Category: AGING

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‘When people can talk about sex, they flourish’

— The rise of sexual wellness

Advice on sex is available on myriad apps, sex toys are for sale on the high street, and the science of sexual fufilment is blossoming. Will this focus on sexual wellbeing have the desired effect?

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Tina was 52 when her long-term relationship ended. She had experienced low libido throughout her perimenopause years, and her relationship had become “pretty much sexless by the end”, so reigniting her sex life felt like a daunting prospect.

But rather than closing the book on her sexuality, Tina turned to a sexual wellness app called Dipsea, and began listening to erotic stories, as well as learning about different self-pleasure and communication techniques.

“I’ve never hugely enjoyed visual pornography and this sounded like something different and worth trying out,” she says. “The app enabled me to explore my sexual wants and fantasies as well as use some of the wellness-focused content, which helped me to feel more confident when dating and navigating having sex again.”

She’s not alone. As attitudes to sex have liberalised, and people increasingly strive for greater physical, mental and social wellbeing, a growing industry in sexual wellness has sprung up. Whereas sex toys only used to be available from sex shops or porn magazines, they can now be bought from high street chemists. Subscription-based apps and websites are offering erotic content alongside relaxation exercises and relationship advice from trained sex counsellors. Sex is no longer taboo, but an integral part of our general wellbeing. But while investors in this industry may have hit the financial G-spot, what does it mean for the rest of us?

Precisely who conceived the term “sexual wellness” is hazy, but the actor Gwyneth Paltrow is credited with catapulting it into the mainstream. In 2015, her lifestyle website Goop.com recommended that women steam-clean their vaginas for extra energy and to rebalance female hormones. Since then, Goop has sparked debates about the pros and cons of jade vaginal eggs, an “aphrodisiac warming potion” called Sex Dust – not to mention the infamous “This Smells Like My Vagina” candle.

Gwyneth Paltrow’s Goop has been credited with initiating the sexual wellness trend – but claims made about the benefits of some of the expensive products it sells lack evidence.

“With the launch of things like Goop, there’s been a much broader, holistic sort of view on what sexual wellness means, and how it can benefit you to be a happier, more confident and satisfied human being,” says Mei-lin Rawlinson, chief of staff at OMGYes, an educational website about female pleasure.

Around the same time Paltrow was preaching the benefits of vaginal purification, OMGYes’s founders were setting out on a mission to use science to help crack a similar nut. Sparked by conversations between friends about how women like to be touched, they realised there was a dearth of academic research on the subject, and little vocabulary for the specific things women find pleasurable.

They partnered with sex researchers to conduct in-depth interviews with more than 3,000 women from across the US, using these insights to develop a trove of educational videos, infographics and how-to’s, designed to educate fee-paying members on how to access greater sexual pleasure.

“Sex is such a core part of life for many people, but it is also a really vulnerable, charged area of life, with lots of taboo. We think that if people can talk about it, learn more about it, learn more about themselves, they can flourish so much more,” Rawlinson says.

In the coronavirus lockdowns, sales of adult toys increased by 25%. Superdrug’s website promotes sex toys with the line: ‘Masturbation is self-celebration’.

Launched in 2015, OMGYes was one of the first sexual wellness platforms, and it now has more than a million users. Research conducted by the platform, in collaboration with Devon Hensel, a professor of sociology and paediatrics at Indiana University, suggests that the benefits of membership aren’t just physical.

They gave 870 women access to the website, and asked them to complete pre- and post-questionnaires to assess their sex-based knowledge and communication skills.

The research, published in the Journal of Sex Research, found that after a month, women reported they had developed a wider repertoire of ways to talk about what they liked sexually and that they felt more positive and confident about understanding what felt good. “These are skills not only important for sex, but also in the context of women’s everyday lives,” Hensel says. Indeed, some of the women also reported an increase in overall agency – such as voicing their thoughts or ideas at work – as a result of this training.

It’s not only educational platforms that are growing in popularity. The global sexual wellness devices market – industry speak for sex toys – was estimated to be worth $19bn in 2021.

With everybody stuck at home due to Covid restrictions, this market experienced a boost. During the first two weeks of UK lockdown alone, orders for adult toys reportedly increased by 25%. But while sales of other consumer categories, such as cycling products, that experienced a “Covid boost” have since fallen back, the sexual wellness market continues to experience accelerated growth.

“I think that’s a good data point to suggest that it is earlier in its life stage. There is more to go for in terms of the number of people who buy these products, and the number of products any one person uses,” says Jacqueline Windsor, UK retail leader for PwC.

She recently co-authored a report on the sexual wellness devices market, and believes several factors may be at play. Interest in general wellness has increased over the past decade, and sexual health and wellbeing are increasingly viewed as central to this. Attitudes to sex are also liberalising, and there has been a shift in sex-toy design away from explicit brands, and towards more discreet and ergonomic models primarily targeting women and couples.

“Commercially, it’s big business, but I think it makes a big statement when we see sex toys and pleasure products on high-street shelves like those in Boots and Selfridges,” says Kate Moyle, a psychosexual therapist and host of the Sexual Wellness Sessions podcast. “It makes the statement that sexual wellbeing should be there, and shouldn’t be taboo or hidden away, and this can have a huge forward impact on how we think and talk about sex, helping us to break away from its links to shame.”

Pleasure isn’t the only benefit: doctors are increasingly recommending vibrator use as a way of treating and preventing conditions such as vaginal dryness and atrophy. Some of these new generation products could go a step further and enhance scientific research into sexual health and orgasm.

Ergonomically designed, the Lioness vibrator is a modern iteration of the classic “rabbit” toy. What really sets it apart though, is the incorporation of sensors to measure pelvic floor movements, such as the rhythmic contractions that accompany orgasm. Paired with an app, this allows users – and (with users’ consent) sex researchers – to better understand how sexual function is affected by factors such as caffeine, alcohol, childbirth, menopause, or medical conditions such as concussion.

“I always tell people that knowledge is pleasure,” says Anna Lee, co-founder and head of engineering at Lioness. “It’s an empowering tool to be curious about your body, and to learn about things that might be changing our pleasure or sexual wellness.”

But the plugging of sexual wellness could also have some pitfalls. Lee worries about the potential for misinformation in the marketing of certain products, and their promotion by social media influencers. For instance, in 2018, Goop was forced to pay $145,000 in civil penalties for making the unsubstantiated claim that jade love eggs were used by women in ancient China to increase sexual energy and pleasure.

“Jade is a porous material that you should never insert [into] your body, and there’s no evidence to indicate that this technique was ever used in ancient China,” Lee says. “We have to be so mindful of how we create this information that so many people are desperately seeking – because they will grab on to anything, it is such a hard topic to talk about.”

Also, whereas novelty and exploration can be a turn-on for some people, for others, it can have the opposite effect. “Some people are much more comfortable with what’s familiar,” says Emily Nagoski, a sex educator and the author of Come As You Are.

Another risk is that the focus on sexual wellness mounts pressure on people to do things they don’t want to do. “Everywhere you look, whether it’s on social media, telly, movies, the emphasis seems to be on the importance of sex – everyone’s having great sex, and if you’re not having great sex there’s a problem,” says Ammanda Major, head of clinical practice at Relate and a trained relationship counsellor and sex therapist.

“Sex toys historically, and some of the new apps, are kind of promoting the idea that you should be having amazing sex. You should be having an orgasm. But having worked with clients for 25-30 years, what they are often asking for is they just need [the sex] to be good enough.”

What these clients are really seeking, Major explains, is intimacy: the emotional closeness and trust that ideally accompanies sex. “A lot of these apps and products focus on the physical stuff, as opposed to what sexual intimacy means for individuals. I think we sometimes put a lot of pressure on people to be sexual, when actually sex isn’t that important to them.”

In other cases, couples genuinely want to have more sex, but struggle to find the time and motivation to achieve this. Here, technology could help. In early 2022, Mark (not his real name) and his partner began using an app called Intimacy to track their sex life – logging both the number of encounters and their orgasm count. “We had reservations, but set ourselves a target of having sex 104 times in the year – or twice a week,” Mark says. “Rather than putting pressure on ourselves, and recognising it won’t be for everyone, we revelled in the experience – we are obviously both target-oriented.

“We rapidly found ourselves ahead of our target, and reset it to 2.5 times a week, or 130 times in the year – and we ended on 134. We had a good sex life before, but this gave us the motivation to be more intimate.”

Complete Article ↪HERE↩!

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Sex after menopause doesn’t need to hurt

— Comprehensive review offers roadmap for doctors to evaluate, treat overlooked condition

  • Between 13% and 84% of postmenopausal women experience vaginal pain during sex
  • Causes of pain other than vaginal dryness are often undiagnosed and untreated
  • Pain during sex can harm relationships, self-esteem and contribute to depression, anxiety
  • Safe, effective therapies exist but condition is rarely evaluated or treated

Between 13% and 84% of postmenopausal women experience dyspareunia—vaginal pain during sex—but the condition is rarely evaluated or treated despite the availability of safe and effective therapies. With life expectancy increasing and the functional health of older adults improving, the identification and treatment of painful penetrative sex represents a great unmet need.

A new Northwestern University Feinberg School of Medicine comprehensive review of medical studies involving painful sex in post-menopausal women provides a roadmap for doctors to evaluate and treat the typically overlooked condition.

It is the only comprehensive review of its kind because it examines multiple reasons for the condition beyond just vaginal dryness due to lack of estrogen, such as post-hysterectomy problems, arthritis, cancer treatments and more.

“Post-menopausal women shouldn’t accept painful sex as their new norm,” said Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Feinberg. “Many women try over-the-counter lubricants but continue to have pain. They, and sometimes their health care professionals, are unaware that there are other, more effective treatments.

“In addition, women are increasingly treated by telemedicine and not examined. The cause of pain with penetration is assumed to be due to vaginal dryness when they may have another condition that has been undetected.”

The review was published last week in Menopause: The Journal of The North American Menopause Society.

Aside from the obvious negative aspects of enduring pain and the inability to have penetrative sex, the consequences of dyspareunia include negatively impacting relationships and self-esteem and can contribute to depression and anxiety. In addition, other sexual dysfunctions such as hypoactive desire disorder and orgasmic dysfunction are often consequences of pain with penetrative sex.

