Older people’s sexual activity problems and desires are being dismissed by health practitioners due to their age, a new study has suggested.
Research by The University of Manchester’s MICRA (Manchester Institute for Collaborative Research on Ageing) and Manchester Metropolitan University highlighted the obstacles some older couples face in maintaining fulfilling sexual lives, and how they adapt to these barriers.
The study analysed written comments from over a thousand adults aged 50 to 90 who responded to the English Longitudinal Study of Ageing Sexual Health and Relationships questionnaire. Respondents of both sexes emphasised their anxiety at not being taken seriously by health practitioners as they sought to overcome issues affecting their sexual activity, such as a drop in sexual desire or physical difficulties. One man in his eighties reported being refused Viagra for erectile dysfunction on the grounds of cost.
Participants in the study, published in Ageing and Society, cited other elements influencing sexual activity, including health conditions and physical impairment, the evolving status of sex in relationships and mental wellbeing. It was also found that men were more likely to talk about the impact of health conditions on sexual activities, but women were more likely to talk about health-related sexual difficulties in the context of a relationship.
The study recommends that health care practice should positively engage with issues of sexual function and sexual activity to improve the health and wellbeing of older people, particularly in the context of long-term health problems.
“This research further improves our understanding of love and intimacy in later life”, said study co-author David Lee, Research Fellow from The University of Manchester. “It builds upon empirical findings published in our earlier paper (Sexual health and wellbeing among older men and women in England; Archives of Sexual Behaviour) which described a detailed picture of the sex lives of older men and women. However, this new research uses narrative data to better understand how changing age, health and relationships interrelate to impact sexual health and satisfaction.”
“Appreciating individual and personal perspectives around sexuality and sexual health is of paramount importance if we are to improve sexual health services for older people.”
[J]ust because social attitudes toward sex at older ages are more positive than in the past doesn’t mean all older women have positive feelings about sex, according to a new Australian study.
Researchers found that nearly 90 percent of women over 70 in the study had low sexual desire and a much smaller proportion were distressed about it. The combination of low desire and related distress is known as hypoactive sexual desire dysfunction (HSDD) and nearly 14 percent of women had it.
Older people are increasingly remaining sexually active and sexual wellbeing is important to them, said senior author Susan R. Davis of Monash University in Melbourne.
“This is probably because people for this age are healthier now than people of this age in past decades,” Davis told Reuters Health by email.
A random national sample of women ages 65 to 79 was contacted by phone and invited to take part in a women’s health study. Those who agreed received questionnaires asking about demographic data, partner status and health history, including menopausal symptoms, vaginal dryness, pelvic floor dysfunction, depression symptoms, sexual activity and sexual distress.
Of the 1,548 women who completed and returned the questionnaires, about half were married or partnered, 43 percent had pelvic surgery and 26 percent had cancer of some kind. About a third had menopausal symptoms and one in five had vaginal dryness during intercourse.
In the entire sample, 88 percent reported having low sexual desire, 15.5 percent had sex-related personal distress, and women with both, who qualified for HSDD, made up 13.6 percent of the group, as reported in Menopause.
That’s lower than has been reported for this age group in the past, and similar to how many women report HSDD at midlife, Davis noted.
“Considering how conservative women of this age are, we were surprised that over 85 percent of the women completed all the questions on desire and sexual distress so we could actually assess this on most of the study participants,” Davis said.
Vaginal dryness, pelvic floor dysfunction, moderate to severe depressive symptoms and having a partner were all associated with a higher likelihood of HSDD. Sexually active women, partnered or not, more often had HSDD than others.
“We would never label women with low/diminished sex drive as having HSDD,” Davis said. “In our study 88 percent had low desire and only 13.6 percent had HSDD, this is because low desire is not an issue if you are not bothered by it.”
Vaginal dryness, associated with HSDD in this study, can easily treated by low dose vaginal estrogen which is effective and safe, she said.
HSDD was also associated with urinary incontinence, depressive symptoms and hot flashes and sweats, she said.
“Even talking about the problem with a health care professional who is interested and sympathetic is a good start,” Davis said. “Conversely health care professionals need to realize that many older women remain sexually active and do care about this issue.”
Sex remains important for many people living in aged care, but a challenge for staff and residents’ family members, writes Michael Bauer, who introduces a new guide to assist.
Sexuality is linked to wellbeing and quality of life and the need for affection, looking and feeling attractive, as well as intimacy, and sex can remain important for many people living in aged care facilities.
Growing old is not a limitation on the expression of sexuality or sexual desire and the above needs do not necessarily change because someone has dementia.
Residents’ sexuality can nevertheless often be a challenge for aged care facilities and staff as well as residents’ family members who may find it an awkward and difficult topic to openly discuss.
It can come as a surprise to some family and staff members alike, to learn that a resident still has sexual needs and this can evoke a range of responses from acceptance through to disbelief, or even disgust.
Children can find it difficult to understand and accept that their parent living in an aged care facility still has sexual desires and furthermore wants to fulfil them, particularly if they have dementia.
It can be equally upsetting for families and partners to learn that their loved one wants to spend time with someone else living in the facility. Families may struggle to understand and make sense of what is happening and why, particularly if the person is unable to verbally express their needs.
Sometimes behaviour may seem very out of character for the person. There may be a changed interest in sex, or a change in sexual inhibitions, all of which can cause concern or embarrassment for the family or partner.
The guide has undergone extensive consumer consultation and aims to assist family members and partners of people living in aged care facilities understand about sexuality, including for people living with dementia.
Issues covered include:
the importance of sexuality in old age
sexuality and living in an aged care facility
sexuality and dementia
sexual behaviours and their impact
how a facility can be supportive of the expression of sexuality
The guide can also be a useful resource for facility staff who need information on this topic. Initially developed in English this resource is soon to be translated into other languages.
A copy will soon be sent to all Australian residential care facilities, and it can be downloaded for free from the DementiaKT hub or here.
