Another View on Aging
It’s no accident that Robert Redford, 77, just gave the performance of his career in “All is Lost,” and that Bruce Dern, also 77, did likewise in “Nebraska.” ... And it’s no accident that many of us, while remembering and sometimes yearning for the electricity of first loves and the metabolism of our salad days, don’t really want to turn back the clock. We know that for everything that’s been taken from us, something else has been given. We don’t move as nimbly as we did, but we manage our emotions with greater dexterity. Our energy may be diminished. Our use of it is more prudent. We’re short on flat-out exuberance. We’re long on perspective. "
Frank Bruni, excerpted from“Maturity’s Victories,” New York Times, Week in Review, February 2, 2014, p. 3
News Flash: Older adults are having sex!
That may surprise some, but in a National Social Life, Health and Aging Project of the National Institutes of Health, over 3,000 Americans were surveyed in order to assess the prevalence of sexual activity in persons between the ages of 57 and 85. The first of its kind, the results (published in the New England Journal of Medicine in 2007) reported that about 3/4 of the 75% of respondents who were married or living with a partner were sexually active.
Frequency of sexual activity remained fairly stable for persons aged 57 to 74 years-old, with about 66% of sexually active men and women reporting having sex at least two or three times a month. However, that figure drops to 54% after age 75, a decline caused more by medical problems than by age. In fact, the most commonly reported reason for sexual inactivity, for both men and women, was the man’s physical health. Nearly half of women in all the age groups studied report a lack of interest in sex, compared with about 25% of men.
Sexuality & Healthy Living
As the research shows, the importance of sex corresponds to different points on a continuum, depending on the person. Being an active emotional and sexual human being is important to an individual’s self-identity and general well-being. Besides contributing to the satisfaction of physical needs, sex fulfills one’s needs in the social, emotional, and psychological spheres of life. Also, sex evokes sentiments of joy, romance, affection, passion, and intimacy that can make the older years truly happy and full of memories.
The sad truth is that society’s culture and attitudes are often to blame for the reason the sexual needs of older adults are either ignored or neglected. Sex through the ages, through the movies and advertising and, more recently, through the powerful media of rock music and videos, has come to be correlated with youthfulness, attractiveness and physical power. Add the concept of sex for reproduction, and the cause for this over-emphasis on youth and sex becomes evident. Older adults need to ignore society’s belief that sex is for the young and debunk that fallacy. For, as we all know, the concept of older adults engaging in fulfilling sex is still a viable and relevant idea. In fact, a lot of sexual dysfunction is caused by what’s between the ears. So an attitude adjustment is called for. Besides, in what can sometimes be a crass, violent and fragmented world, a little warmth and connection with another human being is a welcome affair!
Let’s look at some of the untruths and misstatements that are often made about sex or that prevent older persons from enjoying it or taking it seriously:
His or her equipment doesn’t work and any sex is impossible.
False: Even with severe sexual dysfunction, participants can bring sexual pleasure to each other through ways that do not involve the full use of the sex organs.
You can’t fire up an old engine.
False: Even though a person has been sexually inactive for a very long time, sexual interaction can be achieved again.
An aging body isn’t sexy.
False: This is a “between the ears” notion that needs to be ignored, fueled again by society’s emphasis on beauty and youth. First, sexy is not synonymous with beautiful. As the body ages, certain changes take place in the physical appearance of a body, but this in no way interferes with enjoyment of sex.
Older people shouldn’t have sex.
False: This is probably the most biased and incorrect assumption about older people and sex. As long as they are interested in sex and intimacy with their partners, and both parties are interested, sex over 50, 60, 70, 80 and beyond is indeed possible and recommended. Just because you have reached a certain threshold of age does not mean that you should close the door on that dimension of your life and health. As we know, age is just a number.
Older people who have sexual fantasies and interests are dirty and disgusting.
