It's Never Too Late to Have an Orgasm
Losing one’s sexuality is NOT an inevitable fact of aging. In fact, engaging in healthy sexual activity can help keep you young at heart—both emotionally and physically. Sex can be part of an overall lifestyle that includes many aspects of self-care: healthy eating, exercise, fulfilling, supportive relationships, a positive outlook, a preventive healthcare/wellness routine, and stimulating mental and physical activities.
In my experience, unless there’s a specific problem or concern, most of my senior patients don’t ask me about issues related to their sexuality. So it’s important for us physicians to include that conversation in our clinical visits. And as a patient, you never need to feel shy or hesitant to ask your doctor any question about your sexuality. I’m predicting that, as our generation of Baby Boomers ages, sex for seniors will become a very “hot” topic.
So why do most Americans assume that our sexual lives must fade away as we grow older? True, there are some real physiological, psychological, and logistical issues that can contribute to a decrease in desire and pleasure as we age. And, the good news is, there are answers to address every one of them.
Hormones. A decrease in hormonal levels (estrogen in women and testosterone in men) is the most common reason for sexual decline with age, but it does not have to be! Treatment for these conditions is generally safe, although there may be some side effects.
- In men, low testosterone, in and of itself, is an illness that can lead to anemia, heart disease, muscle weakness, and osteoporosis. So, treating the testosterone level can have many health benefits.
- We don’t fully understand the issues related to low estrogen in women. There are different controversial theories which seem to change about every 10 years. Testosterone levels in females can also contribute to the mix. Your physician, who knows your personal history, will be able to give you the best advice about how to treat female hormonal imbalances.
Impotency and Erectile Dysfunction. Arthritis, diabetes, and heart disease can all have an impact on your general physical function. These conditions can indicate vascular problems, which can lead to decreased blood flow and impotency in men. The most important thing is to identify WHY there is a problem BEFORE treating impotency. Possible solutions may include drugs like Viagra or devices that prevent blood from leaving the critical location at the critical moment.
When a man complains to me about impotency, my number one question is, “How does your wife/partner feel about this?” It’s important to understand the complaint in the context of the relationship, which includes two individuals. You have to be careful about what you create! If the male is dissatisfied with the current state of affairs while the female is perfectly happy with the situation, there may be other issues to address first. Talk it through, and seek counseling to help, if necessary.
Diminished Female Drive. Similar to female hormonal imbalances, we simply don’t know as much about the reasons for decreased sex drive in women. While the most typical reason is hormonal, psychological conditions, medications, and other factors can contribute to women’s lack of desire in senior years. Hormonal issues can often be remedied with estrogen pills or creams, and lubricants can greatly diminish dryness problems that may decrease pleasure.
Medications. In some cases, medications for blood pressure, depression, antihistamines, and over-the-counter sleeping pills may be the culprit. Ask your physician to take a look at your medications with an eye for libido-killers.
Physical Conditions such as diabetes, vascular disease, and neurological disorders, as well as Psychological Disorders like depression and anxiety, can diminish sex drive in both females and males. Oftentimes, healing the underlying condition will open up the desire to be sexual again.
Dementia. People who have Alzheimer’s and other dementia-related disorders view life for the moment. While they have intense feelings and emotions, they may not have much of an understanding about what’s going on around them. Companionship and sexuality issues can be tricky in these situations.
I once had a patient with Alzheimer’s who lived in a nursing home. He had completely forgotten who his wife was and had taken to holding hands and sitting with a new girlfriend--also a resident there. At a Valentine’s Day luncheon, I witnessed the patient’s wife sitting lovingly and graciously with her husband and his new girlfriend. Situations like this one require patience, understanding, and love.
Privacy. In assisted living facilities and nursing homes, privacy can be a hurdle. Remember that these facilities are not prisons! Nursing facilities need to recognize that their residents can benefit from mutually consenting sexual activities and relationships, and should allow for privacy, which is your right. If this is a problem for you, talk to your doctor, who should take it up with the facility staff. Then lock the door and get busy.
Body Image Issues are an unspoken, insidious cause of decreased libido for countless people, not just seniors. This can be especially true for people who have not been an intimate relationship for many years, or for someone who has recently been widowed after a long marriage. The trick here is to remember that everyone’s bodies change as we grow older, and there is no reason to be ashamed or embarrassed. It’s likely that your potential partner may be having the same insecurities. Talk about it honestly, and get past it! You’re wasting time worrying instead of spending it at more...well...enjoyable pursuits!
Decreased Flexibility and range of movement can make sex more difficult. Don’t worry—you don’t have to contort your body to perform crazy gymnastics or athletic positions. Just keep it simple and keep your sense of humor. And, outside of the bedroom, exercise and stretch your body within your own personal limitations as much as possible. Ask your doctor or physical therapist if you have any questions or concerns.
Judgement. Who cares what your kids think? “So what” to the neighbors across the fence or the nosy gossip down the hall. It’s your life and you get to enjoy it to the fullest. Be free of the good opinions of others!
Risks? The potential risks related to engaging in sexual activity in your senior years are minimal, but worth mentioning.
- Heart attack. A common myth is that sex in your senior years can result in heart attacks. The truth is, the potential risk of heart attack during sex is small. (However, be sure to ask your doctor if you think this could be a factor for you.)
- Drug side-effects. The biggest physical risk is probably related to mis-use of medications like Viagra—you must be more cautious with these stimulants if you have heart disease.
- STDs. Of course, one must practice safe sex at any age. Sexually transmitted diseases do not care how old you are. Use condoms if you are with a new partner, and have an open conversation about your history of STDs.
- Pregnancy. Don’t forget: even a 100-year-old man can be capable of fathering a child with a fertile woman. If don’t know whether this is a potential risk, ask your partner. And, by all means, use birth control if you need it.
Benefits Galore! The big benefits of a healthy, active sex life are stress reduction and improved mental outlook. Sex can make you happy and relaxed. Older people can be vital, sexually active beings every bit as much as younger people.
Companionship and simple human physical touch may be equally or more important than the related sexual activity. I once had a dear, dear patient who told me that she just “needed someone’s shoulder to lie on at night.” She was happily married, twice, and she taught me that human companionship is just as necessary, if not more so, later in life than when we’re young. She also taught me that, sometimes, what a patient truly needs is a “prescription for finding a man.”
I treated another patient who, at 89 years of age, showed up in my office with some very challenging health problems. With a positive outlook, she regained her health and fell in love. She told me that 90 was better than 89—because she got a boyfriend!
And, don’t forget, even if you don’t have a partner, it is also possible to have a healthy, fulfilling sex life on your own! Some things never change.
Don’t be bashful. If you have any questions or concerns about engaging in sexual activities, please discuss them with your physician and with your partner. And have fun!