Funding for the project was obtained from the Dementia Collaborative Research Centres (DCRC) 3 – Carers and Consumers as part of the Australian Government’s Dementia Initiative.
Partners Edwin Fisher, 86, and Patrick Mizelle, 64, moved to Rose Villa in Portland, Oregon, from from Georgia about three years ago. Fisher and Mizelle worried residents of senior living communities in Georgia wouldn’t accept their gay lifestyle.
[P]atrick Mizelle and Edwin Fisher, who have been together for 37 years, were planning to grow old in their home state of Georgia.
But visits to senior living communities left them worried that after decades of living openly, marching in pride parades and raising money for gay causes, they wouldn’t feel as free in their later years. Fisher said the places all seemed very “churchy,” and the couple worried about evangelical people leaving Bibles on their doorstep or not accepting their lifestyle.
“I thought, ‘Have I come this far only to have to go back in the closet and pretend we are brothers?” said Mizelle. “We have always been out and we didn’t want to be stuck in a place where we couldn’t be.”
So three years ago, they moved across the country to Rose Villa, a hillside senior living complex just outside of Portland that actively reaches out to gay, lesbian and transgender seniors.
As openly gay and lesbian people age, they will increasingly rely on caregivers and move into assisted living communities and nursing homes. And while many rely on friends and partners, more are likely to be single and without adult children, according to researchpublished by the National Institutes of Health.
Rose Villa Senior Living, located just outside of Portland, Oregon, has made a point of welcoming LGBT elders. The community, which offers independent and assisted living, also has a nursing home on site.
But long-term care facilities frequently lack trained staff and policies to discourage discrimination, advocates and doctors said. That can lead to painful decisions for seniors about whether to hide their sexual orientation or face possible harassment by fellow elderly residents or caregivers with traditional views on sexuality and marriage.
“It is a very serious challenge for many LGBT older people,” said Michael Adams, chief executive officer of SAGE, or Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders. “[They] really fought to create a world where people could be out and proud. … Now our LGBT pioneers are sharing residences with those who harbor the most bias against them.”
There are an estimated 1.5 million gay, lesbian and bisexual people over 65 living in the U.S. currently, and that number is expected to double by 2030, according to the organization, which runs a national resource center on LGBT aging.
Andrea Drury, 69, and Kate Birdsall, 73, got married in 2014 and moved to Rose Villa last year. Birdsall said she wanted to grow old together in an accepting environment. “We are just one of the couples who are here,” she said. “It just so happens we are both women.”
Nationwide, advocacy groups are pushing to improve conditions and expand options for gay and lesbian seniors. Facilities for LGBT seniors have opened in Chicago, Philadelphia, San Francisco and elsewhere.
SAGE staff are also training providers at nursing homes and elsewhere to provide a more supportive environment for elderly gays and lesbians. That may mean asking different questions at intake, such as whether they have a partner rather than if they are married (even though they can get married, not all older couples have). Or it could be a matter of educating other residents and offering activities specific to the LGBT community like gay-friendly movies or lectures.
Mizelle, 64, and Fisher, 86, said they found the support they hoped for at Rose Villa, where they live in a ground-floor cottage near the community garden and spend their time socializing with other residents, both gay and straight. They both exercise in the on-site gym and pool. Fisher bakes for a farmer’s market and Mizelle is participating in art classes. Fisher, who recently had a few small strokes, said they liked Rose Villa for another reason too: It provides in-home caregivers and has a nursing facility on site.
But many aging gays and lesbians — the generation that protested for gay rights at Stonewall, in state capitols and on the steps of the Supreme Court — may not be living in such welcoming environments. Only 20 percent of LGBT seniors in long-term care facilities said they were comfortable being open about their sexual orientation, according to a recent report by Justice in Aging, a national nonprofit legal advocacy organization.
Ed Dehag, 70, at the Triangle Square Apartments in Los Angeles, California, in August 2016. The retired floral designer moved into the building when his partner passed away and he couldn’t afford the rent on his old apartment by himself.
This summer, Lambda Legal, a gay advocacy group, filed a lawsuit against the Glen Saint Andrew Living Community, a senior residential facility in Niles, Illinois, for failing to protect a disabled lesbian woman from harassment, discrimination and violence. The resident, 68-year-old Marsha Wetzel, moved into the complex in 2014 after her partner of 30 years had died of cancer. Soon after, residents called her names and even physically assaulted her, according to the lawsuit.
“I don’t feel safe in my own home,” Wetzel said in a phone interview. “I am scared constantly. … What I am doing is about getting justice. I don’t want other LGBT seniors to go through what I’ve gone through.”
Karen Loewy, Wetzel’s attorney at Lambda Legal, said senior living facilities are “totally ill-prepared” for this population of openly gay elders. She said she hopes the case will not only stop the discrimination against Wetzel but will start a national conversation.
“LGBT seniors have the right to age with dignity and free from discrimination, and we want senior living facilities to know … that they have an obligation to protect it,” Loewy said.
A photo of Dehag’s partner sits on the dresser in his bedroom. Dehag moved into one of the apartments shortly after his partner passed away.
Spencer Maus, spokesman for Glen Saint Andrew, declined to comment specifically on the lawsuit but said in an email that the community “does not tolerate discrimination of any kind or under any circumstances.”
Many elderly gay and lesbian people have difficulty finding housing at all, according to a 2010 report by several advocacy organizations in partnership with the federal American Society on Aging. Another report in 2014 by the Equal Rights Center, a national nonprofit civil rights organization, revealed that the application process was more difficult and housing more expensive for gay and lesbian seniors.
Recognizing the need for more affordable housing, the Los Angeles Gay & Lesbian Elder Housing organization opened Triangle Square Apartments in 2007. In the building, the first of its kind, residents can get health and social services through the Los Angeles LGBT Center. The wait for apartments with the biggest subsidies is about five years.
Residents display rainbow flags outside their doors throughout the building. On a recent morning, fliers about falls, mental health, movie nights and meningitis vaccines were posted on a bulletin board near the elevator.
