4/3/16: I’m bringing this 2014 post to the top because I’m giving a talk to doctors and other medical professionals tomorrow in Milwaukee. I want these comments from my readers to be easy to find if they read my blog after that — which I hope they will!

About half of all sexually active men and women aged 57-85 in the United States report at least one bothersome sexual problem; one third report at least two. Yet only 38 percent of men and 22 percent of women reported having discussed sex with a physician since the age of 50 years. 

Why does this information barrier exist? And what can you, as professionals, do to overcome it with your patients and clients?

These are the questions I posed to the attendees at the beginning of “Talking about Senior Sex:
A Presentation for Medical Professionals, Therapists, and Others Working Professionally with the Older-Age Population,” which I presented at The Smitten Kitten in Minneapolis on June 19, 2014.

I was so jazzed by the responses during that workshop that I wanted to continue the discussion, so I took it to my Naked at Our Age Facebook page (which I invite you to read and “like”).

Our community jumped in eagerly with their comments and experiences. Here are some of those:

  • It would suffice if they just asked. I think they are 1) embarrassed, and 2) afraid that a nestful of psychological tangles would emerge, which would take a lot of their time. As a doctor, you would have to believe that relationships, beliefs, and habits contributed to illness, and I think most of them are just looking for a set of symptoms. The mind-body connection is far from their thoughts. 
  • It may be difficult for physicians to broach topics on sex because of their lack of education on sexual matters – not just with senior sexuality. Often such topics are delegated to nurse specialists or physician assistants. There are also shades of sexuality beyond the range of physiology, endocrinology, anatomy, and other hard sciences that are beyond the scope of topics covered in med school and continuing medical education. We need to take charge and help drag medical providers along with us on this topic.
  • Sex over 55 is often challenging if your parts are in perfect working order, but if they are not, then it’s an entirely different ball game. As someone who has lived with a sexual challenge for 20 years (and who is now 67), I found, in the beginning that it was helpful to write a letter to the doctor prior to the appointment – an ice-breaker. Now, however, after such a long-term medical problem, I am really very open with all the doctors I see and they either handle it or they don’t – they can choose!
  • We live in a culture that allows only a few sexual subjects to be discussed and those in limited ways. Having lived a lifetime hiding or being ashamed of our sexual natures, it can be a huge challenge to just start talking about “it” when we reach those years. The mechanics of sex may be easier to discuss than unmet needs and innate desires. It is a gift to be sexually sovereign in our culture.
  • In my case, no doctor ever broached the subject. I was always the initiator. After 12 years of fertility work, four ectopic pregnancies, numerous spontaneous abortions and nerve damage resulting from a rape, surgeries and malpractice (they refused to remove the infamous Dalkon Shield IUD after the rape and subsequent STD infection), it’s not a stretch to understand why I had a damaged libido. Only with recent help from two amazing physicians, with whom I can discuss anything, have I begun to find help! Finding this and other groups online has also been salvation of yet another kind. Thanks for opening so many doors to those of us who have foundered for so long!
  • Actually, it was through conversations with my nurse practitioner that my road to sexual freedom opened up. Also through my wonderful husband’s patience, and Joan’s book, Naked at Our Age. There is a taboo about sex at a certain age, but for us it has just been renewed!
  • Particularly as sex and disability is also a taboo subject and many people will have genital dermatoses and that will make it even harder for them to open up to anyone. I am 67 and despite lichen sclerosis, I remain sexually active.
  • The doctor needs to be calm, confident and comfortable with the subject. If the doctor is squirmy and clearly uncomfortable, it won’t help the patient to open up. Speaking for myself, if I’m a little squirmy and hesitant, I’d appreciate it if the doctor would give me the time and space to squirm a little and build up my courage. I had that experience with a doctor; he asked what was clearly a scripted question, I hemmed and hawed a little struggling to express an answer. Since the answer wasn’t immediately forthcoming he just jumped right to the next question. I got the distinct feeling he really didn’t want to hear it, so the subject was dropped. On the other hand, a doctor might ask a question and get a very forthright answer they weren’t expecting. They better be ready for that too; no eyes bugging out, no jaw dropping, no flinching. They might need to develop the ‘warm positive regard’ thing that therapists are taught.
  • I’m 73, have an older woman doctor trained in Europe who brought the subject up in the course of an annual physical, and was quite matter of fact about it, made me quite comfortable discussing the subject, and referred me to an endo.
  • I’m not your target age group but my nurse practitioner at Kaiser simply asked if I was happy with my sex life and, after I affirmed that I was, proceeded to tell me that orgasm was good for my vaginal health (not to mention my psyche) and encouraged me to take charge of my pleasure because it would help make perimenopause easier to take, keep my bladder where it belongs and generally support my wellbeing. Hell yeah -this I knew – but what was even better was that she made it clear that she was there to help. My sexual health was not some secondary aspect. It was a full-fledged piece of my gynecological workup. To which I say – well done!
  • I’d like to see it simply become a matter of routine during all regular check ups, or anytime the visit is for more than a sniffle really, as well as anytime mental health/ relationships are discussed. We need to be in the habit of treating the whole person, not just fixing bits and pieces and mending boo-boos.

