Making Love for a Lifetime: Seniors and Sexuality

We are sexual beings, throughout the lifespan. This includes the later years of life, which are often overlooked in discussions of sexuality. In this article I want to address some misconceptions about aging and sexuality; report some survey information on sexual behavior among seniors; describe physical, psychological and medical changes that may accompany aging; and suggest positive and affirming ways for seniors to continue to enjoy their sexuality to the fullest.

I. Some Myths about Aging and Sexuality

Many cultural “truths” convey the message that sexuality is for
the young. If seniors are interested in sex there is something wrong with that. How many of the following myths and stereotypes have you heard?

– Older people don’t have sex, don’t want sex, don’t think about sex.

– It’s perverted for an older person to have sexual thoughts; perhaps he is a “dirty old man”.

– Women don’t want sex, aren’t interested in sex, and are only going along with what men want.

– When you get “old”, you can’t have sex.

– Sex is for younger adults. (I saw a cross-stitched sampler once which said “Kissing don’t last – cooking do”.)

– If you can’t have sex like a porn star, you have no business trying it at all.

These are all misleading and incorrect stereotypes. It is
important to recognize that sexuality is a central part of healthy living – all our lives!

II. Survey Information: What’s Happening Out There?

Three recent national surveys of older Americans have focused on
sexuality and sexual behavior. “Healthy Sexuality and Vital
Aging” (1998) was funded by Pfizer and sponsored by the National
Council on the Aging (NCOA) and surveyed over 1300 people. The
American Association of Retired Persons (AARP) sponsored national surveys in 1999 and again in 2004. “Sexuality at Midlife and Beyond” looked at a nationally representative group of 1700 adults aged 45 and older.

The NCOA survey found that almost half of seniors over sixty are
sexually active; 39% want sex more often. The majority of
respondents reported having sex less often now than when they
were in their forties – 82% of men and 63% of women.

61% of men and 62% of women find sex equal to or more physically
satisfying than it was in their forties. With regard to
emotional satisfaction, 76% of men and 69% of women found sex to
be at least as emotionally satisfying as in their forties.

72% of men and 47% of women consider sex important to their
relationship with their partner. Men, however, were more than
twice as likely as women to report wanting sex more frequently.
This was true in all age segments – even in men 80 and older.

The AARP study found that the proportion of men who’ve tried
potency-enhancing medicines, hormones, or other treatments has
doubled since 1999. The majority (68%) report the treatments
have increased their sexual satisfaction. Their wives also
reported increased pleasure for themselves.

63% of men and women with partners described themselves as either extremely satisfied or somewhat satisfied with their sex lives. 51% of men and women surveyed reported having sexual thoughts, fantasies, or erotic dreams at least once a week.

50% of women in the 45-49 age range reported that they
masturbate; 20% of women 70 and older said they masturbated. A
majority of all women – even those 70-plus – told AARP that self- stimulation is an important part of sexual pleasure at any age.

Both these surveys, based on scientifically randomized samples,
indicate that seniors are having sex, thinking about sex,
enjoying sex – and taking steps to increase their enjoyment and
pleasure. Clearly sexuality is important to older Americans,
contrary to popular stereotypes!

III. Natural Changes Occurring With Aging

Most of us reading this are not twenty years old any more! Our
bodies are constantly changing – though many of us are in denial. Orthopedic medicine is one of the fastest-growing medical specialities, treating rotator cuff injuries, tennis elbow, injured backs, torn cartilage, blown ACLs – in aging baby
boomers. We’re not ready to give it up!

Your body changes as you age, and these changes can affect your
sexual relationships.

A. Physical Changes

Testosterone regulates your sex drive whether you’re a man or a
woman. Most aging men and women produce enough testosterone to
maintain their interest in sex, though patches and creams can
provide an alternative source of the hormone to boost desire if
needed.

Men and women experience different changes in their bodies as
they age.

— Women —

Most physical changes are linked to menopause and reduced
estrogen levels. As you age, it takes longer for your vagina to
swell and lubricate when you’re sexually aroused. Your vagina
also loses some elasticity. Together these can make intercourse
less comfortable or even painful.

What to do:

– Longer foreplay increases natural lubrication.

– Use water-based lubricants, such as Astroglide, Probe or Silk.

– Estrogen creams or hormone replacement therapy can rejuvenate vaginal tissue.

– Regular intercourse helps maintain lubrication and elasticity.

– Do Kegel exercises to keep the pelvic floor muscles toned.

– If you haven’t had intercourse for a while, realize it takes time to stretch out – go slowly!

– Minimize any pain or discomfort. Desire usually returns once any discomfort is relieved.

— Men —

As you age, it might take longer to achieve an erection; it may
be less firm and it may not last as long. Aging also increases
the time between possible ejaculations.