Lee Marquardt, 74, at the Triangle Square Apartments in Los Angeles, California, in August 2016. Marquardt moved into the apartment building two years ago. She said she didn’t want to spend her elder years hiding her true self as she had as a younger woman.
Ed Dehay, 80, moved into one of the apartments when they first opened. His partner had recently passed away and he couldn’t afford the rent on his old apartment by himself. “This was a godsend for me,” said Dehay, a retired floral designer who has covered every wall of his apartment with framed art.
His neighbor, 74-year-old Lee Marquardt, said she came out after raising three children, and didn’t want to spend her elder years hiding her true self as she had as a younger woman. Marquardt, a former truck driver who has high blood pressure and kidney disease, said she found a new family as soon as she moved into the apartment building two years ago.
“I was dishonest all the time before,” she said. “Now I am who I am and I don’t have to be quiet about it.”
Tanya Witt, resident services coordinator for the Los Angeles LGBT Center, said some of the Triangle Square residents are reluctant to have in-home caregivers — even in their current housing — because they worry they won’t be gay-friendly. Others say they won’t ever go into a nursing home, even if they have serious health needs.
Marquardt holds an old photograph of herself of when she was married. Marquardt, a former truck driver who has high blood pressure and kidney disease, came out after raising three children.
In addition to facing common health problems as they age, gay and lesbian seniors also may be dealing with additional stressors, isolation or depression, said Alexia Torke, an associate professor of medicine at Indiana University.
“LGBT older adults have specific needs in their health care,” she said. And caregivers “need to be aware.”
Lesbian, gay and bisexual elders are at higher risk of mental health problems and disabilities and have higher rates of smoking and excessive alcohol consumption. They are also more likely to delay health care, according to a report by The Williams Institute at UCLA School of Law. In addition, older gay men are disproportionately affected by some chronic diseases, including hypertension, according to research out of UCLA.
Torke said LGBT seniors are not strangers to nursing homes. The difference now is that there is a growing recognition of the need to make the homes safe and welcoming for them, she said.
The Los Angeles Gay and Lesbian Elder Housing organization opened Triangle Square Apartments in 2007. In the first of its kind building, residents can get health and social services through the Los Angeles LGBT Center.
At Rose Villa, CEO Vassar Byrd said she began working nearly a decade ago to make the community more open to gays after a lesbian couple told her that another facility had suggested they would be more welcome if they posed as sisters. Today, several gay, lesbian and transgender people — individually and in couples — are living there, Byrd said. Her staff has undergone training to help them better care for that population, and Byrd said she has spoken to other senior care providers around the nation about the issue.
Bill Cunitz and Lee Nolet, who began dating in 1976, didn’t come out as a couple until they moved to Rose Villa last year. Cunitz is an ordained minister and former head of a senior living community in Southern California. He said he didn’t want to be known as the “gay CEO.”
Nolet, a retired nurse and county health official, said it’s been “absolutely amazing” to find a place where they can be open— and where they know they will have accepting people who can take care of them if they get sick.
“After 40 years of being in the shadows … we introduce each other as partner,” Nolet said. “Everyone here knows we’re together.”
Despite the fondness certain corners of the internetandcable television have for mocking sexually vital women of a certain age, new research suggests that those who embrace their sexuality may be laughing all the way to longer, healthier lives—though older men aren’t as lucky.
A study out of Michigan State University (MSU) published this month in the Journal of Health and Social Behavior has found that frequent sex (defined as once or more per week) for women age 57 and older—especially if it’s “extremely pleasurable or satisfying”—resulted in a lower risk of hypertension and protected against cardiovascular disease.
Unfortunately for men, frequent sex in the 57 and older range is actually dangerous, increasing their risk of cardiovascular events such as heart attacks and stroke. The risk is compounded by the use of medications such as Cialis and Viagra.
The study—an analysis of survey data of 2,204 people collected by the National Social Life, Health and Aging Project in 2005-6 and again five years later—isn’t just good news for older women, and should offer hope for younger women as they look to the future of their own sexuality.
Dr. Nancy Sutton Pierce, a nurse and clinical sexologist, suggests the best thing a young woman can do for her continued sexual health is to cultivate an attitude of optimism about it as she ages. “Younger women think sexy has an expiration date. Older women know it doesn’t,” she says.
The study is a stride toward busting the cultural myths that older women are supposedly non-sexual beings, which Sutton Pierce says “absolutely does them a disservice.” Sutton Pierce, who is almost 60, happily defies sexual stereotypes of older women. Married for thirty years to the same man, she says, “My sex life is better than ever, much better than my twenties.” In her work she says she sees women after forty “blossoming,” adding, “As women mature, we mature on all levels, which means we start to own our sexuality and sexual power. We don’t need someone else to tell us we’re hot, we can feel it.”
Study author Hiu Liu, an associate professor of sociology at MSU, also finds that for women, quality of sexual experience is a key contributing factor to the health benefits, not just quantity. “As a sociologist, I don’t see sex as just a physical exercise, as medical doctors do. It’s a social behavior, and has emotional meaning,” she says.
For older women experiencing other kinds of physical declines related to illness, staying sexually active may bring other benefits. Irwin H., who asked to remain anonymous, of San Francisco found that for his 70-year-old wife, who has multiple sclerosis, increasingly limited mobility, and walks with a cane, “Sex gives her back her former sense of her physical self.” He even waxes a little poetic: “Sexuality for her is like an unexpected warm day in the middle of winter. It doesn’t end winter, but it makes it bearable.”
Some older women may believe they’ve lost their sexual selves when they experience the often dramatic physical changes at and after menopause, such as vaginal dryness and reduced libido. They need not despair, says Celeste Holbrook, PhD, a sexual health consultant and sexologist. “Sex, and fulfilling sex doesn’t always have to be centered on the goal of an orgasm, or penetrative sex,” she adds.