I hope you’ll continue this important conversation by commenting here. (And if you’d like me to bring this presentation to your organization, please contact me.)

#AdultSexEdMonth

UPDATE: Thank you to the eleven lively people who partipated in my NYC workshop, Ask Me, I’ll Tell You: Women and Men Talk Out Loud about Sex and Aging, talking candidly about your sexuality in front of strangers, a TV crew, and cameras. You were wonderful!

Excerpts from this workshop will be part of a TV documentary on sexuality in the U.S. airing on a major cable network in October or November. Once the air date is set, I’ll be able to tell you the details — right now I can’t reveal more.

We had such a good time with the abbreviated version of this workshop that the participants requested that I return to NYC to give the full workshop. I’d love to! If you want to be on my NYC mailing list for news of a workshop there (without cameras or a TV crew!), please email me with “NYC workshop info” in the subject line, and tell me a bit about yourself.

We’re also seeking sponsors who can provide a venue and/or cover my travel costs. Let’s make this happen!

If you live in the Santa Rosa/ Marin/ San Francisco area of California, I offer this workshop frequently here. Email me with “local workshop info” in the subject line. I’m about to schedule another one in Santa Rosa in the next couple of months.

If you’re landing on this post for the first time, here’s the background — the original 8/17/12 post about the first NYC workshop event:

Are you:

  • In or near New York City?
  • Age 50+?
  • Energetic, articulate, communicative?
  • Interested in enriching your knowledge of senior sexuality?
  • Willing to share your views about sexual topics candidly — on camera?
  • Available Thursday morning, August 23?

If so, Please email me immediately! You might be invited to appear on a national cable network television special with me on the topic of senior sex! Here’s the scoop:

On Thursday morning, Aug. 23 (venue TBD in New York City), I’m doing a one-hour, abbreviated version of my workshop, Ask Me, I’ll Tell You: Women and Men Talk Out Loud about Sex and Aging (description below). The workshop will be free to you and filmed — you’ll be on camera the whole time. Excerpts will appear as one segment of a national cable television special about senior sex.

If you are enthusiastic about speaking candidly about
senior sex as part of a workshop discussion, which I’ll facilitate,
please email me
right away! If you and a partner want to participate, please submit
separate emails, but indicate that you are partnered with [name].
Singles are encouraged to participate.

Please include this information in your email:

  • Name
  • Phone number
  • Email address
  • Age
  • 2 or 3 burning questions* you would like to hear men discuss about senior sex
  • 2 or 3 burning questions* you would like to hear women discuss about senior sex

Workshop description:

Ask Me, I’ll Tell You: Women and Men Talk Out Loud about Sex and Aging . We’re talking about senior sex—the challenges, the
pleasures, and all the questions we didn’t think we could ask out loud.
What arouses us now, when the old ways aren’t working like they used to?
What do we wish we understood and could communicate better about our
changing bodies and responses? How do we spice up our sexual
repertoire? What if we don’t have a partner? What if we don’t feel
desire for sex any more? In this eye opening, interactive, mixed-gender
workshop, you’ll get to voice your questions and get answers. Joan
Price, author of Better Than I Ever Expected: Straight Talk about Sex
After Sixty
and Naked at Our Age: Talking Out Loud about Senior Sex,
guides the conversation and discovery, and offers tips for putting the
zest back into later-life sexuality. For couples and singles, men and
women. 

(*In the full-length version of this workshop, we arrive together at the “burning questions” we want to hear our own and the other gender discuss, but since we’re limited to one hour of this workshop, I’m speeding it along by collecting your questions ahead of time.)

This show will air in the last quarter of this year — more details to come. I’m really excited about this opportunity to share what I do on a national television special, and I hope you’ll be part of it! I’ll turn over the information you send me to the producer, who has the final word on attendees — space is limited and we won’t be able to accommodate everyone.

I just received a thoughtful and provocative email from a Peter, a handsome, fit, intelligent man of 59 who recently attended my Ask Me, I’ll Tell You workshop at Good Vibrations in Berkeley. He raises a stimulating issue – are women past menopause disinterested in sex if they’re not on hormone replacement therapy? Here’s what he told me:

…I think you should have this input from a man who is a sincere feminist, appreciates your work, and is an incurable romantic and irrespressible horndog to boot.

I look young for my age, keep myself in great shape, have youthful ideas and spirit, but am a month shy of sixty. In our sexist and ageist culture, most women with whom I should have something in common seek a younger man. I’m open to a relationship with any woman who is fit, youthful, and hasn’t lost her sex drive.