Causes of vaginal pain during sex

Post-menopausal vaginal pain is often specifically due to lack of estrogen, but there are other, usually undetected and untreated causes for inability to have penetrative sex, Streicher said. These include post-hysterectomy problems; cancer treatments (chemotherapy, radiation, surgery); lichen sclerosus (patchy, discolored, thin skin) and other vulvar conditions; pelvic-floor tension; arthritis and other musculoskeletal problems; pelvic organ prolapse; and sexually transmitted infections.

More than 30% of women over the age of 50 are single and potentially will have a new sexual partner, Streicher added.

“Sexuality in women after the age of 50 years is marginalized, and gynecologic care is not prioritized, valued or even recommended,” Streicher said.

Why aren’t women being evaluated, treated for the condition?

Despite available treatments, dyspareunia often goes undetected for a variety of reasons. First, most American women no longer see a gynecologist after going through menopause, Streicher said. Secondly, women often don’t discuss painful sex with their primary health care clinicians, and, when they do, most clinicians are not equipped to treat these problems because they haven’t been trained to properly evaluate or treat dyspareunia in this population. Third, sexual function is often a low priority in women with other serious medical problems.

In a 2004 survey of more than 1,000 midlife women, 98% had at least one sexual concern, but only 18% of physicians broached the topic. This is particularly true in postmenopausal women who are unaware that solutions are available and rarely seek care for this complaint.

It’s also difficult to pinpoint the exact prevalence of dyspareunia in post-menopausal women because studies on dyspareunia require women to have at least one sexual encounter the month before enrollment, and women with dyspareunia avoid sexual activity because of pain.

What can be done?

Doctors should broach the topic of dyspareunia with their patients using oral or written questionnaires, Streicher said. In addition to a thorough medical history and physical examination, various tools can be used as further assessments, including vaginal pH, vaginal dilators, imaging, vulvar biopsy, vulvoscopy and photography, the cotton swab test, sexually transmitted infection screening and vaginitis testing.

Some of the treatments discussed in the review include silicone lubricants, moisturizers, vaginal estrogen, ospemifene, dehydroepiandrosterone, local testosterone therapy, cannabidiol and fractional CO2 laser treatments. In some cases, dyspareunia may need to be specifically addressed by pelvic floor physical or sex therapists.

Complete Article ↪HERE↩!

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Start Your Own Later-in-Life Sexual Revolution

— How to rediscover sexual intimacy and passion as you age

By Ellen Uzelac

Securing an early check-in for Room 200 at a Quality Inn on a nondescript highway at noon was like leading a high-level trade negotiation. It took one reservation clerk and two supervisors to sign off on the only time we had that week to grab an hour of pleasure. Blame it on my raging libido and a scheduling crunch. Motel sex or nothing? Nothing is not the correct answer.

After a five-year sex drought, I am in a sexual relationship again. At times, it’s all I can think about. When I see Ed, the sex usually comes first.

Who knew, in my 60s, that sex could feel this powerful? I had missed my sexual self, and for me now there is a sense of urgency around it that I’ve never experienced before. That urgency only makes the sex hotter. I think Ed would tell you the same.

Sex and intimacy disappeared from my landscape when my husband died. Their presence in my life had in part defined me. So did their absence. At some point, I started referring to myself as “celibate.” It seemed more like a glass half-full approach. It’s just a word but it made me feel better — as though I had agency, a choice in the matter. Then I reconnected with Ed, a man I had profiled for a local magazine decades ago. He’d unearthed the article I’d written during a move and found me.

Finally, I figured, I was having sex again, just like everyone else.

Ellen Uzelac
The author at home on Maryland’s Eastern Shore.

But what I discovered in conversations with friends, sexual wellness professionals and physicians is that a lot of older people in committed relationships aren’t having sex at all. And while many couples are OK with that, others, understandably, are distraught about it.

 

One man I talked to told me his wife informed him when she turned 60 that she was done with sex. That was eight years ago. A woman I know says she misses the “sex bunny” she used to be but that her sex drive shut down when she was in her mid-50s. As she frames it: “We could do it, but it would be pitiful. You get sore and you get tired. What we’ve got left are memories.”

Another friend, in her 70s, has turned increasingly to self-pleasure as her husband of 50 years continues to withdraw his physical affection. He won’t tell her why.

“Why aren’t we sitting down and figuring it out? Why do we let go of something that’s so rich and powerful and joyful?” she says. “It’s a deep sadness for me.”

Sad, yes—and also the norm for many couples. In fact, a 2018 National Poll on Healthy Aging sponsored by AARP and the University of Michigan found that among men and women ages 65 to 80, only 40 percent were still having sex. Even among those who were in relationships, the rate was a mere 54 percent.

Margery Kates, M.D., my gynecologist, calls the sex drought an epidemic among folks 50 and older. But it’s an epidemic without a name because no one’s talking about it.

“It’s a real problem,” Kates notes. “There’s a lot in the academic literature that’s coming out now. Has that awareness translated to patients? Not really.”

One of the biggest contributors to the sex drought is a failure to communicate. Many of us don’t have the words to express even the simplest concepts and concerns around sex — not to our partners and not to our physicians.

“Sexual health is one of the most challenging things for us to discuss,” says Wendy Strgar, founder of Good Clean Love, a sexual wellness products company in Eugene, Oregon. “So it becomes an avoidance issue. Sex becomes this thing we don’t do.”

And a lot of older couples aren’t doing it in part because of conditions associated with aging that can be easily treated: erectile difficulties, vaginal dryness, a testosterone deficiency, low libido. Once sex becomes a bit challenging, psychological issues can take over, says Irwin Goldstein, M.D., director of San Diego Sexual Medicine. Erectile dysfunction, for example, “can be devastating to a guy,” he says. “If you want to be intimate and you can’t get hard, your entire ego, your value as a male, your self-esteem shatters.”

Fear of discussing sex can be the biggest barrier to having sex, especially when it comes to getting help. “Many men are reluctant to consult with a urologist or sexual medicine physician,” Goldstein says. Yet there’s a whole array of treatments: hormones, ED pills, injectables, vacuum devices, restriction rings and shock wave therapy, among them. “If a man has a penis, then a man can get an erection,” he says. “There are very few who can’t be treated.”

There are also medical conditions—a bad back or arthritis, for example—that can make it difficult to have sex. In that event, couples may opt to explore what the sexual wellness community calls outercourse: masturbation, oral sex, cuddling, rubbing, fantasizing, sex toys.

I had forgotten how warm and wonderful it feels to want and to be wanted. When I drive to Ed’s, my body often tingles in anticipation. No wonder sex is good for you. Among many other well-documented health benefits, it improves sleep, clears the mind, releases natural painkillers and creates a sense of well-being that, for me, is like no other.

I spoke to Abraham Morgentaler, M.D., the author of The Truth About Men and Sex: Intimate Secrets from the Doctor’s Office and an associate professor of urology at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston. “Sex is this magic sauce for couples. It’s something that is not only incredibly intimate, but it involves a primitive part of our brain that creates this sense of partnership, exclusivity and intimacy. Once that disappears in a relationship, a lot is lost.”

I know what that loss feels like. To be on the other side of it is magical, as Morgentaler says. But it took some work to get here. I, like most women my age, experience vaginal dryness that can make sexual intercourse painful. A medically prescribed estrogen cream and an over-the-counter lubricant have been game changers. And I’m not the only one experiencing a sexual renaissance: Despite the fact that older women have less sex than men, a study by the National Council on Aging found that women in their 60s often rated their physical satisfaction with sex as equal to or better than it was in their 40s.

Yet many of us remain uninformed about our sexual health as we age. But we can take some lessons from those around us, who have made it work, joyfully.

Real People, Real Sex

Michelle Paris and Kevin Porter
Michelle and Kevin, married three years. Lexey Swall Michelle, 59, & Kevin, 63

When Michelle Paris started dating Kevin Porter in 2015, she was 52 — and on the other side of menopause. Among other common side effects, she suffered from vaginal atrophy, or dryness.

“Having sex was like rubbing my vagina against a carpet. It was painful,” says Paris, whose novel, New Normal, will be published this spring. “I went to a gynecologist when we got serious to explore what alternatives there were.”

Paris’ fix? A vaginal estrogen cream that has made sexual intercourse comfortable again.

“When you’re single in your 50s, it creates this anxiety around your body and your sexuality,” adds Paris, who lives in Elkridge, Maryland. “Everyone comes to middle age with so much baggage. I kept telling myself that if I remained alone, I’d be OK. But Kevin and I are compatible in every way. To this day, I get giddy when he touches me.”

Paris and Porter, who met on the OurTime dating site, wed in 2020.

“I tease Kevin about my taking old lady cream,” says Paris. “But, in all honesty, it saved me.”

Billie Best and Roger Emmert
Billie and Roger in Oregon. Celeste Noche Billie, 68, & Roger, 67

“Instant physical chemistry.” That’s how wellness blogger Billie Best sums up her first date with Roger Emmert. The couple, both in their late 60s, had sung in the same choir as teens, but they hadn’t seen each other in more than five decades until early 2020, when they reconnected on Facebook.

“We were very attracted to each other physically,” says the Eugene, Oregon-based Best, creator of the Billie Best Blog: Aging Beyond 60—Loving Life, Staying Relevant. “We had both been single for years. Sex and intimacy? It had been forever.”

During that sex drought, what Best describes as the “geography between my legs” had grown dry as a result of age-related vaginal atrophy, and both she and Emmert, a hot tub salesman, have joint issues with knees and hips. Their preference at this stage in life is oral sex and skin-to-skin contact throughout the day.

“One of the benefits of being older is that you’re clear on what you want, what your boundaries are, who you are as a person,” says Best.

“Older sex is slower, it’s not gymnastic. It’s about finding ways to give each other pleasure. I just love going slow, really drawing out the experience and taking time for it. I only see it getting better and better.”

Raven Wylde and Istvan Szilvassy
Raven and Istvan in California. Yuri Hasegawa Istvan, 73, & Raven, 67

Twice a week, Istvan Szilvassy and his wife, Raven Wylde, find time for a lingering sexual encounter that leaves them “fulfilled” and “happy.”

“What we do is colorful and sexy and stimulating. We talk about it. We believe in it,” Szilvassy says. “We do everything to please each other. And there are all kinds of tools to make that happen.”

Szilvassy, an artist known professionally as Pali X Mano, hasn’t had reliable erections for the better part of a decade, so he takes a medically prescribed pill in advance of their sex dates.

The Santa Barbara, California, couple face “the usual challenges” with sex and aging, according to Wylde, a retired nurse. Both of them have arthritis, which has caused them to modify their positioning during sex. Wylde also uses an estrogen cream to treat vaginal dryness.