However, Liu points out that the female sexual hormone released during orgasm, oxytocin, “may also promote women’s health” by reducing cortisol and increasing estrogen.
Holbrook urges communication between partners rather than silent acceptance. “Redefining your sexuality as we age for anybody is really good. Talk to your partner about your body changes and how you can create a fulfilling sex life while embracing those changes.”
Men shouldn’t worry too much, however. Though the MSU study seems to be the research equivalent of a cold shower for older men, Liu reminds them, “Moderate sex is good for older men, too.”
Having sex frequently – and enjoying it – puts older men at higher risk for heart attacks and other cardiovascular problems. For older women, however, good sex may actually lower the risk of hypertension.
That’s according to the first large-scale study of how sex affects heart health in later life. The federally funded research, led by a Michigan State University scholar, is published online in the Journal of Health and Social Behavior.
“These findings challenge the widely held assumption that sex brings uniform health benefits to everyone,” said Hui Liu, an MSU associate professor of sociology whose vast research on the link between health and relationships has been featured in the New York Times, USA Today, NPR, Time and many other national and international news outlets.
For the current study, Liu and colleagues analyzed survey data from 2,204 people in the National Social Life, Health and Aging Project. Participants were aged 57-85 when the first wave of data was collected in 2005-06; another round of data was collected five years later. Cardiovascular risk was measured as hypertension, rapid heart rate, elevated C-reactive protein and general cardiovascular events: heart attack, heart failure and stroke.
Older men who had sex once a week or more were much more likely to experience cardiovascular events five years later than men who were sexually inactive, the study found. This risk was not found among older women.
“Strikingly, we find that having sex once a week or more puts older men at a risk for experiencing cardiovascular events that is almost two times greater than older men who are sexually inactive,” said Liu. “Moreover, older men who found sex with their partner extremely pleasurable or satisfying had higher risk of cardiovascular events than men who did not feel so.”
She said the findings suggest the strain and demands from a sexual relationship may be more relevant for men as they get older, become increasingly frail and suffer more sexual problems.
“Because older men have more difficulties reaching orgasm for medical or emotional reasons than do their younger counterparts, they may exert themselves to a greater degree of exhaustion and create more stress on their cardiovascular system in order to achieve climax.”
Testosterone levels and the use of medication to improve sexual function may also play a role. “Although scientific evidence is still rare,” Liu said, “it is likely that such sexual medication or supplements have negative effects on older men’s cardiovascular health.”
Ultimately, while moderate amounts of sex may promote health among older men, having sex too frequently or too enjoyably may be a risk factor for cardiovascular problems, Liu said. “Physicians should talk to older male patients about potential risks of high levels of sexual activity and perhaps screen those who frequently have sex for cardiovascular issues.”
For women, it was a different story. Female participants who found sex to be extremely pleasurable or satisfying had lower risk of hypertension five years later than female participants who did not feel so.
“For women, we have good news: Good sexual quality may protect older women from cardiovascular risk in later life,” Liu said.
Previous studies suggest that strong, deep and close relationship is an important source of social and emotional support, which may reduce stress and promote psychological well-being and, in turn, cardiovascular health.
“This may be more relevant to women than to men,” Liu said, “because men in all relationships, regardless of quality, are more likely to receive support from their partner than are women. However, only women in good quality relationships may acquire such benefits from their partner.”
Moreover, the female sexual hormone released during orgasm may also promote women’s health, she said.
Liu’s co-authors are Linda Waite, professor at the University of Chicago, Shannon Shen, an MSU graduate student, and Donna Wang, professor of medicine at MSU.
The research was partially funded by the National Institute on Aging, the National Institute of Child Health and Human Development, the Office of Behavioral and Social Sciences Research, and the National Heart, Lung and Blood Institute, which are all part of the National Institutes of Health.
New research from the University of Chicago investigates what happens to men’s and women’s sexual function and relationships after a heart attack in an effort to help clinicians develop better care guidelines for patients. The study, published in JAMA Cardiology, shows impaired sexual function or new problems are common after heart attacks. They occur at the same rate as a loss of general physical function and at a higher rate than the incidence of depression after heart attack, but rarely do health care providers address these issues – particularly with women.
“Too often physicians and researchers are too embarrassed to ask questions about sexual health, and yet these issues are important to many people,” said Harlan Krumholz, MD, professor of medicine at Yale and director of the Center for Outcomes Research and Evaluation, one of the authors in charge of the study. “We need to concern ourselves with gaining knowledge about how to help our patients achieve a high quality of life in all aspects of their lives.”
The data show that if a physician talks to the patient about sexual health and function after a heart attack the patient is more likely to resume sex. However, women were less likely to be counseled by physicians on what to expect and more likely to have problems with sexual function as they recover. More than half of women (59%) and less than half (46%) of men reported sexual function problems in the year after a heart attack.
“The next step is to design the optimal intervention to improve sexual function outcomes after heart attack for men and women,” said Stacy Tessler Lindau, MD, associate professor of obstetrics/gynecology and medicine-geriatrics at the University of Chicago, who authored the research. “The rehabilitation phase begins with the cardiologist counseling the patient about her or his functional capabilities and what she or he can expect, including physical, psychological, and sexual function.”
ATLANTA — Older adults in assisted-living facilities experience limits to their rights to sexual freedom because of a lack of policies regarding the issue and the actions of staff and administrators at these facilities, according to research conducted by the Gerontology Institute at Georgia State University.
Though assisted-living facilities emphasize independence and autonomy, this study found staff and administrators behave in ways that create an environment of surveillance. The findings, published in the Journals of Gerontology: Social Sciences, indicate conflict between autonomy and the protection of residents in regard to sexual freedom in assisted-living facilities.
Nearly one million Americans live in assisted-living facilities, a number expected to increase as adults continue to live longer. Regulations at these facilities may vary, but they share a mission of providing a homelike environment that emphasizes consumer choice, autonomy, privacy and control. Despite this philosophy, the autonomy of residents may be significantly restricted, including their sexuality and intimacy choices.