It’s the latter that always poses the problem. My experience is that post-menopausal women fall into two categories regarding sex: those who take hormone replacement drugs (few, as the statistical association with breast cancer becomes known) and those who don’t. The former have sex; the latter don’t. I have been with close to a hundred women who are post menopausal in sexual situations and the results have never varied.

I fully understand the issues you discussed about changing arousal patterns, lubrication, patience, etc. I’ve explained – in a general and restrained manner – my understanding of this, but have only made it to bed a few times with those who don’t take hormone supplements, only to find a freeze up once I get there.

I notice many laments from women over forty who characterize themselves as “old,” laments from women over fifty who claim to be “sexually active” while no man their age is (defying biological reality), and laments from both that all men want is sex.

But when I date them, write them, talk to them, embrace them, always respectfully, the response is always the same if they are past menopause. This even holds true after lengthy dating and what seems to be an emotional connection.

I want what you preach, but my experience is that it’s women who block it. Most men my age I know who would be a good catch have given up because they think no one wants them any more. It sounds like the women say the same. They need to accept that men want to communicate and connect with them, and if refusing to do so governs their actions, that is the problem – one that they must face and overcome.

I think your workshop was well prepared and taught, and you have an important issue. I’ve taken several classes at GV and thought yours was outstanding. Please stick with your message. You’re doing it right and you’re appreciated. Thank you.

I would love to read your reactions to Peter’s comments. In my experience, both personally and through interviewing women for my book and afterwards, I have not found this kind of clear division between women who choose to have hormone replacement therapy (HRT) and those who do not.

Certainly the lack of estrogen does affect sexual comfort and pleasure, and some of us who say no to full HRT still use estrogen vaginally, which is thought to be safe and effective. (Disclaimer: I’m not giving medical advice. Please consult your medical professional to make your health decisions.)

But is Peter right that women post-menopause who don’t go on HRT just aren’t interested in sex? Here’s a good guy, attractive, sensitive to women, and romantic – the kind of man so many of you have said you’re looking for. What’s your experience?

Last Saturday, a group of women gathered for my workshop, which promised “Straight Talk about Sex after Sixty”–and “straight talk” it was.

The women, ranging in age from 50 to 74–single, partnered, married–came together to express what was on their mind about their sexuality and relationships. We discussed how to stay sexy when “we don’t have that hormonally driven freight train any more,” as one woman put it, and the challenge of feeling sexual energy “squashed down” when men seem drawn to younger women without getting to know what we have to offer. We discussed past and present relationships, finding in the safety of the workshop an opportunity to share our experiences, attitudes, and hopes for the future. We also laughed a lot over shared experiences and a couple of “tools” that I passed around the room.

On November 4, I’m repeating this Straight Talk about Sex after Sixty workshop for women only in Sebastopol, and I encourage women to join us. You don’t have to be over 60 — in fact, many of the participants are in their fifties and experiencing post-menopausal changes that they want to talk about.

Our ground rules promise confidentiality — you’re encouraged to tell others about the ideas brought up in the workshop, anything I say (since my sexuality is an open book– literally!), and anything you personally experience or learn–but not to divulge any private information that other people share.

I’m not shortchanging the men — My workshop for men and women, Ask Me, I’ll Tell You: Women and Men Talk about Sex and Aging, happens October 14 — see below. When I presented this workshop before, I was happy and grateful that the men wanted to share their views as much as the women. Certainly the reader response bears that out, too — men frequently write me their questions and stories, and are asking–as the women are–to be heard.

Interested? Details about both workshops below:

Saturday, October 14, 1:30-4:00 pm: Workshop for men and women: Ask Me, I’ll Tell You: Women and Men Talk about Sex and Aging, in Sebastopol, CA. For many people, sex and aging are two of the hardest topics to talk about. Add in the challenges of communicating across the genders and it can sometimes seem impossible. But Joan Price, ageless sexuality advocate, and author of Better Than I Ever Expected: Straight Talk about Sex After Sixty is here to help! In this interactive and fun discussion, you’ll have a chance to get the answers you’re looking for. Joan will guide an afternoon of conversation and discovery, and will help everyone in the room learn from each other. For couples & singles, men & women. If you’re 60+, or you plan to be, this workshop is for you.

Saturday, November 4, 1:30-4:00 pm Straight Talk About Sex After 60 (women only) in Sebastopol, CA. Yes, sex after sixty has its challenges,but it can also be sizzling and satisfying. Joan Price, ageless sexutality advocate, fitness expert, and author of Better Than I Ever Expected: Straight Talk about Sex After Sixty will help you face the challenges and celebrate the joys of older-age sexuality. By sharing experiences and learning with other women in a spirit of candor, acceptance, creativity, and humor, you’ll take home new tools, techniques, and attitudes that help women over sixty experience hot, joyful sex with or without a partner.

Either workshop $40, or both for $75. Preregister by phoning 707-874-2285. Please register early. (Address & directions will be sent to you when you register)


[Photo by Constance Cavallas, published with permission]