It wasn’t until she was in her 50s, Wylde says, that she began to value slow, languorous sex that is as much about her pleasure as her partner’s.

“I just love slowing everything down and savoring it,” she says. “Sex at this stage is so much more fun. When you’re older, you let a lot of self-criticism go. It’s liberating.”

Complete Article ↪HERE↩!

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5 Facts All Men Should Know About Sexual Problems and Dysfunction

Male sexual dysfunction can include a wide variety of problems, ranging from low libido, erectile dysfunction (ED), premature ejaculation, and other issues. While many men know that these issues are common, they can be difficult to talk about. In fact, many men wait several months, or even years, before raising the issue with their primary care physician.

Thankfully, both normal and abnormal male sexual function are now better understood medically than ever before. Dr. Sharon Parish, Professor of Medicine in Clinical Psychiatry at Weill Cornell Medicine, maintains an active faculty practice specializing in sexual medicine. “I use an integrated, holistic approach, looking at the whole man,” explained Dr. Parish. “Often, men will first see a urologist and then are referred to me for a more detailed evaluation and discussion of their overall health.”

Here, Dr. Parish shares her insight as to the connection between male sexual, physical, and mental health.

Sexual problems may signal a cardiovascular or other medical issues

“Any man that experiences a change in libido, erection, or ejaculation should bring this up to their primary care physician,” said Dr. Parish. Any issue that lasts for several months may indicate a more serious medical issue that should be addressed:

  • Early ejaculation can develop because of medication, nerve damage, or other direct urinary conditions
  • A change in libido or erection may be the first sign of diabetes
  • Problems with libido or erection may be related to a hormonal imbalance
  • Problems with erection may be a sign of a cardiovascular issue or prostate cancer

There is a strong link between sexual function and mental health

Mental health issues — including depression, anxiety, and other psychiatric illnesses — can lead to many different types of sexual disorders. “It’s clear that there is a strong connection between ED and depression,” asserted Dr. Parish. “Women, on the other hand, who experience depression are more likely to see a decrease in libido. It’s very important to diagnose the psychiatric illness first to improve sexual function.”

Sexual function is often improved by addressing, managing, and alleviating anxiety and depression. “There are many helpful therapies,” Dr. Parish explained, “including mindfulness, cognitive behavioral therapy, and relaxation techniques to help one be more present in the experience and enjoy it more fully.”

Medications for mental illness may cause sexual function changes, to varying degrees

“There is a wide misconception that the medications for mental illness cause sexual problems, but the data is clear that sexual function is more likely to improve when the mental illness is treated,” said Dr. Parish. “It’s not a good idea to avoid the medication because of the potential side effects.”

Fifty to 70 percent of men do not experience any sexual side effects from medications, and men taking medications for serious psychiatric disorders are more likely to experience a sexual side effect.

“If you do experience sexual problems as a result of a medication,” Dr. Parish explained, “work with your doctor to manage the side effects. Several drugs are known to produce lesser side effects.”

Again, Dr. Parish emphasized the importance of mental health for sexual health. “The key,” she stated, “is to treat the mental disorder and then the sexual disorder. It’s best to get the condition treated and work with the doctor to manage the side effects.”

With age, some changes in sexual function are normal

Some changes in sexual drive, performance, and function are normal parts of aging. “As men get older,” said Dr. Parish, “they may need more time for foreplay or direct stimulation. If this isn’t enough to improve normal age-related changes in sexual function, sex therapy can be very beneficial.”

However, if the changes are dramatic or difficult to work through, Dr. Parish suggested talking to a primary care physician. “Your doctor can help you differentiate normal changes from more problematic issues, including medical issues,” she said. “Don’t assume it’s a normal change that comes from getting older.”

Improving overall health can improve sexual performance

Dr. Parish ascribes to the “biopsychosocial model” for overall and sexual health. “There is so much interconnectivity when it comes to our health,” she explained. “It’s important to take a holistic view.”

Indeed, cardiovascular, neurological, hormonal, and psychological systems all interact together for sexual performance. A healthy lifestyle can significantly help improve sexual function — improving diet, achieving and maintaining a healthy weight, and exercising regularly all help promote greater overall health and, therefore, greater sexual health.

Complete Article ↪HERE↩!

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Fight Sexual Ageism and Boost Your Sexual Self-Confidence

— While some assume the thrill of sex dies down with age, that’s just one of many misconceptions

By Taneia Surles

For many individuals, having sex can release stress and be a way to explore different forms of intimacy with their partners. While some assume that the thrill of sex dies down in the latter stages of life, that’s not the case.

An older couple kissing in the kitchen. Next Avenue, sexual ageism, sex in your 60s, midlife
You may not be able to engage in sexual experiences as you did in your 20s and 30s, but that’s completely okay. Instead of focusing on the past, learn to love and appreciate your body and find new ways to have fun in the bedroom.

Unfortunately, this popular misconception has caused many older adults to hold back on exploring their sexuality, leading to physical and emotional insecurities that can be difficult to overcome. Here’s a look at what sexual ageism is and how you can revamp your sexual self-confidence as an older adult.

What Is Sexual Ageism?

Ageism itself is any form of discrimination against older adults. Combined with sexuality, sexual ageism is the social stigma that older adults no longer have an interest in sexual intimacy with others.

Although many might assume that older adults are no longer sexually active, many still pursue intimacy in their later stages.

“Sexual ageism is when older people are stereotyped as being non-sexual, not capable of having sex or enjoying a sex life like they did when they were young,” said Amy Killen, MD, an anti-aging and regenerative medicine physician specializing in aesthetics and sexual medicine, and the medical advisor at Joi Women’s Wellness.

Although many might assume that older adults are no longer sexually active, many still pursue intimacy in their later stages. In fact, according to 2018 findings from the University of Michigan’s National Poll on Healthy Aging, many older adults still have an interest in sex, regardless of whether they are or aren’t sexually active.

Here are some of the poll’s results:

  • 65% said they had an interest in sex.
  • 40% of respondents reported that they were sexually active.
  • 83% of those who reported being sexually active noted that sex was essential to their quality of life.
  • 73% of respondents were satisfied with their sex life.

3 Myths Associated With Older Adults and Sex

Sexual ageism is commonly associated with older adults because there are many misconceptions implying that the older generation isn’t looking for sexual relationships.

“The world is rife with the idea that we ‘age out’ of both being sexy and wanting sex.”

Some widespread misunderstandings about older adults and sex are:

1. Once you become older, you’re no longer capable of having sex.

“The general misconceptions from people outside of that age group is that no one is having any sex and that if they are, it’s probably boring,” said Alice Leach, sexpert and creative director of Tapdat, a casual dating app. “The world is rife with the idea that we ‘age out’ of both being sexy and wanting sex.”

2. Older adults don’t talk about sex, so they must not be active.

Although society is now more sex-positive, many older adults may feel uncomfortable sharing their sex lives with others. Because of this, many may assume that because older adults are not talking about sex, it means that they aren’t doing it.

3. Aging bodies are seen as “unattractive.”

Due to the media and pornography, if someone’s body is not slim, tan, and flawless, it may be deemed “unattractive” by society. With this in mind, there are misconceptions that older, aging bodies are not appealing, which isn’t the case.

Effects Of Sexual Ageism

The negative misconceptions surrounding older adults and sex can pose significant mental and physical effects on this population.

“The first step to staying sexually healthy is to stay physically healthy.”

Sexual ageism can affect their perceptions of sex by keeping them from sharing their sexual health concerns with their doctors, like STD prevention, or cause them to lose interest in sex due to the social stigma that they shouldn’t be sexually active.

Aside from the social factors, sexual ageism can affect their overall health. For example, a 2017 study reveals that ageism’s effects on sexual activity can lead to poorer health outcomes.

Reasons Why Some Older Adults May Not Be Sexually Active

Sometimes, older adults may want to explore their sexuality, but factors hinder their ability to do so. Some of these factors primarily occur among older adults.

Here are a few reasons why older adults may not be sexually active:

  • Chronic conditions like arthritis, gout, diabetes
  • Mental health conditions like Alzheimer’s disease, dementia or depression
  • Certain medications
  • The loss of their partner
  • Negative body image or low self-esteem issues
  • Low sex drive or libido
  • Incontinence (loss of bladder control)
  • Pain during sex
  • Menopause

Tips For Embracing and Exploring Your Sexuality

Your sex life doesn’t have to stop when you become older. Unfortunately, sexual ageism may always exist, but it shouldn’t hinder you from exploring your sexuality. Learn how to embrace your sexuality and overcome negative stereotypes with these tips:

Prioritize your health

One way to lead a healthy sex life is to ensure you’re taking care of your health. Eating a nutritious diet, being physically active, and staying on top of your health conditions can help you have more enjoyable sexual experiences.

“The first step to staying sexually healthy is to stay physically healthy,” said Killen. “The foundations of long-term health, such as daily exercise, adequate sleep, stress management, and a balanced diet are also the foundations of a good sex life.”

Communicate with your partner(s)

Communication is key to having safe and fun sexual experiences. As an older adult, you may encounter more pain, dryness, and low libido when engaging in sex. With this in mind, it’s essential to be comfortable telling your partner when you’re feeling discomfort or want to try something else.

“Open communication with a partner is very important,” said Amir Marashi, MD, a board-certified cosmetic gynecologist/pelvic pain specialist, sexpert, and founder at Cerē. “There is no shame in explaining that you might need extra help or time becoming aroused or lubricated.”

Celebrate Who You Are

You may not have the same body or be able to engage in sexual experiences as you did in your 20s and 30s, but that’s completely okay. Instead of focusing on the past, learn to love and appreciate your body and find new ways to have fun in the bedroom.

While age and age-related health conditions can potentially limit some of your sexual capabilities, there are still multiple ways to be sexually confident and lead a healthy sex life.

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Yes, Online Dating Works For Seniors

— 18 Tips For Success

By Kelly Gonsalves

People can sometimes assume that dating sites and dating apps are exclusively for young people. In reality, people of all ages can benefit from the convenience of dating apps—including seniors.

If you’re new to the world of online dating, here are some of the top online dating tips for seniors to keep in mind.

Does online dating work for seniors?

Online dating can be an effective, streamlined way for seniors to meet potential partners, and many people in their 50s, 60s, 70s, and above have found love online. According to one 2020 report from the Pew Research Center, around 16% of people over 50 in America have used a dating site or app, and one in 10 U.S. adults have been in a committed relationship or married someone they met online.

