experts agree that sex is a key component of marriage, and they encourage couples to maintain a healthy sex life throughout their relationship.

"We believe if you don't have sex, you are roommates," said Joan Sughrue, a Woodstock, Ga., sex therapist. "The thing about roommates is they can care about each other and be respectful and they can plan and cook together, but without sex they are basically on parallel courses and there is nothing to connect them."

Almost half of Americans 60 and over are sexually active, according to the National Council on Aging, and about 40 percent of these people indicated a desire for more sex, according to a survey conducted by the council. The frequency of sex dips in older years. Among men and women aged 75 and older, about 25 percent engage in sex at least once a week, down from 60 percent of people between the ages of 45 and 59, according to an AARP Modern Maturity Sexuality Survey conducted in 1999.

Many experts believe that as long as health allows a couple should be able to enjoy the same sexual frequency as in their younger years. Many experts steer clear of offering specific numbers when discussing sexual frequency. Sughrue puts it this way: "It can't be put on a shelf weeks or months at a time."

Although some health issues create serious challenges for couples wanting to be sexual, experts say other forms of intimacy can be a perfect substitute to intercourse. They suggest kissing, sleeping naked together, even simply snuggling together on the couch.

Romance and intimacy have changed over the years for Millie Kagan and her husband, Irving - both in their mid 80s - but it is still very much alive.

"I go up to my husband and ask for a kiss and he says, 'Didn't we just kiss?' and I say, 'But that was two minutes ago.' "

The Atlanta couple cuddle every night together in bed. They hold hands and play.

"It's not that we don't miss some of the excitement and oneness that comes with the sexuality," said Kagan. "But there is a new found love that gets created with sensuality. I just love touching my husband."

Many believe some seniors enjoy certain advantages over younger people.

"Their sessions can last longer with no pressures of children, work, etc.," said Los Angeles therapist Nancy Irwin. "And, of course, no worries about pregnancy."

Still, older couples are more likely to experience health problems that interfere with sexual performance. Women deal with menopause normally between 40 and 55 years of age, a time of life marked by a major reduction of the sex hormones estrogen, progesterone and androgen. Older men are more likely to experience erectile dysfunction because of medical conditions - diabetes, heart disease, high blood pressure or high cholesterol levels - that affect the blood vessels and restrict blood flow to the penis.

In some cases, medication and therapy are needed.

But other times, experts say communication and patience will help couples cope.

"When we were younger, the sex was more fiery," said Millie Kagan. "At this point, there is much less of the passion but more of the fantasy of love and you can set in motion loving memories. We can still play and that can add a great deal to our lives."

Helena Oliviero write for the Atlanta Journal-Constitution. E-mail: eoliviero(at)ajc.com

Story Filed By Cox Newspapers

For Use By Clients of the New York Times News Service

NYT-09-21-04 1622EDT