False: Sexual fantasies and offbeat interests that are not harmful to anyone can be very titillating and add to a sexual experience. It sometimes helps to reignite and power a sex drive that has been lessened for some reason.
Sexual satisfaction always diminishes with age.
False: Although some extra time and work may be required to reach sexual satisfaction among older people, the quantity and quality of sexual satisfaction does not have any less power than younger people, and can maintain intensity.
Evidence-Based Facts about Sex
As we age, our body changes. Here are some of the changes that occur that can substantially affect sex:
Health and medical issues/conditions. These occur more in older adults and they can interfere with sex.
Loss of a spouse or partner. A person who loses a spouse often cannot imagine sex with anyone else, and the grief can be crippling.
Physical impairments. Disabilities and the physical effects of arthritis, stroke, etc., can hinder sex.
Cognitive impairments. A person with Alzheimer’s disease might not understand sex, or might become frightened by sexual advances.
Dependency on adult children and others. The lack of privacy and other issues can stifle sex.
The following are physical changes that occur to men as they age. Knowing about them will help you to understand certain things about your body:
Erectile Dysfunction (ED) can be caused by many things and you are encouraged to speak with your doctor, who will look into the causes, and in some cases, can prescribe medication.
Slower response to stimulation is a common complaint and this is natural among older men.
The interval between ejaculations may increase and older men may experience an increased ability to postpone ejaculation for longer period of time.
Orgasms can become less intense as we age.
These are some of the medical causes that can interfere with sex in men:
An enlarged prostate, the effects of prostate, bladder or testicular cancer.
Medications such as antidepressants, antihistamines, chemotherapy and drug treatments for high blood pressure.
The following are physical changes that occur in women as they age:
Vaginal dryness that can often be easily alleviated with the application of creams.
A slower response time is common among women as well.
These things can affect a woman’s response to sex:
Chronic medical conditions such as arthritis, heart disease, diabetes and cancer.
Medications, including antidepressants, antihistamines, chemotherapy and drug treatments for high blood pressure.
These things may not be welcome, and it may depress you to think about them. But there are many steps that you can take to maintain and enhance your sexual well-being. These are:
Think positively. Positive thinking can improve things.
Talk with your partner. Open communication is of the utmost importance.
Remember that there are many ways to enjoy sexual intimacy. The old way may not work anymore, but there are other ways that may have to be learned.
Use it or lose it. It is a medical fact that the more you have sex, the more readily your body will respond to sexual stimulation.
Stay healthy. As the National Social Life, Health and Aging Project found, medical problems were the major reason people were unable to enjoy or have sex.
Talk to your doctor. There are many ways your doctor can help. Plus problems with sex can be a symptom of other medical issues, and they should not be ignored.
As an exercise, write down a few words about what sex means/meant/ will mean to you at 20, 40, 60, 80 and 100. Then look at some errors in thinking you may be making about sex at these different ages. Recognize for yourself that these are false assumptions and make an effort to re-tread your thinking about sex and older persons. Since sex is so closely tied with the psychological and emotional, you’d be surprised how effective a little attitude adjustment can be. Armed with a new viewpoint about sex, it’s time to practice.
Making Sex Enjoyable
Maybe your partner is not as enthusiastic as you are though. Here are many ways to rekindle a relationship and to help sex become more enjoyable.
Surprise one another. This can mean anything from just lighting a candle at the dinner table, buying flowers to show love and affection or making your partner’s favorite meal.
Book a night at hotel. A new setting can do a lot to bring romance back into the relationship. The same bed in the same room in the same house could be boring, and what could be more exciting than slipping out to a hotel for a rendezvous with your partner?
Communicate with one another about changes or insecurities. Nothing hurts a relationship more than secrets or lack of communication. Your partner may not know that sex is painful for you, that you don’t like something, that you feel less than attractive. Talk about it and be honest about how you feel. Tell your partner what you like.
Try something new in the bedroom. If you’ve been having sex the same way for ages, it’s time to change it up a bit. Buy a book on sex if you’re unsure what to do.