Sexual activity does not necessarily decrease as people age. The frequency of sexual activity in older adults is lower than in younger adults, but the majority maintain interest in sexual and intimate behavior. Engaging in sexual relationships, which is associated with psychological and physical wellbeing, requires autonomous decision-making.
While assisted-living facilities have many rules, they typically lack systematic policies about how to manage sexual behavior among residents, which falls under residents’ rights, said Elisabeth Burgess, an author of the study and director of the Gerontology Institute.
“Residents of assisted-living facilities have the right to certain things when they’re in institutional care, but there’s not an explicit right to sexuality,” Burgess said. “There’s oversight and responsibility for the health and wellbeing of people who live there, but that does not mean denying people the right to make choices. If you have a policy, you can say to the family when someone moves in, here are our policies and this is how issues are dealt with. In the absence of a policy, it becomes a case-by-case situation, and you don’t have consistency in terms of what you do.”
The researchers collected data at six assisted-living facilities in the metropolitan Atlanta area that varied in size, location, price, ownership type and resident demographics. The data collection involved participant observation and semi-structured interviews with administrative and care staff, residents and family members, as well as focus groups with staff.
The study found that staff and administrators affirmed that residents had rights to sexual and intimate behavior, but they provided justifications for exceptions and engaged in strategies that created an environment of surveillance, which discouraged and prevented sexual and intimate behavior.
The administrators and staff gave several overlapping reasons for steering residents away from each other and denying rights to sexual and intimate behavior. Administrators emphasized their responsibility for the residents’ health and safety, which often took precedence over other concerns.
Family members’ wishes played a role. Family members usually choose the home and manage the residents’ financial affairs. In some instances, they transport family members to doctor’s appointments, volunteer at the facility and help pay for the facility, which is not covered by Medicaid. They are often very protective of their parents and grandparents and are uncomfortable with new romantic or intimate partnerships, according to staff. Administrators often deferred to family wishes in order to reduce potential conflict.
Staff and administrators expressed concern about consent and cognitive impairment. More than two-thirds of residents in assisted-living facilities have some level of cognitive impairment, which can range from mild cognitive impairment to Alzheimer’s Disease or other forms of dementia. They felt responsible for protecting residents and guarding against sexual abuse, even if a person wasn’t officially diagnosed.
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Co-authors of the study, Georgia State alumni, include Christina Barmon of Central Connecticut State University, Alexis Bender of Ripple Effect Communications in Rockville, Md., and James Moorhead Jr. of the Georgia Department of Human Services’ Division of Aging Services.
The study was supported by a grant from the National Institute on Aging at the National Institutes of Health.
Ladies, libido means sexual desire. Women having decreased libido is one of the most common complaints I hear in the office, especially for those stressed out supermoms. Trust me – you’re not alone, ladies. It is estimated that more than 40% of women experience some sort of sexual dysfunction in their lifetime. Here’s why, and what you can do about it.
Female sexual dysfunction can include problems with desire, arousal, achieving orgasm and sexual pain that causes significant distress in your life. More specifically, decreased libido is when you don’t want to engage in any type of sexual activity, including masturbation, and you don’t want to have any sexual thoughts or fantasies. Sound like someone you know? Let’s review some reasons why you may not want to have sex with your significant other:
1. Bad Relationship.
Fighting with your partner is an easy way to kill your sex drive. When you are angry or hurt, sex is the last thing on your mind. Fix your relationship — go to couples’ therapy.
2. Stress.
It doesn’t matter where the stress comes from, all of it can cause your libido to drop. It doesn’t matter if you’re stressed out from financial problems, from trying to get pregnant, or from worrying about your job – it all negatively impacts your libido. Stress can also lead to you being fatigued, which worsens the problem. Find ways to chill out ladies – I mediate daily to deal with stress, and that might work for you, too.
3. Alcohol and Smoking.
Both of these drugs have been shown to decrease sexual desire and satisfaction. While alcohol in moderation is okay, when you binge drink, sexual dysfunction starts to occur. On the other hand, any kind of smoking is bad – just quit!
Easier said than done, right? You have to know why you are smoking. Substitute that why with something else. For example, if you smoke because you are bored, instead of lighting up go to the gym.
4. Mental Illness.
Mental conditions such as depression and anxiety can also cause your libido to drop. Talk to your doctor and get treated. Sometimes medications used to treat these conditions can also cause a drop in libido – but not every medication does, so talk to your doctor.
5. Birth Control.
Hormonal birth has been shown to decrease testosterone in your body, which could lead to a lowered libido. This is because testosterone is one of the hormones that makes you horny.
Other medications such as antidepressants, anti-seizure meds, opioids, medical marijuana, antihistamines, and hypertensive medications can also decrease your sexual desire. Talk to your doctor about switching your medications if you think any are giving you a problem. Your healthcare provider can also potentially switch you to a non-hormonal birth control option, like the Paragard IUD.
6. Trauma in your Past.
Negative sexual experiences in the past can cause issues with decreased libido. Women who were raped or have been victims of domestic violence may, understandably, have issues here. Going to therapy to work through your pain can help.
7. Poor Body Image.
In a world full of fake butts and boobs, it isn’t hard to image women struggling with their body image. Not thinking you are sexy enough can cause your sex drive to plummet. If you don’t like something about yourself, change it – in a healthy way, of course. Eat clean, drink water and exercise – though, keep in mind that a lot of times this is something that you have to work out in therapy.
8. Medical Conditions.
Medical illnesses such as diabetes, hypertension, thyroid disease, congestive heart failure, or cancer can all affect libido. They can alter hormones that have an impact on your sex drive. Proper treatment of the underlying disease can often improve libido.
9. Pregnancy and Breastfeeding.
Hormones fluctuate during pregnancy and breastfeeding, which can decrease your sex drive. Being pregnant can cause you to be tired and not feel sexy, which certainly doesn’t help your libido! Do your best to focus on intimacy with your partner — also, when you have the baby, get help. Let those grandparents help out with babysitting!
