January 2, 2010

Mythbusting: Sex and the Elderly

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Sex doesn’t stop as we get older. Let me refer you to a report by Patricia Bloom, MD of Mount Sinai-New York, expert on the matter of sexuality from the third age and beyond:

The level of sexual interest and activity among people over the age of 65 is as diverse as the individuals who make up that population. A survey of married men and women showed that 87% of married men and 89% of married women in the 60-64 age range are sexually active. Those numbers drop with advancing years, but 29% of men and 25% of women over the age of 80 are still sexually active. These figures would probably be higher if one or the other partner weren’t hindered by infirmities or if opportunity presented itself to widows or widowers

The older years are for many a time when children are no longer lurking in nearby bedrooms, and there is no longer a need to rise early in the morning for work. Older age can be a time of freedom to explore sexual expression in ways never before possible.

Recent studies showed that men who have more than two orgasms per week have lower mortality statistics. What is probably true is that people who are well, healthy and vigorous enough to engage in sexual activity are also healthier in general. Sexual activity, in its many forms, can be physically, intellectually, and spiritually fulfilling. It is often a good form of exercise, and it can stimulate the brain and promote good mental function. What is most important is to find the type of sexual expression that suits you best.

Some people, either by choice or by necessity, find much gratification in sexual self-stimulation. Many who have overcome resistance to this have been exhilarated by the experience especially with the availability of sex toys. Others explore sexual sharing in new ways with a longtime partner, or with new partners. Still others, especially elderly women, have discovered new intimacies with same-sex partners, even after spending most of their adult lives in heterosexual relationships. The key to satisfaction and sexual fulfillment in later life is individual choice.

There are many bodily changes as we age, and some can modify our sexual experience in later years. Both women and men experience slower arousal responses. This can lead to anxiety in people who do not understand that this change is normal. Women’s bodies change in some of the following ways: The lips of the vagina (the labia) and the tissue covering the pubic bone lose some of their firmness. The walls of the vagina become less elastic. The vagina itself becomes drier. The clitoris can become highly sensitive, even too sensitive.

The entire male sexual response tends to slow down in the following ways: there is a delay in erection. There is a need for more manual stimulation to achieve an erection. The “plateau” phase, or period between erection and ejaculation, is prolonged. Orgasm is shorter and less forceful. The penis loses its firmness rapidly after ejaculation. The refractory period can be quite long, even up to a week in very elderly men.

There are numerous ways in which men and women can adapt to aging changes and continue to be, or become, a sexually active:

  • Realize that sexual arousal takes longer and requires more manual stimulation. Take all the time that you often didn’t have in younger years to pleasure each other or yourself.
  • Share what makes you feel good with your partner.
  • Take time to explore all the tactile, visual, auditory, and even olfactory aspects of intimacy.
  • Make adequate lubrication part of your routine, to avoid irritation of the vagina or painful intercourse. A water-based lubricant is best; oil-based lubricants and petroleum products such as Vaseline may be difficult to flush out of the vagina, possibly causing irritation or infection. You should make applying the lubricant part of your lovemaking routine.

Some women with extreme vaginal dryness and irritation may benefit from vaginal estrogens, effects of estrogens, both positive and negative, should be discussed with your doctor. If you use estrogen cream, use as little as is effective for as short a time as possible to get the desired effect. If you are taking oral estrogens for other reasons, you will probably experience beneficial effects on the vagina.

For older men; be patient. Realize that more stimulation is required to achieve an erection. If you can’t achieve a satisfying or effective erection despite prolonged manual stimulation, you may be one of many men who experience erectile dysfunction. See your doctor, who may well be able to treat the problem. If you are taking medications that may be impairing your sexual performance, be sure to discuss it with your doctor. Let him or her know that sexual activity is important to you. Frequently, medications can be substituted that have less effect on sexual activity.

If the above suggestions are not sufficient to help you achieve the level of activity you desire, ask for help; your primary care doctor, urologist, or gynecologist may be able to help, or may refer you to a sex therapist.

“The human animal should be a sexual critter throughout life,” says Patricia Bloom. The key is understanding and rolling with the changes.

Information from Global Action on Aging, via Othniel Seiden, MD.

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