Expand beyond just intercourse. This can be the one of the most effective ways of regaining intimacy with a partner. Try anything from cuddling, caressing, kissing and sensual massages.
Figure out what time of day you and your partner are the most energetic. Are you both morning and evening people? That settles that question. If you are exact opposites in that area, find a balance, a place in between where you both might have the most energy together.
Dating—Don’t Shy Away From It in the Later Years!
So how do you meet someone and get to know them enough to have sex with them? The tried and true ritual of dating is still the way most people become acquainted and gain more intimacy with a partner. For older people it can be a little different, particularly time-wise, when people do not feel like they have all the time in the world to “date around.”
Remember, older people are wiser, more experienced and have a lot more self-knowledge, so knowing who you are compatible with might come a little easier as you age. Once you’ve found someone you’d like to exclusively date, or even marry, you might be able to make a decision more readily.
How many older adults are out there in “the field” dating? A very large portion of our population is unmarried, so dating and companionship are a big concern among older persons. In a 2003 AARP study that focused on 3,501 single men and women aged 40 to 69, a third of the people had an exclusive dating arrangement; a third of the people had a nonexclusive dating arrangement; and almost one tenth expressed no interest in dating. So, if the statistics prove correct, one third of single older Americans are in a nonexclusive dating arrangement and are fair game.
Emerging from your solitude and dating might be what you want and not be difficult at all, but for many it can pose problems. If you are among the older adults who find they can date freely and without any barriers, it is good to appreciate that. However, for some older adults, many issues emerge that can make dating difficult. Issues like unsupportive children and budget constraints can enter the picture.
When children are unsupportive, they must first be reminded that you deserve to live out the rest of your days in a happy relationship, if that’s what you want. If this is a sore topic, it’s not necessary to talk about it all the time, but remember not to keep any secrets. A show of affection with another person who is not your children’s father might upset them too, so be discreet in those situations.
If you have been dating someone you are serious about, do not force this person on your children. Have him or her over for dinner with your children and let them get to know each other gradually. Hopefully the children will come around and accept your partner. If they have violent objections to a certain person, don’t let them turn you against him or her. At the same time, be sure to pause to make sure that their objections are unfounded.
Often a common concern for children when their single parent dates or remarries is the disposition of any kind of inheritance or a home. Be prudent about expenditures if necessary. If you’ve reached the point when marriage is in the picture, a prenuptial agreement is recommended, no matter how sure you are about your intended. This will allay your children’s concerns too.
Where to Find Older Singles?
If you are resourceful, you can find many opportunities where you can meet other older adults who are looking for friendships and relationships. The easy answer is the local Senior Center. However, if that isn’t fruitful, many community programs exist that are designed specifically for older adults.
Elderhostel has a Northern Illinois Chapter as well as a Road Scholar program that features interesting trips nationally and internationally. The website www.roadscholar.org (link is external) lets you choose location, price range, interest and more. It includes commuter rates for some programs located in Chicago, including a general trip about Chicago, coordinated by Jewish Community Center of Chicago.
Besides regular volunteering, check out the Senior Corps, which is the ultimate resource for volunteering. In the end, most people in the previous AARP study found dating prospects through friends, family, or work. Some used an online dating service.
Fortunately, there are many dating websites created for the 50 and older crowd. Online dating has exploded among older persons; some of these sites have seen up to 400% growth in users in just a few years. According to an AARP survey, older adults choose online dating for many reasons:
23% said they can meet a broader range of people.
20% said there is no pressure to contact people they don’t want to.
14% said a friend recommended it.
Just use your favorite search engine and type in “Older Adults Online Dating.” When using online sites, be sure to narrow your focus to a target age group, and be specific about whether you are interested in simple companionship or a serious relationship. This is the one place where you can specify what you want in a person. Be as honest about yourself as possible.