What to do:

– Relax, stop worrying about it! Anxiety makes it worse.

– Let go of performance expectations. American media is filled with messages implying that masculinity and virility is equated with youthful performance.

– Kegel exercises are very helpful for men also, to tone the pelvic floor musculature.

– Take longer with sexual activities. You may also need more direct physical stimulation.

– Try different positions, for comfort and extra stimulation.

– Focus on pleasurable sensations, rather than on hurrying towards orgasm and ejaculation.

– Viagra, Cialis or Levitra may help intensify erections.

– Other medical devices, such as pumps, drugs and implants have been developed. I would encourage a natural and relaxed exploration of sexual possibilities before submitting to an expensive and invasive medical procedure.

Intercourse is Not the Only Way to Have Sex!

Helen Gurley Brown, author of Sex and the Single Girl, has said,
“When people say they can’t have sex because they have a bad
back, or arthritis, or all of the things that can affect our
bodies as we get older, I think what they’re really saying is
they’re looking for an excuse not to have sex. When you care,
you find that there are all sorts of ways to express sensuality.”

Sexual ignorance, cultural values and media images combine to
“sell” the story that sex = intercourse – and having an orgasm is the way to tell if you’re accomplishing anything!

This mindset gets everything backwards. The purpose of having
huge concentrations of nerve endings and pleasure receptors in
our genitals is to experience pleasure. While orgasms are
wonderful, when sex becomes goal-driven to “achieve” climax, it
short-changes both partners’ pleasure and places enormous
performance expectations and demands – which can turn sex from
playful, spontaneous, pleasurable sensual intimacy between two
people who care about each other into something like a chore.

I highly recommend Marty Klein’s book Let Me Count the Ways:
Great Sex Without Intercourse as an excellent guide and
encouragement in your creativity. (For more information about
Marty Klien’s book look on:
http://www.books4selfhelp.com/sexuality.htm )

Passionate kissing, oral sex, mutual masturbation, telling erotic stories to each other, massage, hugging, touching, cuddling — all of this can be great sex!

What is most important is pleasure – giving and receiving
physical and emotional pleasure. We are all hungry to be
touched. We need touch. Without touch, babies do not thrive,
and may even die. Grownups need to be touched too. (If you’re
reading this and do not have a partner in your life, remember
that self-pleasure can be a very important aspect of self-care
and nurture. It is always possible to choose pleasure for
oneself!)

B. Psychological Changes

The aging process may have psychological and emotional effects –
particularly as we live in a culture that glorifies youth and
extols youthfulness as the epitome of physical beauty. (I would
remind us all that this is market-driven: marketers learned long
ago that younger people are more likely to spend disposable
income, and are more influenceable by advertising.)

– We may be embarrassed or ashamed of our sexual needs as an older adult.

What to do: Get over it! Join the party. You deserve pleasure in your life, from birth until the day you die.

– Changes in appearance affect how we feel about ourselves. Bodies no longer match the idealized body images we see in advertising and the media.

What to do: Realize that media has created the youthful ideal of beauty. Celebrate and love the body you have! Every wrinkle, stretch mark, gray hair, rounded contour, ache and pain is a mark of your ever-increasing maturity and wisdom! Bette Midler once said that if you are a woman and consider yourself unattractive — visit another culture for a wake-up call. American stereothypes of physical attractiveness are insane dreams invented by marketers who are playing on our anxieties and insecurities in order to sell us more products.

– Worrying about sexual performance may actually reduce the body’s ability to perform sexually; men may experience erectile dysfunction, women an inability to lubricate.

What to do: Relax! Relax… Enjoy your partner. Look into his or her eyes. Breathe together. Cuddle, stroke, gently massage each other. Sexuality is about pleasure, playfulness, and spontaneity.

– Depression may reduce energy, optimism and desire.

What to do: Exercise, do pleasurable activities, get sun on your face every day. Talk with your doctor about an antidepressant medication. See a therapist. Talk with your friends. Write your feelings in a journal. Any positive action taken – even drinking a glass of water! – is a step towards moving out of depression.

C. Changes Due to Medications and Surgery

Chronic pain or surgery and illness that cause fatigue can make
sexual activities more challenging or painful.

What to do: Talk about it. Slow down, focus on simple pleasureable activities. Experiment with different positions or activities to discover what is most pleasureful.

Some commonly used medications can interfere with sexual
function. High blood pressure medications can reduce desire and
impair erection in men and lubrication in women. Some
antihistamines, antidepressants and acid-blocking drugs can have side effects that affect sexual function.

What to do: Talk with your doctor about how to minimize these effects. It may be possible to substitute alternative medications that work as well as the original, but without affecting sexual function.