Seniors: Please Just Say Yes to Condoms

The media blast continues over the Big News that seniors are still having sex. (At what age were we supposed to stop,and why?) I’m happy to see this media coverage help raise awareness, even though I marvel that it’s also raising eyebrows.

A very interesting story appears in the August 13, 2007 print edition of U.S. News & World Report about a subject I’ve harped on all year — the fact that seniors in the dating world are often in denial about their risk for contracting STDs. “Sex Ed for Seniors: You Still Need Those Condoms: Sexually transmitted diseases stalk older singles, too” by Deborah Kotz makes this point:

With Viagra and Internet dating sites at their fingertips, a growing number of seniors are enjoying a renaissance between the sheets, but some are paying the piper, contracting sexually transmitted diseases. As HIV carriers live longer, the majority will be over age 50 by 2015, and even now about 15 percent of new infections occur in this age group, according to the Centers for Disease Control and Prevention. Other STDs, including herpes, chlamydia, and human papillomavirus, which is linked to cervical cancer, are also making the rounds. “While it’s a good thing that older people are more sexually active, they need to connect the dots, see that they’re at increased risk, and make sure they use condoms,” says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Kotz discusses a University of Chicago study revealing that nearly 60 percent of unmarried women ages 58 to 93 said they didn’t use a condom the last time they had sex. An Ohio University study found that about 27 percent of HIV-infected men and 35 percent of HIV-infected women over 50 sometimes have sex without using condoms.

Kotz makes the excellent point that postmenopausal women may be particularly prone to getting infected with blood-borne diseases like HIV or chlamydia.

That’s because their thinner and more fragile vaginal lining can easily tear during penetration, allowing pathogens to enter the bloodstream. And new research indicates that older women are at risk of getting infected with HPV, which can give rise to genital warts or cervical cancer.

The message is this: If you’re dating and sexually active, please use condoms, whatever your age. Men complain to me that it makes sex less pleasurable, especially when erections are less reliable. Women insist that they’re not at risk and they would be embarrassed to insist on condoms. Haven’t we heard variations on these objections from youth? Isn’t this one area where we can learn from experience and our own good sense?

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!

Beyond Sags and Bags: MSN.com

Thanks to Jeremy Egner for his enlightening article, “The New Definition of ‘Sexy'” on the men’s lifestyle channel at MSN.com.

Egner cites a recent poll of more than 10,600 American adults that found that “sexy is more an attitude than it is a perfect physique.” More than 76 percent said a woman can be sexy if she was a size 14 or larger (well, sure!) and that “women (84 percent) are much more likely than men (63 percent) to say sexiness derives from an intangible quality … rather than looks.

Egner interviewed me about how non-physical qualities become even more sexy as we age. On page 2, he writes,

But as we get older and gain status, emotional security and hard-won wisdom, we’re looking less for hotties and babymakers than for compatible mates that will help create durable and rewarding relationships, says Joan Price, author, blogger and self-described “advocate of ageless sexuality.”

Such considerations feed our personal ideas about what is sexy. Other factors include our awareness of our own changing bodies.

“We have wrinkles, sags and bags. If having perfect faces and unlined bodies was a prerequisite for sexiness, we’d be out of the story already,” says Joan Price, 63, who wrote about evolving sexuality in her book, Better Than I Ever Expected: Straight Talk About Sex After Sixty. “We yearn for the same touch and intimacy but we have to first internalize the changed idea of what sexy is. We have to see ourselves as sexy.”

Price recalls asking her 70-year-old husband Robert, whom she married last May, to explain exactly how he could consider her to be as beautiful as he claimed when she could plainly see all her lines and physical imperfections whenever she looked into a mirror. (So don’t expect those sorts of questions to go away anytime soon, guys.)

“He told me, ‘If I am to know myself and accept my own aging process, how could I want anything less from you?'” Price says. “I tell that story sometimes when I’m asked to speak somewhere and women always ask, ‘Does Robert have a brother?'”

“When two people who really accept themselves come together, that’s where good sex happens,” she adds. “The most powerful sex organ is the brain.”

With this article, though, is a slide slow of the so-called “Sexiest Women Over 35,” which I found very disappointing. Why? The oldest “woman over 35” is Elle Macpherson, who is just 44 (a teenybopper in our world). Why isn’t Sophia Loren (73) on that list? Julie Christie (66)? Lena Horne (88)? Or any of the other women listed on my post, How Old Are They Now?

Or does “over 35” have a nine year cut-off date?

This list is one more reminder of how much work is left to do in tearing down the stereotype of sexiness as synonymous with youth, and substituting real live role models of sexiness twice as old as the youngsters MSN.com chose as the “sexiest women over 35”!

What is Sexual Desire? How does it change with age?


“What is sexual desire, and how do you know you’re feeling it?”

Natalie Angier explored that question in “Birds Do It. Bees Do It. People Seek the Keys to It,” published in the New York Times on April 10, 2007. This exploration of sexual desire concluded that although sexual desire is universal, what turns us on (and how we know we’re turned on) is as “quirky and personalized as the very chromosomal combinations that sexual reproduction will yield.”

The article says,

For researchers in the field of human sexuality, the wide variance in how people characterize sexual desire and describe its most salient features is a source of challenge and opportunity, pleasure and pain. “We throw around the term ‘sexual desire’ as though we’re all sure we’re talking about the same thing,” said Lisa M. Diamond, an associate professor of psychology at the University of Utah. “But it’s clear from the research that people have very different operational definitions about what desire is.”

I suggest that not only are our reactions varied and individual, but they vary even more as we age. Certainly I would have answered the opening question differently thirty years ago. I would have said, “Sexual desire is a driving urge of attraction. I feel tingling in my genitals, and a feeling of physiological hollowness yearning to be filled. I fantasize touching my lust object, kissing him, discovering what he looks like, smells like, what noises he makes, how he makes love.”

Today, at age 63, I’d answer differently: “Sexual desire is a yearning for intimacy, for touch, for bonding with my beloved man.I fantasize arousing him, connecting with him, becoming joined in intimacy and ecstacy. It is both physical and emotional, though without the electric arousal I used to feel — that takes much more warm-up.”

What about you? how would you define and describe sexual desire now, compared to when you were younger?

If you’d like to answer Richard A. Lippa’s survey on sexual desire, which is mentioned in the NYT article, click here.