10. Aging.
In menopause, estrogen levels drop drastically because the ovaries aren’t working anymore. Low estrogen causes, among other things, a dry vagina, which makes sex painful. This can lead to decreased sexual desire. Arthritis in the aging population can make having sex less fun. When vaginal dryness makes sex uncomfortable, use lubricants (try a free sample of Astroglide Liquid or Astroglide Gel, which temporarily relieve dryness during intercourse). Some women find using vaginal estrogen also helps.
A medical ethicist and a team of Australian researchers say nursing homes should not discourage residents from having sex.
Research by the Australian Centre for Evidence Based Aged Care, published in the Journal of Medical Ethics (JME), stated that sexual freedom is considered a fundamental human right by most Western societies.
While laws regarding consent and coercion must be abided, in general, people should be able to engage in sexual behavior whenever, and with whomever, they choose.
Nonetheless sexual relationships are often a no-no for many competent and healthy elderly people in residential aged care facilities, reported the New York Daily News.
Art Caplan, a medical Ethicist at the New York University Langone Medical Center, told Medscape that one of the reasons for this is that nursing homes are set up to give people very little privacy for legal and safety reasons.
FoxNews added concerns about “duty of care, anxieties about potential repercussions from relatives and ageism are other reasons nursing home staffs deny privacy or separate potential partners, according to the Australian researchers.”
New York Daily News said that nursing home staffs receive little training on the sex lives of the elderly, focusing primarily on their ability to make decisions and provide consent.
Many simply don’t look at the elderly as mature adults, but as children who must be policed.
For older people with dementia living in residential aged care facilities the issue becomes more complex, wrote the researchers in the JME.
However, the JME article added that even elderly people in the early stages of dementia still enjoy sexual relationships.
Researchers argued that even when a person receives a poor score on a mini mental state test which assesses cognitive impairment, they are often still capable of expressing preferences for a friend or lover, wrote FoxNews.
Intimate relationships can help lessen feelings of loss and loneliness that come with age, Robin Dessel, director of memory care services and sexual rights educator at the Hebrew Home at Riverdale in New York, told ABC News.
The good news is, in response to the topic of geriatric sex, some facilities such as the Hebrew Home are establishing policies to ensure staff support for residents’ rights, wrote AgingWell.com.
“Clinical staff needs to understand that elderly long-term care residents have very real sexual needs that might exceed what staff would consider their clinical needs,” Dessel told AgingWell.com.
Caplan believes this awkward topic of geriatric sex should be discussed by doctors with patients and families as someone prepares to enter a nursing home because, as he stated, sex is a part of old age.
Name: Billy
Gender: Male
Age: 46
Location:
I have heard it’s normal for sex drive to diminish as you age. I’ll run this by you. I’m a 46 year old male and the last time I was at a strip club with bare boobs bouncing around me, you may as well have rolled a grapefruit across the floor. Actually, I can see more use from the grapefruit. I don’t recall the last time I did it, and jerking off was almost disgusting. My tool has shrank to nothing. I barely touch it and it just dribbles, it doesn’t fire off anymore. I don’t even like to touch it to go piss anymore. I’ve had to shave around it, so I actually find it, to keep from pissing my pants. Is this normal?
No, Billy, this isn’t normal. I think you already know that too, right?
Do you know anything about andropause? If not, you ought to. Here’s what I suggest. Use this site’s search function in the sidebar. Type in the key word: “andropause” and you will come up with a wealth of information about this issue.
You can also use the CATEGORY pull down menu. Look for the subcategory: Sex and Aging, under the main category: Aging. Everything is alphabetized.
But for the time being, here’s a typical question and response —
Name: Wilson
Gender: male
Age: 58
Location: Lancing MI
I’m a successful entrepreneur, in decent health (I could stand to lose a few pounds.) I have just about everything a man could want in life, but I’m miserable. I have no energy and I feel like I’m sleepwalking through my life. I have no sex drive at all; my wife thinks I’m having an affair…I wish. Even Viagra doesn’t do the trick anymore. Is this just old age, or what?
Old age, at 58? Middle age, perhaps! Regardless what we call it, you sound like you’re in the throws of andropause — male menopause — ya know, the change of life!
Never heard of such a thing? You’re not alone. It’s only been recently has the medical industry has begun to pay attention to the impact changing hormonal levels has on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!
Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.
There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.
While most all of us have heard of a mid-life crisis, and it’s tragic consequences — red convertible sports cars, comb-overs, and the trophy wife or lover — fewer have heard of andropause. A mid-life crisis is essentially a psycho-social adjustment to aging — bored at work, bored at home, bored with the wife or partner — that sort of thing. Andropause, although it may coincide with a mid-life crisis, is not the same thing. Andropause is a distinct physiological phenomenon that is in many ways akin to female menopause.
Unlike women, men can continue to father children after andropause, but like I said, the production of testosterone diminishes gradually after age 40. I suppose you know that testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for our sexual drive. But did you know that by the age of 55, the amount of testosterone secreted into our bloodstream is significantly lower than at 45. And by age 80, most male hormone levels have decreased to pre-puberty levels.
Men, are you over 50? Are you feeling weak, lethargic, depressed, and irritable? Do you have mood swings, hot flashes, insomnia, and decreased libido, like our buddy Wilson, here? Then you too may be andropausal. You need to get some lead back in your pencil!
All kidding aside, andropausal men might want to consider Testosterone Replacement Therapy (TRT). Ask your physician about this. Just know that some medical professionals resist testosterone therapy, mistakenly linking Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. However, before starting a testosterone regiment, insist on a complete physical, including blood work and a rectal examine. Mmmm, rectal exams!
Testosterone is available in many forms — oral, injectable, trans-dermal and by way of implants. The oral form is not recommended because of the high risk of liver damage. But injections, patches, pellets, creams and gels might be just the answer. I encourage you to be informed about TRT before you approach your doctor, because the best medicine is practiced collaboratively — by you and your doctor.