“Mature daters often find that online dating increases their pool of potential daters,” Carla Marie Manly, Ph.D., a clinical psychologist and author of Date Smart, tells mbg. “And for those who are working from home or retired, online dating and dating apps can replace the pool of possible candidates who may have naturally been encountered in the workplace.”

She also adds that single seniors often know exactly what type of partner and relationship they’re looking for, and dating apps can help easily filter out partners who aren’t a fit and funnel in more well-suited candidates.

The biggest barrier to online dating as a senior is often simply getting used to the technology and the digital culture around dating apps and sites. “Not being digital natives, many mature daters are wary of online dating and dating apps simply because they are not comfortable with engaging with people they’ve not met organically,” Manly adds. While it’s a fair concern, it’s helpful to remember that dating sites are just the connection point—once you exchange a few messages, you’re encouraged to move to meeting up in real life to get that organic get-to-know-you process.

And if the tech itself is a pain point, Manly recommends asking a tech-savvy friend or your adult kids to help you choose a site, set up your profile, and sort through candidates. “Once the fear factor is reduced, many mature daters find that they actually find the process achievable—if not enjoyable.”

Best dating sites for over 50:

1. eharmony

One of the oldest and most reputable dating sites around, eharmony is often lauded as one of the best dating apps for seniors. “It has a proven history of success, and they consistently improve their site and are well known for helping couples reach long-term relationships,” couples’ therapist Kyle Zrenchik, Ph.D., LMFT, ACS, previously told mbg.

When you first sign up, eharmony will take you through a lengthy questionnaire to learn about your personality, lifestyle, and relationship preferences so that it can show only the most relevant potential matches to you. It’s a great option for those who know exactly what they’re looking for and want to connect with similarly intentional people. (We have a full eharmony review if you want to learn more.)

2. OurTime

OurTime is a dating app made specifically for people over 50 to connect with each other. While the interface is not a glitzy as some of the other more mainstream dating apps, OurTime is effective at what it claims to do: help seniors make new romantic connections. “I have had friends, family, and clients use it with success. My uncle met his long-term partner on OurTime, and a former client also met his partner on OurTime,” certified sex therapist Heather Shannon, LCPC, CST, previously told mbg.

3. Tinder

Yes, Tinder can be a great dating app even for the older crowd. People in their 50s, 60s, and 70s all use Tinder, and it’s actually a great option for seniors because it’s free and easy to set up compared to the more “serious” dating apps. If you’re a beginner to online dating, Tinder can be a great place to start dipping your toes in the water. While the app does have a reputation for more casual dating, many people have found their lifelong partners on Tinder.

Top online dating tips for seniors:

Ready to dive in? Online dating does have its own culture around it, including unspoken norms, expectations, and rituals people typically use as they meet and get to know each other. To succeed on dating apps, keep these top online dating rules in mind:

1. Create an authentic profile.

When making your profile, showcase who you are and be upfront about what you’re looking for from online dating. “Create an authentic profile that represents who you are as a person, the qualities you are seeking in a partner, and the type of relationship you ultimately want (e.g., marriage, short-term dating, etc.),” Manly recommends. “An inauthentic profile may deter potential partners or, on the other hand, attract partners who aren’t a good fit.”

2. Don’t lie about your age.

It may seem like a small fib, but lying about your age sets up any relationship you form on a foundation of dishonesty. When this person finds out your real age—and they will, eventually—it can feel like a massive betrayal of trust.

This also includes using up-to-date photos. “Take care that your photos represent you as you are now; avoid using photos taken more than two years ago,” says Manly.

3. Take some good photos.

Speaking of photos, take some good ones if you don’t have any already! “Make sure that your profile pictures represent you in a positive, upbeat way,” Manly recommends. “No matter your age, a warm and smiling face is always inviting.”

A few good rules of thumb are to take photos that are clear and high-quality (not blurry), without a lot of background clutter or other focal points (cats, children, etc.), she adds. You should be the focus of these photos.

4. Take initiative.

Don’t be afraid to send out introductory messages to people you’re interested. This applies to people of all genders, too. In the world of dating apps, being assertive and engaged is the name of the game. When people are sifting through so many profiles, the people who stick out are the ones who go out of their way to start up conversations, respond in a timely fashion, and generally make you feel special.

5. Meet in person sooner rather than later.

“Although it’s important to connect via messaging or phone until you feel comfortable, don’t delay and in-person meeting for too long; what feels like a great connection online doesn’t always translate into a great real-life fit,” Manly says.

6. Be patient.

Just like good ol’ fashioned courtship from the days of yore, online dating takes time. It takes time to get your profile to a place that feels thorough and authentic, it takes time getting the swing of online dating culture, and it takes time to find someone who you’re interested in getting to know who’s also interested in getting to know you. Not every interaction you have on a dating site or app will blow your socks off, and you’re not going to feel sparks on every first date.

“Be patient and persevere,” Manly says. “It’s natural to find online dating a bit daunting, but there’s a great deal of truth in the old axiom that you sometimes need to (metaphorically) kiss a lot of toads to find the right partner.”

7. Enjoy the process.

You’ll get the most out of your dating experience if you go in with an open mind and a light heart. There’s so much joy, excitement, and curiosity to be had in getting to know an intriguing stranger and galivanting about town for dates. Try not to put too much pressure on yourself (or anyone you meet), and enjoy the process. Even when you encounter people who are not the right fit, gracefully let them go, keep your head up, and keep it moving.

How to stay safe when online dating as a senior:

Practicing online dating safety is vital for everyone but especially for seniors, who may be more likely to be targeted by scammers and frauds. While online dating scams can take many forms, one of the most common is someone matching with you with a very desirable profile, enthusiastically connecting with you, and then asking you for money in some way or form.

“Although some issues can be detected by staying aware, there are dating charlatans who are so practiced that it’s difficult to detect their toxic ways early on,” Manly notes. “If you get scammed, know that it’s not your fault. Use the experience to improve your dating savviness.”

Here are a few safety measures to adopt while online dating:

1. Never transfer money to someone you haven’t met in person.

Many online dating scams involve getting you to send money to a person you think you’re developing a romantic connection with. For example, a person you’ve been talking to from a dating site or app suddenly says they’re having a financial emergency and asks if you can help them out by wiring them some money, putting money on a gift card, or sending some cash through Venmo or PayPal. Don’t fall for it. If anyone asks you for money before you’ve even met in person, it’s likely a scam.

2. Protect your personal and financial information.

Never share any personal information that can be used to access your finances or identity, such as your:

  • Banking information
  • Credit card information
  • Social security number
  • Work or home address
  • Last name
  • Phone number

Yes, it’s recommended to keep even your phone number private until you’ve met the person in real life or at least had a video call to confirm that they are who the say are. Until then, keep communication on the dating app or site where you originally connected.

3. Screen your matches carefully.

When you match with a new person on a dating site, Manly recommends screening their profile and messages very carefully. According to the Federal Trade Commission, scammers will often say they’re currently traveling abroad or otherwise have a job that prevents them from meeting up with you in person, such as working on an oil rig, being in the military, or working for an international organization. They may also use disjointed language, answer questions vaguely, or have profiles on various dating sites under different names.

“Pay close attention to details that don’t match up,” Manly adds. “Don’t hesitate to report any suspected fraud; customer service staff are generally very helpful and supportive as they want to protect consumers.”

4. Set up a video call or meetup early.

Try to meet up in person or at least hop on a video call sooner rather than later after matching with someone on a dating app. This way, you can make sure the photos match up to the person you’re meeting in real life. If a person keeps avoiding meeting up with you in person and refuses video calls, that’s a red flag.

5. Be wary of love bombing.

Love bombing is when someone starts to becoming way too romantic and affectionate with you way too soon. This is usually done to make you feel closer to them and make you more likely to acquiesce when they make requests for money or private information. Be wary if someone seems overly attached to you before they’ve even had a chance to meet you in person.

6. Meet up in public places.

You’ll also want to keep safety in mind on any dates you go on from a dating app, but especially first dates. Manly recommends picking a public place such as a coffee shop, as these are generally safe and have other people in the vicinity.

7. Designate a safety buddy.

Manly recommends leaning on a trusted friend or family member who can help you vet profiles and people objectively. When you’re going on a date, let this person know who you’re meeting, when, and where, so they can keep tabs on you and make sure you get home safe.

The takeaway.

Online dating works for people of all ages, including seniors. They can be an excellent way of widening your dating pool, especially if you don’t have many opportunities to meet new people in your day-to-day life.

“It’s natural to want to meet a partner organically, but our social groups are often far more disconnected than they were even 25 years ago,” says Manly. “And although you might hear complaints or a few horror stories about online dating, there are plenty of successful matches that began in the online world.”

Exercise thoughtful online dating safety measures, be yourself, and be patient. You never know who you’ll meet.

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The Most Effective Erectile Dysfunction Treatments for Older Adults

By James Roland

Erectile dysfunction (ED) is very common. Although it can affect men of all ages, it occurs more often in older adults and those with certain medical conditions, like diabetes.

Older research estimates that about 70 percent of men ages 70 and older report being “sometimes able” or “never able” to achieve an erection adequate for satisfactory intercourse, compared with just 30 percent of older men who report being “usually able” or “always or almost always able.”

Though it isn’t inevitable for everyone, ED is considered a normal part of aging as its risk factors include conditions common among older adults, such as:

  • cardiovascular disease
  • diabetes
  • reduced levels of testosterone
  • use of medications that treat conditions including:
    • high blood pressure
    • chronic pain
    • prostate disorders
    • depression
  • long-term, heavy substance use, including alcohol and tobacco
  • psychological conditions, including stress, anxiety, and depression
  • overweight or obesity

Sometimes treating an underlying condition can cure or reverse ED. However, most ED treatments are designed for temporary symptom relief, so an erection can be achieved that’s satisfactory for both the person with ED and their partner.

Best ED treatment for 70s and over

A variety of ED treatments are currently available. Researchers continue to develop new medications and other therapies.
For older adults, treating ED may require a two-prong approach:

  1. treat underlying conditions that contribute to ED, such as cardiovascular disease and diabetes
  2. address ED symptoms with oral medications or other alternatives

Medications

The most commonly used ED medications among older adults are from a class of drugs called phosphodiesterase-5 (PDE5) inhibitors.

