Posts by Joan Price
New England Journal of Medicine: Seniors having sex despite “bothersome problems”
When the news splashed all over the media today that older adults are, indeed, having sex, my first reaction was to laugh and say, “Duhhh!” The idea that senior sex is alive seemed to me as much a news story as the revelation that most people find feet at the end of their legs!
But there was much more to the story. “A Study of Sexuality and Health among Older Adults in the United States,” published today in the New England Journal of Medicine, was a major study of 3005 U.S. adults (1550 women and 1455 men) 57 to 85 years of age which revealed some fascinating facts and a few surprises:
The majority of older adults are sexually active and regard sexuality as an important part of life. The prevalence of sexual activity declines with age, yet a substantial number of men and women engage in vaginal intercourse, oral sex, and masturbation even in the eighth and ninth decades of life.The frequency of sexual activity reported by sexually active older adults (age 57+) is similar to the frequency reported among adults 18 to 59 years of age.The study reported that 78% of men 75 to 85 years of age, as compared with 40% of women in this age group, had a spousal or intimate relationship. Since women live longer, and on average, older men marry younger women, this disparity can be accounted for by the lack of available men for the older single women. The sexually active people in the oldest age group interviewed — 75 to 85 years of age — reported having sex at least two to three times per month, and 23% reported having sex once a week or more.About half of the sexually active men and women reported at least one “bothersome sexual problem,” and almost one third reported having multiple problems. The women’s most prevalent sexual problems were low desire, difficulty with vaginal lubrication, inability to climax, finding sex not pleasurable , and pain, usually during entry. The most prevalent sexual problems for men were erectile difficulty (14% of all men interviewed reported using medication or supplements to improve sexual function), lack of interest in sex, climaxing too quickly, anxiety about performance, and inability to climax. About one quarter of sexually active older adults with a sexual problem reported avoiding sex as a consequence.
Most surprising, given the extent of these problems that prevented sex from being satisfying or pleasurable, was this fact:
Only 38% of men and 22% of women reported having discussed sex with a physician since the age of 50.
The study suggests that the reasons for poor communication include the unwillingness of both patients and physicians to talk about sex and the gender and age differences between patients and their physicians.
Negative societal attitudes about women’s sexuality and sexuality at older ages may also inhibit such discussions.
When I give workshops and talks, both women and men frequently bring up physical problems that affect their sexuality and want me to provide a solution. I always say, “Please get a diagnosis from your doctor.” I emphasize that the problem may be caused by retreating hormones, or by an underlying health condition that you don’t know you have, or a medication, or interactions of medications. You can’t treat a problem until you know what’s causing it.
As the NEJM article states,
Sexual problems may be a warning sign or consequence of a serious underlying illness such as diabetes, an infection, urogenital tract conditions, or cancer. Undiagnosed or untreated sexual problems, or both, can lead to or occur with depression or social withdrawal. Patients may discontinue needed medications because of side effects that affect their sex lives, and medications to treat sexual problems can also have negative health effects, yet physician–patient communication about sexuality is poor.
I invite your comments!
Woman tolerates husband’s sexual advances, how to tell him what she wants?
A reader who calls herself “Hot Momma Frigid Lover” posted a comment on another post which contained a point that was so important that I decided to comment on it here. Here are excerpts from her comment:
… I have never had that much pleasure in sex… My husband, on the other hand, has had a very healthy sexual drive and I had a mother who taught me to be sensitive to that drive and take care of his needs. So…well…we have had a good marriage for 32 years.
… I am starting to resent his advances a little more. Not that I don’t want to give him pleasure any more but that he does so little to actually ‘earn’ it. He has always gone for my breasts as an ‘invitation’ to give him some sexual attention. Since I prefer sleep over sex, grabbing at my breasts is a rude awakening and definitely does not awaken any sexual desire.
I think I know what might help him to arouse me in a more romantic way but how can I tell this man (that I love so much) that he just doesn’t turn me on!
Here is what I wish he could learn from someone or somewhere else. If I am asleep (or if he thinks I am …lots of times I am pretending hoping he will arouse me awake)…I would love a good back massage. Some kisses on the back of my neck, some full body hugs (that don’t include his hand on any part of my sexual annatomy)some physical contact that says “I love you” before it says “I need sex”. In fact I wouldn’t mind hearing the words “I love you” that can be very inviting.
How can I help him to ‘learn’ this stuff without me having to teach him. Most of the information I have found is for help with sex itself … I am not interested in sexual pleasure…I just want a little physical love and attention before I give him the “sex” he needs.
I implore you, please talk to your husband about what would turn you on or at least make you feel receptive to sexual intimacy. Surely he would LOVE to know this! Instead of asking how to tell him that he doesn’t turn you on (that would be devastating to hear), why not tell him what you DO want from him?
If that seems really difficult to you, start by requesting the back massage, and let that turn into sexual intimacy if it feels right. Then, when you’re in a neutral situation (walking in the park, or sitting over coffee, not in bed), try saying to him, “It really makes me feel relaxed and loved when you give me a back massage/kiss me/ hug me for no reason. I love it when you do that.”
He needs to hear from you what you like and want from him, because he’s certainly getting the message that you’re not enjoying his sexual advances. Give him the opportunity to please you and show you his love.
I invite other readers to talk about what has worked to open communication in your relationships.