Sexuality is much more than having sex even though many people think only about sexual intercourse when they hear the word. Sexuality is sometimes equated with intimacy, but in reality, sexuality is just one way that we connect with a spouse or partner we love (the true meaning of intimacy). Our sexuality encompasses how we see ourselves as men and women, who we are attracted to emotionally and physically, what turns us on (eroticism), our thoughts and fantasies, and yes, also what we do when we are sexually active, either alone or with a partner. Our sexuality is connected to our image of ourselves and it changes over the years as we age and face threats from illness and disability and, eventually, the end of life.
Am I still a sexual being?
Illness can affect our sexuality in many different ways. The side effects of treatments for many diseases, including cancer, can cause fatigue. This is often identified as the number one obstacle to sexual activity. Other symptoms of illness such as pain can also affect our interest in being sexually active. But there are other perhaps more subtle issues that impact how we feel about ourselves and, in turn, our desire to be sexual with a partner or alone, or if we even see ourselves as sexual beings. Think about surgery that removes a part of the body that identifies us as female or male. Many women state that after breast cancer and removal of a breast (mastectomy), they no longer feel like a woman; this affects their willingness to appear naked in front of a partner. Medications taken to control advanced prostate cancer can decrease a man’s sexual desire. Men in this situation often forget to express their love for their partner in a physical way, no longer touching them, kissing them, or even holding hands. This loss of physical contact often results in two lonely people. Humans have a basic need for touch; without that connection, we can end up feeling very lonely.
Just talk about it!
Communication lies at the heart of sexuality. Talk to your partner about what you are feeling, how you feel about your body, and what you want in terms of touch. Ask how you can meet your partner’s needs for touch and affection. The most important thing you can do is to express yourself in words. Non-verbal communication and not talking are open to misinterpretation and can lead to hurt feelings. Our sexuality changes with age and time and illness; we may not feel the same way about our bodies or our partner’s body that we did 20, 30 or more years ago. That does not mean we feel worse – with age comes acceptance for many of us – but we do need to let go of what was, and look at what is and what is possible.
The role of health care providers
Health care providers should be asking about changes to sexuality because of illness or treatment, but they often don’t. They may be reluctant to bring up what they see as a sensitive topic and think that if it’s important to the patient, then he or she will ask about it. This is not good. Patients often wait to see if their health care provider asks about something and if they don’t, they think that it’s not important. This results in a silence and leaves the impression that sexuality is a taboo topic.
Some health care providers are afraid that they won’t know the answer to a question about sexuality because nursing and medical schools don’t provide much in the way of education on this topic. And some health care providers appear to be too busy to talk about the more emotional aspects of living with illness. This is a great pity as sexuality is important to all of us – patients, partners, health care providers. It’s an important aspect of quality of life from adolescence to old age, in health and at the end of life when touch and love are so important.
Ask for a referral
If you want to talk about this, just do it! Tell your health care provider that you want to talk about changes in your body or your relationship or your sex life! Ask for a referral to a counselor or sexuality counselor or therapist or social worker. It may take a bit of work to get the help you need, but there is help.
In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.
It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.
Communicating About Sexuality with the Terminally Ill
Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.
We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.
For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.
While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.
Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.
This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.
Sexual Functioning At The End Of Life
Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:
Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.
The needs of the couple
Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.
Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.
Addressing sexual needs
Couples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.
Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.
Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.
More specific strategies for symptoms include the following suggestions.
Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
Couples may find information about alternative positions for sexual activity very useful.
Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.
It is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.
If you think only young people are at risk of sexually transmitted infections, think again – rates could be on the rise in older adults.
With more of us living longer and healthier lives, and divorce a reality of life, many of us are finding new sexual partners later in life.
While an active sex life comes with a myriad of health benefits, experts are warning those of us in mid-life and beyond not to forget the risk of contracting a sexually transmitted infection from a new partner.
Figures suggest rates of infections have been on the increase among older people in the US and UK in recent years and there is a suggestion the same could be happening in Australia.
Chlamydia, a common bacterial STI, is on the up among all age groups in Australia, and has more than doubled in those over 50 since 2005; going from 620 cases to 1446 in 2010.
Gonorrhoea, another bacterial infection, has seen a slight increase in the over 50s, rising from 383 infections in 2005 to 562 in 2010.
While these increases could partly be attributable to more people being tested, the trend has caused concern in some parts of the medical community here and overseas.
Cultural shift
Older people are increasingly likely to be single or experiencing relationship changes these days, according to the UK’s Family Planning Association, which last year ran its first sexual health campaign aimed at over 50s.
It’s much easier to meet new partners, with the advent of internet dating and the ease of international travel. Plus, thanks to advances in healthcare, symptoms of the menopause and erectile dysfunction no longer spell the end of an active sex life.
But despite this, education campaigns about safe sex are generally aimed at younger people; not a great help when it’s often suggested that older people are more likely to feel embarrassed about seeking information about STIs and may lack the knowledge to protect themselves.
And, as noted by Julie Bentley, CEO of the UK’s Family Planning Association, “STIs don’t care about greying hair and a few wrinkles”.
Risky sexual practices
Dr Deborah Bateson, medical director at Family Planning NSW, started researching older women’s views and experience of safe sex after noticing a rise in the number of older women asking for STI tests and being diagnosed with STIs, particularly chlamydia.
The organisation surveyed a sample of women who used internet dating sites and found, compared with younger women, those aged between 40 and 70 were more likely to say they would agree to sex without a condom with a new partner.
Similarly, a telephone survey commissioned by Andrology Australia found that around 40 per cent of men over 40 who have casual sex do not use condoms.
While the reasons behind this willingness to engage in unsafe sex are uncertain, Bateson says older people may have missed out on the safe sex message, which really started to be heavily promoted in the 1980s with the advent of HIV/AIDS.
In addition, older women may no longer be concerned about becoming pregnant and have less of an incentive to use a condom compared with younger women.