There are common pitfalls to online dating, that were brought out in a review of online dating services commissioned by the Association for Psychological Science. This includes an over reliance on profiles and rigid use of them. The study found that people might not fully know what attracts them to others, so they might put incorrect characteristics in their profiles. Another problem is that with the hundreds of thousands of profiles available, some people become picky. People can tend to objectify potential partners and compare them like a pair of shoes. It creates a shopping mentality that is not useful in personal interactions.
Sexually Transmitted Diseases (STDS)
April is STD Awareness Month, and there is no better time than now to discuss this subject. Getting out and dating is one thing. Being exposed to easily transmitted STDs is an unwelcome result. However, people age 50 and older represent almost one-fourth of all people with HIV/AIDS in the U.S. In fact, rates of STDs have doubled among 50-90 year olds. Because older adults are not worried about getting pregnant, the importance of using protection seems not necessary. But don’t fall into that trap and use condoms, the method of protection most commonly used. They should be used for all sexual encounters, unless you are in a long-term relationship. Taking chances that someone is disease-free is not an option.
Remember, being a sexual being is something that contributes to the enrichment of your life. But healthy aging is the other side of the equation, and you do not want to endanger that pursuit.
Family Life and Social Support.” Issues in Aging. 2nd ed. Boston: Pearson, 2009. 329-32. Print. Montenegro, X.P., & AARP. Knowledge Management. National Member Research. Knowledge Networks, Inc. (2003). Lifestyles, dating and romance: A study of midlife singles for AARP The Magazine. Washing, DC: AARP, Knowledge Management, National Member Research. National Institute on Aging. HIV, AIDS, and Older People. Bethesda, MD: U.S. Department of Health and Human Services; 2009. (cited 2012 Jan 12). Available from: http://www.nia.nih.gov/health/publication/hiv-aids-and-older-people (link is external). Pieper, H.G., & Petkovsek, L.A. (1991). Remarriage among the elderly: Characteristics relevant to pastoral counseling. Journal of Religious Gerontology, 8(2), 1-9. Schwartz, Dr. Pepper. (9 May 2011). 5 Myths about Sex and Aging. AARP. Retrieved from http://www.aarp.org (link is external). Voo, Jocelyn. (9 October 2007). Sex and dating after 50. CNN. Retrieved from http://cnn.com (link is external)
The Doctor's Opinion on
Sexual Activity in Seniors
Noel DeBacker, M.D
Sexual activity can be very pleasurable and satisfying for many seniors. There are special precautions, however, to consider. If starting a relationship with a new partner, the possibility of acquiring a sexually transmitted disease exists. “Safer sex” means the use of condoms for protection. Ten percent of HIV cases are over fifty years old and four percent are over seventy. Hepatitis B is a sexually transmitted disease that people can have without knowing it. If you have never been immunized, ask your doctor about having a Hepatitis B immunization series. Sexual intercourse generally requires enough aerobic capacity to climb up two flights of stairs without stopping.
There are instances when your doctor should be consulted prior to sexual activity. This is very important if you have cardiovascular disease or emphysema,
especially if you have a history of chest pain or undue shortness of breath. It is a good idea, however, to do so with any chronic medical condition, or if you believe that you are frail. Osteoarthritis and osteoporosis pose their own difficulties and risks, as do neurological disorders such as stroke and Parkinson’s disease.
Although vaginal dryness is very common and in many cases can be overcome with commercially available lubricants, pain or bleeding should cause you to consult your doctor. Erectile dysfunction is also very common, occurring in almost forty percent of men aged 57 to 85. Medications such as Viagra, Cialis or Levitra are generally safe, well tolerated and effective, however, like any other medications, they have potential side effects, some serious, as well as drug interactions. Your doctor will review your medical history and determine if you can take these medications safely.
Lieberman Center Medical Director.
This article originally appeared in the Spring 2014 issue of LIFE, CJE SeniorLife's quarterly magazine.