Sexual adventurer, age 58, has “every time/ everyone” condom rule
Many thanks to the people who are responding to my request for interviews for my next book! I am getting such interesting stories! For example…
When I asked Tinggi, age 58, how active his sex life was, he said, “Depends on what you mean by ‘sex’!” His erotic activity includes self-pleasuring to orgasm one to three times a day, and intercourse with one to three or more partners (male and female) per week, one to two orgasms per partner. “I tend to have several partners at the same time,” says Tinggi. “I’ve been with two of my partners for five years, another for two years. All of the relationships are open and all my partners regularly have sex with others.” His sexual adventures in the past few years have included multiple partner scenes at sex parties, masturbating for four hours while riding an anal plug while being videocast globally, and nude theater performances.
Tinggi is diligent about practicing safer sex, and has not indulged in partner sex without a condom in 30 years. “My barrier policy is standard, long fixed, and known by all who have shared erotic times with me: Barriers are always used, for everyone, every time, for any genital contact,” he explained in a comment on my blog. “This ‘every time/everyone’ policy makes life simpler — no need for elaborate calculations as to number of partners, who they were, days since last std check-up, partners since our last date, etc. When sex is likely, or probably, or possible, or even a wisp of my imagination, I bring my own supply of barriers. Should the opportunity arise, and both having shed clothes, I simply say, ‘Ok, now time to get Charles (not my name) dressed,’ and put on a condom.”
When dates insist on sex without a barrier, which rarely happens, “the date becomes a chaste one and a last one.” Steady dates, people with whom he has sex repeatedly, get the same treatment each date: “every time/everyone.”
“I do not ask my dates about STD check-ups, partners, etc. I am going to use barriers regardless of my date’s answers. People can have an STD of which they show no signs detectable outside of a laboratory. I believe this ‘every time/everyone’ policy protects my dates, myself, and my community. A sad fact is that HIV is being transmitted in our retirement homes – by their residents. It is already there waiting for me. Barrier use can be eroticized to become a fun and arousing part of sexual interaction.”
Bill B: 59-yr-old Guy’s Viewpoint
I just received an email from Bill B., age 59, who brings up so many provocative topics and expressed so skillfully that I’m giving Bill his own post here:
Hi, Joan, I just became aware of your book about sex over 60 featuring the feminine perspective and look forward to reading it. In response to some of your questions, as a guy, I think we generally like things presented in a “Problem: Solution” format. For example; a chapter titled ‘Rise & Shine’ might present the various forms of ED, and then some of the available answers for each ‘challenge’.
While I’m currently most interested in keeping my long term relationship viable and fun, I would like to know how I might have to deal with forming new relationships after becoming a ‘sudden single’. I hope there’d be room and topic enough for both sides of relationship issues.
I would like to read men’s perspectives on the issues, both from a what didn’t work, to what did and, when possible, why. Possibly a survey of some sort, answered by both men and women might provide some supportive insight to the specific cases or examples you would cite. Maybe it would present something like:
“John’s gruff attempts at intimacy made him feel like something else had been lost to aging; he couldn’t remember the way to a woman’s heart, so he quit trying because he would just fail again. Marcy is married to a man like John, and feels … about it. Our Survey shows xx% of men say that they share these feelings and have found that … helps fix the problem. yy% of women responding to Marcy’s situation say … Clinical remedies suggest that … is usually effective in cases like this because …”
I would also like a woman’s perspective on the things I feel and experience. Sometimes a spouse can be too supportive, when a firm dose of reality might be better in the long run (maybe that’s another ‘guy’ thing).
I like all the topics you suggest. Most guys in my age group were pretty heavilly ‘John Wayne-ized’ as kids, i.e.: emotions are for women and non-men. I think a chapter or section titled something like “I wonder if other guys … ?” that dealt with subjects guys don’t usually discuss could be worthwhile. I grew up in a single mother household and didn’t get to see the daily life of a man. I’m far from alone in that. We’ve had to make it up, or copy it, from whereever we could.
Another thought occurs to me; If you want to lose a little title symmetry with your other book, you might call it “Sex after 60 for men: A user’s guide” — Muy Macho! I suspect that might cost you quite a few readers, because I think more women are still going to buy this book than men. After all; we’re men, and don’t need to stop for directions for anything (a feeling too true for too many guys).
Most of the sex manuals I’ve bought in the past were intended for my wife; I might browse some, pause at the art, and then put it somewhere she’d have to almost stumble over in hopes she’d read it and become my dreamt of ‘whore in the bedroom’ without my having to actually deal with anything. Of course it didn’t work, so my fix was to stop buying those silly manuals — they clearly weren’t worth much! I wonder if any of the publishing companies have buyer stats on their various sex manuals, and if they’d share them?
You have my permission to post any or all of this email with my signed name. I’m clearly no author; these are just some ramblings that occurred to me as/after I read your request for thoughts. I’m 59, Male, Married, Cauc, Some College, retired from USAF, retired from a computer consultancy, and have way too much time to annoy others.
Best of luck with your project,
Bill B.
What good timing, Bill, because I’m drafting my new book proposal this month. You’ve reinforced my ideas and given me some new ones. Readers like you, who get genuinely involved in speaking out about senior sexuality, let me know that I’m not on this mission alone!
Readers: Please comment. Men, do you agree that you’d be interested in the book Bill describes? Any additional ideas? Women, do you agree that you buy the books about sex, even (especially?) those for and about men?
Thanks, everyone!
— Joan