PDE5 inhibitors block the activity of an enzyme in the walls of blood vessels. As a result, blood vessels are able to relax. In the penis this means more blood can fill the blood vessels, producing an erection.

The main PDE5 inhibitors available with a prescription are:

  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil (Levitra)
  • avanafil (Stendra)

Except for avanafil, all of those medications are available in both brand-name and generic versions. (As of 2020, avanafil is still only sold as the brand-name drug Stendra.)

More ED medications are in the testing and approval process. In the United States, PDE5 inhibitors require a prescription. None are available over the counter.

Side effects from these medications are usually temporary and minor. More serious reactions such as priapism (a painful, prolonged erection) may occur in some cases.

Typical side effects include:

  • headache
  • flushing
  • congestion
  • stomach and back pain

ResearchTrusted Source indicates that PDE5 inhibitors are appropriate for most older adults.

Each medication works a little differently. For example, vardenafil usually works faster than the other medications, while tadalafil’s effects last longer.

Tadalafil is often a good choice for older adults who also have an enlarged prostate because it can be prescribed for daily dosing.

Sildenafil should be taken on an empty stomach and may require dose adjustments to get it right.

Talk with your doctor to find the right ED medication for you and your lifestyle.

Who shouldn’t take these meds

People who have certain health conditions, including heart disease, shouldn’t take these medications.

People who take certain medications to manage another health condition shouldn’t take PDE5 inhibitors either. This includes nitrates and alpha-blockers.

Older men are more likely to have heart disease or take nitrates for blood pressure.

Your doctor will take into consideration your overall health and lifestyle when prescribing an ED medication.

Injections

For older adults who find that PDE5 inhibitors don’t produce the results they want or who don’t like their side effects, self-administered penile injections may be a preferred option.

The three most widely used medications for penile injection therapy include:

  • papaverine
  • phentolamine
  • prostaglandin E1 (PGE1) or alprostadil (Caverject, Edex, MUSE)

To use these, you inject the medication into the penis with a syringe before intercourse. While this approach often results in some minor, temporary pain, research shows that about 90 percentTrusted Source of men who used alprostadil were satisfied with the results.

These medications are often used in combination with other treatments and require dosing adjustments. Your first injection should be done in your doctor’s office so they can make sure you do it correctly and safely.

Who shouldn’t use these

Older adults who feel they or their partner can’t carefully administer an injection should consider other options, whether due to lack of dexterity or other reasons.

Taking blood thinner medications is another reason to avoid injectables.

Inflatable prosthesis

If oral or injected medications can’t be used or don’t provide desired results, another ED treatment is an inflatable prosthesis surgically implanted in the penis.

In a 2012 studyTrusted Source of men ages 71 to 86, researchers found that an inflatable penile prosthesis was well tolerated and largely effective in treating ED.

Because it’s a surgical procedure, it carries the slight risks of infection or other complications. It’s important to go over all the risks and benefits of this treatment approach with your doctor. Together you can decide whether your overall health makes you a good candidate for the procedure.

It’s also important to note that an implant is permanent. It would only be removed under certain circumstances, such as infection or malfunction.

Once you have a penile implant, it permanently alters the penile anatomy. This means other treatments can’t be used after it’s placed.

Lifestyle changes

While not a specific treatment, making some changes in your day to day can make a noticeable difference in erectile function. Some helpful strategies include:

  • quitting smoking
  • limiting or avoiding alcohol or substance use
  • maintaining a moderate weight
  • exercising more often than not
  • following a healthy diet that supports cardiovascular health, such as the Mediterranean diet

Why these treatments?

PDE5 inhibitors are widely used among older adults because they’re generally safe, effective, and convenient.
Because ED medications are taken on an “as needed” basis, there isn’t the same concern about missing a dose that there may be with potentially lifesaving drugs, such as high blood pressure medications or blood thinners.

Older adults who find the side effects of PDE5 inhibitors too uncomfortable may prefer injections. Those who are used to self-administering medications, such as people who give themselves insulin shots to treat diabetes, may be more comfortable with penile injections.

Penile implants avoid the concerns about side effects altogether. And since the body’s response to medications can change over time, an implanted prosthesis also means not having to worry about changing medications or dosages.

How effective is it?

ED treatments vary in how long each one is effective, as well as side effects. Regardless of which kind of treatment you choose, there are some important facts to keep in mind:

  • ED medications typically take 30 to 60 minutes to become effective. Medications such as sildenafil usually wear off in about 4 hours or so, while tadalafil’s effects can linger for nearly 36 hours. Your general health and other factors will affect these time estimates.
  • If you don’t get the results you want from one PDE5 inhibitor, a different one may be a better match.
  • ED medications don’t cause erections. Sexual stimulation is still required to become aroused.
  • As you get older, you may require more stimulation to become aroused than you did when you were younger.
  • An erection triggered by a penile injection may occur within 15 minutes, though sexual stimulation may still be required for the medication to work.
  • Recovery from inflatable penile prosthesis surgery can take 4 to 6 weeks. This means no sexual activity or great physical exertion should take place during that time. Once you’re free to engage in intercourse, the prosthesis takes only minutes to be inflated.
  • Lifestyle changes, such as strategies that boost cardiovascular health and weight management, have also been proven to be effectiveTrusted Source.

Is it safe?

ED medications can be taken safely with most other medications, though they shouldn’t be used if you take nitrates or alpha-blockers.

The combination of PDE5 inhibitors and these medications could causeTrusted Source a dangerous drop in blood pressure.

People with heart disease or kidney disease should discuss the use of PDE5 inhibitors with their doctor. They may prescribe a lower dose, which may or may not help you achieve the results you want.

Injections pose different risks than oral medications as it may be possible to hit a blood vessel or nerve with the syringe. Also, scarring is possible. It’s best to make the injections in different places each time to reduce scarring.

Implant surgery is generally safe, and the technology is constantly improving. It’s important to find a surgeon who has ample experience with this procedure.

When to see a doctor

You can often chalk up occasional episodes of ED to stress, fatigue, relationship conflicts, or other temporary conditions. They don’t necessarily indicate a problem that needs medical attention.

But frequent problems with ED can point to the need for medical attention, especially if the ED is affecting relationships, self-esteem, and quality of life. Talk with your doctor or a urologist if this is the case for you.

Having that conversation is also important because ED can sometimes be an early symptom of diabetes or cardiovascular disease. Your doctor may want to order blood tests and other screenings to check for these underlying conditions.

The bottom line

ED at any age can be a troubling condition. Among older adults, it may be more expected, but it’s nevertheless still a concern.

ED medications and other treatments have a track record of effectively and safely treating ED symptoms in older adults.

Proper treatment starts with a frank conversation with your doctor. Don’t be embarrassed to have this conversation. Rest assured your doctor has the same talk with many other people, year in and year out.

It’s also important to talk openly and honestly with your partner. ED is simply a health condition. It should be approached thoughtfully in a straightforward manner, in the same way you would address any other condition, like arthritis or high blood pressure.

Counseling may also be helpful for both you and your partner while you seek the right medical care for this common concern.

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Unraveling the Mystery of “Male Menopause”

Is andropause a real thing? Or just a buzzy invention of masculine media?

Women lose estrogen. Men lose testosterone. It’s a simple comparison…right?

By Josh Sims

The thing about getting older is that it’s hard to know whether the symptoms that come with it are normal or require medical attention. Tiredness, brain fog, mood swings, loss of libido, erectile dysfunction, weight gain, and muscle loss all have arrive with degrees of subjectivity. Maybe they’re par for the course of middle-age. Maybe you feel like you’ve entirely lost your mojo. Or maybe they’re symptomatic of the andropause.

That’s not a term that Dr. Robert Stevens of London’s Men’s Health Clinic much likes. Sure, it’s a catchy media concoction, suggesting the male counterpart to female menopause. That said, he stresses, the menopause is a defined biological event — the slowing and then cessation of periods, with accompanying hormonal flat-lining — whereas the andropause, sometimes dubbed the “manopause,” is much less clear, and, in a way, much more complex. 

Indeed, many in the medical world argue that there’s no such thing at all. “Endocrinologists don’t like the vagueness of it. They want to find a definitive pathology and can’t,” says Stevens. The whole idea has only been on the medical radar for a decade or so — on the medicinal timeline, that’s not very long at all.

Still, this is a collection of symptoms that many men, typically in their 40s and 50s, regularly experience. And often, though not always, testosterone replacement therapy (TRT) does provide relief. Hit that age group and testosterone levels in men start to drop away, albeit very gently.

Unlike the rapid shutdown of estrogen production that ushers in female menopause, men typically see only a 2% testosterone decline per year over their thirties and beyond. Whatever physical or biochemical symptoms this process heralds will likely be spread out over many years and affect men over a much broader age range (relative to menopausal women). In some cases, it may fail to arrive at all.

“The main thing is coming to some conclusion in yourself as to whether the way you feel is a product of ageing, which arguably you just have to accept, or whether it’s in some way properly and negatively affecting your quality of life and you should do something about it,” suggests Dr. Chris Airey, medical director of the Optimale men’s health clinic. “The whole subject [of ‘the male menopause’] is complicated and even the terminology is woolly. I’ve never had a patient come to me and say ‘I think I’m going through the andropause’.

“But what is clear is that as men age some will complain of a common set of symptoms,” Airey adds. “We might investigate those to determine if that’s because there is an underlying cause or, well, because that’s just what getting older is like. But we have to be mindful of the fact that, as awareness of testosterone deficiency grows, we also sometimes see men with very normal testosterone levels who are nonetheless convinced the problem is their testosterone levels.”

Clinical resistance to TRT is often influenced by common misconceptions of testosterone. Rather than being seen as the primary sex hormone — found in men and women alike, and stable levels of which are necessary for normal physiological function — its injection is, Stevens says, too often conflated with anabolic steroid abuse “and the idea that there are men who just want to look good with their tops off.”

Plus, while the role of testosterone is incredibly important, “it’s not well-taught in medical school, because it’s not well-understood,” he says. All told, you have a perfect storm of a lot of men feeling bad but unable to work out why, some of them jumping to the wrong conclusions, too many clinicians biased towards an overenthusiastic prescribing of testosterone, and some not keen on it at all.

Testosterone isn’t even mostly about sex, interest in sex, or your ability to get it up (all things that, inevitably, cause most men acute embarrassment and further stop them seeking medical advice). Indeed, testosterone’s decline is also linked to muscle atrophy, reduced bone density and a susceptibility to depression; and there’s an inverse correlation with obesity and mortality from heart failure — the less testosterone you have, the more prone you are to both issues. Not for nothing, then, some experts dub the ‘male menopause’ as something more akin to Testosterone Deficiency Syndrome.