“There is a lot of the information around chlamydia that relates to infertility in the future, so again for older women there may be a sense that it’s not relevant for them,” she says.
However, the Family Planning survey did find that older women were just as comfortable as younger women with buying condoms and carry them around.
“There’s obviously something happening when it comes to negotiating their use. Most people know about condoms but it’s just having the skills around being able to raise the subject and being able to negotiate their use at the actual time,” Bateson says.
As with most things in life, prevention is better than cure – something to remember when broaching the topic of safe sex and STIs with a new partner.
“If you’re meeting a new partner, they are probably thinking the same thing as you [about safe sex],” says Bateson.
“So being able to break the ice [about safe sex] can often be a relief for both people.”
Stay safe
Anyone who has had unprotected sex, particularly with several people, is potentially at risk of STIs, says Professor Adrian Mindel, director of the Sexually Transmitted Infections Research Centre based at Westmead Hospital, Sydney.
“People who are changing partners or having new partners, they and their partner should think about being tested,” he says.
“Also think about condom use at least until [you] know [the] relationship is longer lasting and that neither of [you] are going having sex with anyone outside the relationship.”
The UK’s Family Planning Association also stresses that STIs can be passed on through oral sex and when using sex toys – not just through intercourse.
It also notes that the signs and symptoms of some STIs can be mistaken as a normal part of aging, such as vaginal soreness or irregular bleeding.
And remember that often infections don’t result in symptoms, so you may not be aware you have an STI. However, you can still pass an infection on to a sexual partner.
So if you are starting a new sexual relationship or changing partners, here is some expert advice to consider:
If you have had unprotected sex, visit your GP to get tested for STIs. This may involve giving a urine sample to test for chlamydia, examination of the genital area for signs of genital warts, or a swab of your genitals to test for STIs such as herpes or gonorrhoea. A blood test may also be required to test for syphilis, HIV and hepatitis B.
If you are starting a new relationship, suggest your partner also gets tested.
Use a condom with a new partner until you both have been tested for STIs and are certain neither of you is having unprotected sex outside the relationship.
If you have symptoms you are concerned about, such as a urethral discharge in men or vaginal discharge, sores or lumps on the genitals, pain when passing urine or abdominal pains in women, see your GP.
Name: Gwen
Gender:
Age: 57
Location: Philly
My husband and I have been married for 33 years. Our relationship is hell when it comes to sex. My husband is overweight, and he’s stressed out about his elderly parents. Sex is non-existent. He never was the instigator in our relationship. And he is the kind of guy who thinks having sex on the couch as opposed to the bedroom is adventuresome. He has become so boring. I don’t believe the man feels sex should be that important at our ages. (I’m 57 and he’s 62) I, on the other hand, am more sexually aroused and creative than ever now that I am more mature and the kids are out of the house. Menopause and all the sex on the internet helps too. 😉 Is there anything I can do to make my man return to being a healthy sexual being once again? Thank you, Gwen
No, thank you, Gwen. Your complaint is a familiar one. In fact it’s so familiar I regularly offer therapy groups for couples in long-term relationships. Like you and your old man, these couples have, for one reason or another, hit a wall when it comes to their sex lives.
I take a very unique approach to these groups by inviting both straight and gay couples to the same group. At first I got a lot of resistance. Most couples, both gay and straight, think there is nothing to be learned from a couple unlike them. They can’t imagine why I would want to integrate the group in such a manner. I think most of my couples feel more comfortable being in a segregated group — straight folks with straight folks, gay folks with gay folks.
But that is of course the reason I integrate the groups. I don’t want them to feel all comfy and cozy, I wanted them to work and learn and stretch themselves out of their sexual doldrums. At first, I had to ask all my couples to suspend judgment about an integrated group until they had an opportunity to participate in one. Now I don’t encounter so much resistance. Word’s gotten out that this is a really creative solution to an otherwise tricky problem. And that old married couples, regardless if they are gay, lesbian or straight have very similar problems. And they can and do learn from one another.
To your specific issue, Gwen, I’m sad to say there’s not much you can do to beef up your sex life if there’s no interest on the part of your husband to do so. I mean, you can lead the horse to the cooch, but you can’t make him lick, if ya know what I mean.
Fat man holding a measurement tape against white background
You confide that you husband is overweight and stressed; this is not a happy combination when it comes to his sexual response cycle. In fact, your husband sounds like a heart attack waiting to happen. Perhaps if your challenged him about his general health — encourage weight loss and stress reduction, you might find that this would also reignite his sex drive. It’s worth a try.
And thank you for mentioning menopause. So many women find the changes that take place in midlife confusing and disorientating. It’s so good to hear from a woman who is eager to explore and enjoy her sexuality post-menopause.
Men also go through changes, in midlife. There’s even a name for it — andropause — the male menopause as it were. It’s clear that as we age, both women and men need more time and stimulation in which to get aroused. The slower, more sensuous foreplay that often results is a welcome change for most women and even some men.
Increased focus on sensuality, intimacy, and communication can help a sexual relationship remain rewarding even well into our senior years. I think you already know this, Gwen, but many women in my audience don’t.
If your husband is avoiding intercourse, there still many ways of expressing your love and staying connected:
Hugging, cuddling, kissing
reading erotica aloud together
Touching, stroking, massage, sensual baths
Masturbation and oral sex
However, if your husband is more wedded to food and stress than he is to you, and if he continues to refuse to join you in finding an appropriate outlet for your sexual frustration, then it’s up to you to make this happen on your own. 57 is way too young to say goodbye to your sex life.
May I suggest joining a women’s group. Not a therapy group, but more of a support group or activities group. Getting out of the house, involving yourself with other self-actualized mature women, may uncover the secret solutions other women have put in place to find sexual satisfaction when they are without a partner or have a partner who’s no longer interested in a sex life with them. I think you will be surprised by how creative your sisters can be. Make it happen, Gwen. Don’t sink to the lowest common denominator of living a sexless life.
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