But that only account for part of the hormonal story. Current understanding suggests that subtle shifts in testosterone levels are more part of a broader package of metabolic changes in various key hormone levels — prolactin, gonadotropin, DHEA and others you’ve likely never heard of — with consequences similar to those experienced by menopausal women. So where does that leave you?

Let’s be clear: lifestyle is a major part of this. The major part. “You can’t get around lifestyle. Testosterone is no substitute for those things you need to be doing, anyway,” as Airey puts it.

If you head to to a doctor, seeking TRT as some silver bullet to solve this higgledy-piggledy set of symptoms — some of which are debilitating, others are just irritating — the first thing they’ll do is assess how you live, and ask you to make necessary corrections. Are you sleeping enough? Are you eating well? Do you smoke or drink too much? Do you get enough exercise? Do you do anything to mitigate stress?

You should, at a minimum, be taking good, regular, long walks. You might train gently but regularly with weights. Eat a low-carb, high protein diet. Get a good eight hours sleep every night. Address the stress in your life rather than normalizing it. But if you do all this, and your way of life is largely health positive, yet you still feel like crap, then the next step is blood screening; you’ll definitely want to assess testosterone levels. But they’ll check for adrenal and thyroid dysfunction too. Both are also more common in middle-age. TRT is the end of the road, after all, not the start of it.

And for good reason: it’s expensive. Prices vary, but we’re typically talking at least a few hundreds dollars per month; and unsurprisingly, those who recommend this treatment profit from it. Working out a patient’s ideal level of testosterone for their physiology is hard: their normal operating level may be atypically high or low…who knows? And once you’re on TRT, your body’s own testosterone production shuts down — sometimes that’s for good, making TRT a crutch, not a cure, while sometimes (if you’re on TRT for a limited period), it might allow the the patient to return to their pre-TRT levels.

That’s why Stevens’ clinic adopts an approach based more on testosterone micro-dosing and frequent monitoring, an idea worth pursuing with your own physician if it comes to it. Prescription levels of testosterone vary wildly country to country, which is testament to the idea that there’s a lot of guesswork going on here.

Is more research required? Definitely. We still have miles to go in fully understanding menopause…so unpicking the andropause has barely begun. That’s a problem for those men in middle-age who feel deeply out of sorts in ways they can’t quite understand or mitigate or name.

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Sex After 50

— Don’t Lose That Lovin’ Feeling


Connection, communication and self-acceptance keep intimacy alive

By Lisa B. Samalonis

Although advancing age can pose some challenges to a healthy sex life, with a shift in perspective, intimacy can still be satisfying, good for your health and overall fun.
Frequently discussed obstacles include:

  • Vaginal dryness/atrophy.
  • Erectile dysfunction.
  • Lost libido.
  • More extended refractory periods.
  • Sexually transmitted infections.
  • The emotional toll of disappointing encounters and disconnection.

However, the future does not have to be bleak. “We all need to acknowledge that sex after fifty (like pretty much anything with our bodies) isn’t the same as when we were twenty,” said Karyn Eilber, MD, a board-certified urologist and associate professor of urology and obstetrics and gynecology at Cedars-Sinai Hospital in Los Angeles.

With age comes experience. “Middle age also brings wisdom and confidence in our lives, so why not take that wisdom and confidence to the bedroom?” she suggests. Noting that with some education and normalization of the discussion of sexual health, women and their partners can benefit.

For example, women can discuss hormone replacement therapy with their doctor if they are experiencing menopause-related issues. Incontinence and prolapse can also affect a woman’s sex life after 50.

Also, pelvic floor physical therapy for a more robust pelvic floor may improve incontinence, prolapse, and sexual function.

Vital Connection

Emotional connectivity is central to long-term well-being and satisfaction. Previous studies show that loneliness, or feeling alone regardless of the amount of social contact and touch starvation (when a person has little to no physical contact for a prolonged time), might contribute to chronic disease.

“Chronological age does not define me.”

These include depression and anxiety, as well as an increase in stress, cortisol and infection, poor quality of sleep, and digestive issues.

According to Daniel Boyer, MD, of Farr Institute in Des Moines, Iowa, maintaining a closer relationship can help improve mental and physical health and increase creativity, productivity and social interaction.

Intimacy can also provide a sense of security, help build strong relationships and deepen connections with others.

Shifting Your Mindset

Confronting myths and misconceptions about sex in middle age — such as “people age out of sex,” “it is unsatisfying,” “desire is not existent as we age,” or “older bodies are unattractive” — leads to enhanced intimacy.

The issue of unconscious ageism is often a critical factor that affects sexuality and sexual intimacy, said Carla Marie Manly, PhD., a clinical psychologist and author of “Aging Joyfully.”

“While we can often get support from medical practitioners to help with underlying physical changes, the psychological elements that affect sexuality and a sense of self are often overlooked,” Manly said.

She also noted that people in their 50s can enjoy the best sex by letting go of stereotypes and exploring the beauty of more mature sexuality.

Becoming aware of often-unconscious self-ageism is the first step. Then age-negative thoughts, such as “younger women/men are more desirable” or “I am fat and past my prime,” can be addressed and transformed into a more age-positive attitude.

Phrases like “chronological age does not define me,” “I am glad to be able to contribute my energy to my community,” or “I enjoy giving and sharing with those I love” are a few examples. In addition, practicing a mantra, such as “I am a valuable, passionate, resilient person” or “I love who I am,” is helpful.

Another common misconception is that libido fades or ends as we get older so that in the late adulthood stage of life, individuals no longer have sexual desire, explained cognitive behavioral coachRobin Buckley, PhD.

Evaluating the relationship with their partner and the relationship with themselves are two things people can do to get to their version of ideal sexual desire.

“This is inaccurate and becomes part of how society dehumanizes older individuals. Yes, libido can vary with age and biological changes, but it doesn’t mean it is the end of our sexual desire. It might take different strategies to encourage and sustain the libido, but it is possible to have a strong libido throughout life.”

Evaluating the relationship with their partner and the relationship with themselves are two things people can do to get to their version of ideal sexual desire.

“If you are in a relationship, take time to determine what parts of it are satisfying and what parts you’d like to improve so you can improve your experience. This will likely increase your libido because you will be and will feel more connected to your partner,” she said.

Whether coupled or uncoupled, taking time to appreciate yourself is essential for self-esteem and libido. “This includes doing things that connect you to the things you love. Tap into your sensuality through experiences that stimulate your senses. Talk to yourself as you would to your best friend,” Buckley added.

Jessica Jolie Badonsky, a registered family nurse practitioner, emphasized people are more than the sum of their aging parts. For example, men’s refractory time lengthens with age, meaning after orgasm and ejaculation, it may take longer until the body is primed to do it again.

“This doesn’t mean that sex has to stop. On the contrary, the organ that can get stimulated over and over is the biggest sex organ, the brain,” Badonsky said.

Moreover, by expanding the definition of sex (not just penetration/orgasm), couples can bring in erotic elements, such as spending more time cuddling, kissing, talking, and exploring touch, like mutual massage.

Extended foreplay allows couples to take time to get in the mood, set it, and discuss what they want. Often post-menopausal women can have vaginal dryness even while excited, so vaginal moisturizers that are pH balanced and as free from fragrance and additives as possible can be used.

Maintain and Revive The Connection

Frequently people over 50 have more time for romance, said Lisa Concepcion, a certified professional life and relationship coach. “There’s an excellent window of opportunity to reinvent and reconnect as a couple once the nest is empty and before grandchildren.”

For instance, couples who have raised kids can come together and decide on what they want to achieve in this next stage of life. Couples who set new goals connect, and where there’s a connection, there’s intimacy and good sex,” she suggested.

Although some people might not feel comfortable talking about what they desire…speaking up can deepen their emotional and physical connection.

Buckley advocated making a confidential appointment, such as a date night or time in the early morning, to relax and reconnect. “As adults, we tend to put important things on our calendars, like appointments, work meetings, and vacations, to ensure we remember to do them and to allow enough time for those activities to occur,” she said.

“Research shows that as individuals enter midlife, the frequency of sex decreases due to children, care for elderly parents, and work/life stressors. If having time to connect with your partner physically and emotionally is important to you, then why wouldn’t it be on your calendar to make sure it happens?” she said.

“Keeping the libido stimulated through masturbation, physical affection, or sexual touching helps keep your libido engaged. Having a regular sex life is part of the process.”

Communicate Wants and Feelings

Creating a space to communicate honestly and freely without negative consequences is part of sustaining a solid connection with your partner. Once individuals know themselves and their preferences, they can better communicate them to their partners.

“Many women are still ashamed of the idea of masturbation due to societal double standards and stereotypes regarding sexuality and women. But when approximately 15% of women have never had an orgasm, and 81% do not orgasm through vaginal penetration, the most significant benefit masturbation offers for women is an understanding of what sexual practices work best for their body,” said Buckley.

Likewise, women can learn to use different techniques to achieve the best results. “They develop greater awareness about their individualized signs of arousal or climax and learn how to control their responses, creating sexual experiences they want.”

Although some people might not feel comfortable talking about what they desire physically or emotionally, speaking up can deepen their emotional and physical connection.

More Intimacy Tips

  • Accept each other “as is:” Despite your current body (sagging breasts, a big stomach, or a slow start-up to arousal), accepting oneself is vital.
  • Strive for ease: Be playful and use humor to lighten the mood, which can ease embarrassment if things don’t go as planned. When problems occur, switch from intercourse to whole-body light touching and kissing or agree to cuddle and talk. Then try again later.
  • Be health conscious: Activities that contribute to physical health also contribute to higher libido. So, get on a regular sleep schedule, avoid smoking, keep to a nutrition plan rich in vegetables, lean proteins and low in sugar and exercise daily.
  • Get physical: Life coach Concepcion, 51, says she and her partner prioritize physical health. “The sex is the best of my life. We’re making love five days a week on average,” she says. “We both maintain good health. We work in our home gym, walk five miles three times weekly, and have fun cooking low-carb meals together. Stretching for ten minutes daily can make a big difference in the bedroom.”
  • Manage mental health: High stress or anxiety levels can reduce libido. Managing these are beneficial for sexual desire and physical health, Buckley notes. Orgasms are an effective method to relieve stress, so masturbation should be a part of self-care.
  • Talk it out: “If there are any issues in your relationship—or your past, such as trauma, abuse or shame—it pays to find a compatible therapist and delve into them,” says sexologist Carol Queen, Ph.D. “Your partner can accompany you to a couples’ counselor; if they don’t go, do it solo.”
  • Keep exploring: For some users, sexual toys add to the intimate experience. “Toys can be great fun, extremely pleasurable, and a way to explore, but they can also help partners deal with anorgasmia (delayed, infrequent, or absent orgasms), erectile dysfunction, and other situations that change or affect our sexual expression,” explains Queen. “More importantly, playing with sex toys helps de-center simplistic ideas of what sex should or must be and helps people understand that pleasure can be whole-body and accessible in many ways. That can reassure people whose bodies are changing or who never felt they were getting the kind of stimulation that worked for them in the first place. But beyond that, it can open doors to erotic possibilities many people might not have explored, which can help couples think about intimacy differently.”
  • Advocate for your health: Speak up and discuss changes in your body, pain, difficulties, and concerns with your physician.

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10 Surprising Health Benefits of Sex After 50

— Research shows that regular sexual activity comes with some unexpected health benefits

By Michelle Crouch

A quick romp in the hay doesn’t just feel good. It turns out that sex has advantages that go way beyond simple pleasure.

In fact, sexual activity with or without a partner is linked to some impressive, research-backed health benefits, says Kate Thomas, director of clinical services at The John Hopkins Sex and Gender Clinic. And, she noted, it’s not just for young people.

“Sex can be hugely beneficial for people as they get older, not only for the reported medical health benefits but for our psychological and emotional health,” Thomas says. “It can strengthen our relationships, promote self-esteem and improve our sense of identity.”

Here are 10 other surprising health benefits of sex.

1. Boosts immunity

Hopping in the sack on a regular basis may help boost your immune system and protect you from getting sick, studies show.

Researchers at Wilkes University in Pennsylvania found that college students who had sex one to two times a week had significantly more immunoglobulin A in their systems than people who had sex less often. Immunoglobulin A is an antibody in the mucosal membranes that is considered a first-line defense against infection.

Another study published in 2021 found that having sex more than three times a month seemed to offer a protective effect against COVID-19.

Researchers aren’t sure exactly why sex seems to drive up immunity, but Thomas said it may be because sex increases blood flow, helping to distribute antibodies throughout the body.

2. Improves heart health

Some men worry that sex could trigger a heart attack, but studies show that’s exceedingly rare, especially if you exercise regularly. In fact, the latest research shows that regular romps with your partner are linked to a lower risk of heart problems.

A large study published in The American Journal of Cardiology found that men who had sex at least twice a week were 50 percent less likely to die of heart disease compared with men who had it once a month. In another study, British researchers followed 914 men for 20 years and found that as sexual activity increased, the risk of stroke and heart attack decreased.

For women, a large analysis revealed that those who are satisfied with their sex lives are less likely to have peripheral artery disease, a condition that narrows the arteries and makes stroke more likely.

Researchers believe the protective effects stem from a variety of factors, including lower stress levels, improved sleep and the stronger connection to your partner that has been linked to sex.

3. Strengthens the pelvic floor

A study published in International Urogynecology Journal found that sexually active women were significantly more likely to have a strong pelvic floor compared with those who were not sexually active.

That’s probably because every time you have sex, you give the muscles in your nether regions a workout, Thomas says. When you’re aroused, muscle tension in the pelvic region naturally increases, Thomas explains. Then, during orgasm, all the muscles contract, just as they would during a Kegel exercise.

Having strong pelvic floor muscles gives you control over your bladder and helps prevent incontinence. In men, a weak pelvic floor can contribute to erectile dysfunction.

Another bonus to strengthening your pelvic floor: Researchers say it may make sex even more pleasurable.

4. Relieves headaches and other pain

Before you reach for an over-the-counter pain reliever, try an orgasm. Whether you have headaches, arthritis or another type of chronic pain, sex may offer relief, Thomas says.

One large observational study found that 34 percent of the patients had experience with sexual activity during an attack; out of these patients, 60 percent reported an improvement of their migraine attack and 33 percent reported worsening. Some patients, in particular male migraine patients, even used sexual activity as a therapeutic tool.

Another study found that vaginal stimulation in women elevated their pain tolerance by about 40 percent, while orgasm pushed it up nearly 75 percent.

Experts credit the release of feel-good hormones including endorphins, the body’s natural pain reliever.

5. Helps with symptoms of menopause

Regular sexual activity can help counteract the physical changes, such as vaginal dryness and atrophy, that come with menopause, says Amir Marashi, a gynecologist practicing in Brooklyn, New York.

Sex stimulates blood flow and helps keep vaginal tissues healthy, toned and stretchy. In fact, studies show the more you have sex, the healthier your tissues will be.

“Any organ that you bring more blood supply to, you keep it more youthful,” Marashi says. “A lot of patients come to me for hormonal replacement therapy. Before all of that, I say, ‘Make sure you get regular, consistent, good orgasms, because that’s going to help a lot.’ ”

6. Reduces the risk of prostate cancer

For men, several studies have revealed a link between frequent orgasm and a lower risk of prostate cancer. The prostate holds some of the fluid that is released at ejaculation.

One Harvard study of almost 32,000 men found that the more a man ejaculated, the lower his risk of the cancer. In fact, those who ejaculated more than 20 times per month reduced their prostate cancer risk by about 20 percent, compared with those who ejaculated four to seven times per month.

While the reason for the link isn’t entirely clear, experts believe that frequent turnover of the fluids in your prostate is likely good for you. “That way, you flush out more of the potential carcinogens that are there,” Thomas says. “Our system is designed to be flowing and replacing itself.”

7. Boosts mental health and relieves stress

A large body of research has found that sexual activity and intimacy are linked to lower rates of depression, anxiety and feelings of isolation, and that regular sexual activity can boost happiness and mood. One of the more recent studies published in The Journal of Sexual Medicine found that anxiety and depression scores were significantly lower in those were sexually active during the COVID-19 lockdown compared with those who weren’t.

“One of the top benefits of sex, particularly in the acutely stressful world in which we’re living these days, is its ability to immediately melt away built-up stress,” says Paul Hokemeyer, a licensed marriage and family therapist based in New York City.

When you have sex, your body releases a cocktail of hormones and neurotransmitters that “help calm us down and make us feel safe and secure in the world,” Hokemeyer explains.

8. Burns calories

Getting busy with your partner isn’t going to replace a session on the treadmill, but it does count as physical activity.

In a study published in the journal PLOS one, Canadian researchers found that men burned 101 calories on average during a 24-minute session, while women burned 69 calories. “These results suggest that sexual activity may potentially be considered, at times, as a significant exercise,” the authors wrote.

Of course, how many calories you actually burn depends on how long your session lasts and how vigorous it is. But even if your romp lasts only six minutes, the typical length of a session, that’s still better than doing nothing at all. The latest research on physical activity reveals that getting your heart rate up even for just a few minutes conveys health benefits.

9. Helps you sleep

If you tend to doze off after sex, there’s a scientific explanation. During sex, the body releases hormones such as oxytocin and prolactin that induce pleasant and relaxing feelings, Marashi says. Sex also reduces cortisol, which is associated with stress.

“This can cause someone to feel relaxed and drowsy and make it easier for them to fall asleep,” Marashi says.

In one study, about 63 percent of participants reported that it was easier to fall asleep after orgasm, and 71 percent of participants reported better sleep quality after orgasm. Despite common perceptions that men are the ones who roll over and start snoring after sex, there was no gender difference in the results.

If you struggle with sleep, try sex in lieu of a nightcap or sleep medication, Marashi advises.

10. Extends your life

You’re never too old to have sex, researchers say, and making it a regular part of your routine may be a tool to extend your life span.

In Ikaria, Greece — one of the regions of the world where people live significantly longer than average — more than 80 percent of people ages 65 to 100 are having sex, according to Blue Zones, an organization that researches the world’s longest-lived cultures.

A variety of studies have found a correlation between an active sex life and a longer life. For example, an observational study of 15,269 U.S. adults published in 2020 in The Journal of Sexual Medicine found that death rates were about 50 percent lower for those who had sex at least once a week, compared with those who rarely had sex.

Experts believe the lower risk of death likely stems from all the other known health benefits of sex, including better heart health, improved sleep, lower stress and a closer relationship with your partner.

Thomas and Marashi both stress that help is available if physical problems such as erectile dysfunction or vaginal dryness are keeping you from being sexually active.

“You may not be as frisky as you once were, but [sex] should still be a part of your identity,” Thomas says. “If there is pain or a lack of desire or another problem, there are people out there who can help.”​​

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Sex doesn’t stop after 60

— ‘We can stay sexually zesty and vibrant’

While sex after 60 does have its challenges, it can also be “sizzling.”

By Rachel Grumman Bender

Sex after 60 isn’t something people talk about that much — but Joan Price is looking to change that.

The 79-year-old speaker and author of Better Than I Ever Expected: Straight Talk About Sex After Sixty and Naked at Our Age: Talking Out Loud About Senior Sex tells Yahoo Life that if “we give ourselves regular sexual attention and orgasms, we can stay sexually zesty and vibrant and reap all the benefits of regular orgasms such as a sense of well-being, being in touch with our physicality, sleeping better” and more.

The University of Michigan’s 2018 National Poll on Healthy Aging found that most older adults (76%) agreed that sex is an important part of a romantic relationship at any age. The poll also found that 45% of those 65 to 80 years old are sexually active.

But Leah Millheiser, director of the female sexual medicine program at Stanford University Medical Center, acknowledges that it’s still a taboo topic and people don’t typically see women being depicted as sexual beings after menopause, telling Yahoo Life: “That’s unfortunate because we know men and women across their lifetime will go on to having very enjoyable and satisfying sex lives. You have to work a little harder for it to be enjoyable and successful. But it’s very achievable.”

Millheiser says that society has “definitely made strides” in talking about sex and sexuality in midlife and beyond but that “we are nowhere near where we need to be.” She points to Jennifer Lopez during the 2020 Super Bowl LIV halftime show, where the star, then 50, “came out and blew people’s minds — she looks great and gorgeous. For many people it was shocking.” Millheiser also points out that 50-year-old Gwyneth Paltrow has also been vocal about sexuality in midlife.

Even so, “we are very far from having normalized sexuality in the golden years for women,” says Millheiser. “We can have erectile dysfunction ads all over the place, but you can’t say ‘vagina’ and ‘vaginal dryness.’ It starts with normalizing sexuality after a certain age.” She mentions how on the show Grace and Frankie “they actually show a sex scene with Jane Fonda and it was extremely hot to watch — there needs to be more of that.”

Joan Price (Photo: Courtesy of Joan Price)
Author Joan Price says she “was having glorious sex” in her 60s — and still is at 79.

It’s something Price can relate to. “Usually, sex and seniors were never mentioned in the same sentence, and if they were it was doom and gloom. But I was having glorious sex” in her 60s with her lover, who eventually became her husband (he died of cancer 7 years after they met). After wondering why there weren’t any books that talked about positive sexual experiences past age 60, Price ended up writing a book about it herself — and she’s been vocal about the topic ever since.

Price says that as people age, there are ways that sex can actually be better than ever. “When I say can be, I mean it doesn’t happen automatically,” she shares. “This is something we make a priority. … It’s important to keep yourself sexually healthy and vibrant by having regular sex sessions — whether that’s sex dates with yourself or a partner. Solo sex is real sex.”

That said, sex after 60 does have its challenges. Millheiser says it can be a “double-edged sword.” On the one hand, there can be issues with low libido, vaginal dryness and sexual dysfunction. But on the other hand, sex can also be better “because you know what you want and you know how to ask what you want,” she says.

Price acknowledges that it can be harder to get aroused and reach orgasm with age. “But that doesn’t mean sex is over,” she says. “It means we explore new ways and new erogenous zones. It may be the addition of a sex toy and not just a partner’s finger or mouth or genitals. We need to ask for what we need, and before we can do that we need to know what to ask for. That’s again why solo sex is important — even if we’re in a relationship — because we can explore on our own to know what to ask for.”

Of course, one of the benefits of aging, says Price, is worrying less about what other people think — and that includes in the bedroom. “We’ve spent too much of our lives worrying about being judged or shamed,” she says. “Let’s apply this to sex too” — meaning speaking up about what you like and don’t like between the sheets, especially if what aroused you in the past doesn’t work for you anymore.

“We can do it in a loving way,” Price says. “‘Honey, I know I used to love being touched this way, but now it feels different to me and I’d love it if you’d touch me this way.’ Or even, ‘I’m not sure how I like to be touched — could we explore and I’ll give you feedback?’”

She adds: “You are doing your partner a favor by giving direction in a loving way.”

That also includes adding sex toys — along with lubricants to help with vaginal dryness — to the mix. “Don’t be shy about saying, ‘I will only have an orgasm if we bring my vibrator into this wonderful relationship,’” says Price. “One of my taglines is, ‘A well-chosen, well-placed vibrator may be the difference between orgasms and no orgasms.’”

She continues: “We have our best sex when we have enough intensity and sensation. Often bringing a vibrator into the mix, whether solo or becoming a threesome with your partner — you, me and the vibrator — can make sex sizzling and splendid.”

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‘I want an orgasm but not just any orgasm’

— How To Please A Woman shifts the way we depict the sexuality of older women

By , &

Australian writer and director Renée Webster’s new film How to Please a Woman turns much of what we think we know about sexual desire – especially for older women – on its head.

How to Please a Woman features 50-something Gina (Sally Phillips), who hasn’t had sex with her husband (Cameron Daddo) in over a year because he is no longer interested in sexual relations – with her or anyone.

Gina’s main source of intimacy comes from the regular beach swims she has with a group of three women (Tasma Walton, Caroline Brazier, and Hayley McElhinney) and their changing-room conversations that cover everything from peeing on jellyfish stings to the multipurpose use of coconut oil, including as a natural lubricant.

When Gina’s friends rent a stripper (Alexander England) to dance for her on her birthday (a much more intimate present than the two $50 bills she receives from her husband), and he offers to do anything for her (“Anything?” “Totally …”) she asks him to clean her house.

Realising the pleasure she experienced having her house cleaned by a shirtless, handsome man, Gina starts her own male cleaning business and her swimming crew become her first clients.

But they want more than their houses cleaned.

The sexual desire of women over 50

One of the strengths of this film is the sensitive way it represents the different desires of individual women. After all, the title of the film is How to Please a Woman not How to Please Women.

For Gina to ensure her clients receive the pleasure they want, she meets individually with them and writes down their preferences. One woman wants to take it slow and start with gin and tonic. Another woman does not want her breasts touched. A third woman wants a very specific orgasm: she does not want just any orgasm that sneaks up on you, but one you ease up to and pull away from, ease up to and pull away from until total annihilation. Another client says that after several bookings with men she is starting to feel all kinds of things, so she wants to book a session with a woman.

Hayley McElhinney, Tasma Walton, Sally Phillips and Caroline Brazier in How To Please A Woman.

It is rare to see in popular culture a range of mostly older women being frank about what gives them sexual pleasure and to see how their desire become more adventurous and diverse. Sadly, the sexual desire of women over 50 is often unrepresented, misrepresented, and/or shown as comedic.

The socially transmitted disease of ageism

According to Foley, Kope & Sugrue,

The greatest barrier to a woman’s sexuality in midlife is the socially transmitted disease of ageism.

Older women are represented as asexual and past it. They are “cougars” or ageing femme fatales, like Blanche Du Bois in Tennessee William’s A Streetcar Named Desire, who set a tone for generations as a figure of fun whose desires are twisted, ridiculed, and ultimately punished.

Older age is by far the largest developmental human period plagued by misconceptions and stereotypes, kept alive by incessant jokes.

And no gender absorbs these jokes more than the female. Sexiness is equated with youth, and older women and their sexuality are made invisible. When older women are represented in popular media, their sexuality is often not shown or is aligned with deviance, such as in the relationship between Darlene and Wyatt in Netflix’s highly-acclaimed Ozark.

Depictions in media trivialising desirous or sexually active older women, or women who seek sex outside of loving and steady relationships as abnormal, contribute to negative stereotypes and to judgemental attitudes about older sexuality.

Alexander England and Sally Phillips.

And just like that…

Fortunately, we are starting to see the lives of women over 50 appear more positively in stories on television, recent examples including And Just Like That the reboot of Sex and the City, and the hugely popular Netflix comedy series Grace and Frankie – and in films like It’s Complicated and Girl’s Trip.

The tone of these stories plays more for laughs, though, while How to Please a Woman balances between comedy and drama. As director Renée Webster says,

The best comedy comes from truth and a little bit of pain.

How to Please a Woman shows older women’s sexual desire as respectful and tender for both women and men, even though it is set within a comedy.

But the women aren’t being laughed at, they’re the ones laughing. This depiction seems new and significant. Stories impact and inspire relationships and images about ageing and sexuality influence individual behaviour.

Webster herself says she is “starting to get unsolicited texts of my friends’ husbands vacuuming the carpet and hearing from people that they took something home from the movie, and it opened up some new conversations for them.”

Female sexuality is seen as part of a rich fabric of women’s lives, not its single orgasmic culmination. As Steve (Erik Thomson) says in the film while eating a croissant, “one is never enough.”

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Living and Loving with Low Libido 

There are numerous approaches to targeting low libido to promote sexual wellness

“If you’re choosing not to participate in intimacy, make sure your decision doesn’t steal your partner’s choice about sexuality. Everyone has a right to enjoy and express sexual well-being without pain, coercion, guilt, blame or shame.”

By Linda Wheeling, MSN, FNP-C 

Recently I saw 65-year-old Loretta* for a “personal discussion” visit (*name changed). Loretta shared she lost her husband a year ago after an extended illness but now reported having a new gentleman friend and believed they would soon become intimate.

Loretta had never had a sexual partner besides her husband. She was worried that she wouldn’t be able to perform since her last sexual encounter was ten years ago. And while she accepted having low libido during her husband’s extended illness, she was now afraid that intercourse would not be enjoyable because of concerns with vaginal pain.

She had already been using estrogen cream to treat atrophic vaginitis (AV), which is vaginal thinning, dryness, and inflammation. AV is commonly experienced in post-menopausal women when the ovaries no longer produce estrogen. She said, “I know sex might hurt since my vagina is nothing like it was before menopause.”

A lifestyle that supports physical, emotional, mental, and social well-being is essential for everyone to enjoy optimal sexual health.

I first advised Loretta to schedule an annual female exam to ease her worries. Next, I educated her about medical-grade vaginal dilators that gently reopen the vaginal canal. I explained how to use the set of four dilators for 15-30 minutes daily until she was comfortable using the largest dilator.

Also, I advised her to continue using the prescription estrogen cream and informed her that sexually transmitted infections (STIs) are a definite risk for all age groups. I stressed the importance of using latex condoms for three months until she could be sure of her new partner’s sexual history.

I, too, instructed her to use personal lubrication to avoid discomfort during intercourse and told her to prevent urinary tract infections by emptying her bladder immediately after intercourse. Loretta thanked me for the information and said she would follow my recommendations moving ahead.

When she returned for her annual female exam, she had successfully used the largest dilator and reported that her love life was proceeding without further complications. Loretta’s compliance led to a successful reversal of her low libido.

Back to Low Libido

People choose to refrain from sex for multiple reasons. For example, emotional distress driven by the feeling of being stuck in a loveless relationship can lead to psychological withdrawal and damaged libido. Other individuals have an asexual lifestyle because they become widowed, divorced, or are in between relationships. Others opt out for religious or moral reasons or choose abstinence as their sexual orientation.

Indeed, reasons for low libido abound; both genders may have experienced sexual abuse earlier in life, leading to guilt, stress, and feelings of shame. Issues with body image and efforts to avoid judgment can also lead many to choose platonic relationships. One supportive resource is The Asexual Visibility & Education Network, a platform for all who claim to be asexual or question whether it is acceptable in today’s world to choose a lifestyle that excludes sexual activity, no matter the reason.

Intimacy Issues

The Centers for Disease Control and Prevention (CDC) states that a lifestyle that supports physical, emotional, mental, and social well-being is essential for everyone to enjoy optimal sexual health. The CDC emphasizes that sexual pleasure requires a healthy attitude about intimate relationships and positive sexual encounters that allow both parties to feel secure. In contrast, unhealthy lifestyles consisting of a poor diet, lack of daily exercise, or being overweight inevitably lead to a decline in health.

Poor health precedes various medical conditions such as mental health disorders, heart disease, or diabetes. Long COVID complications are known to have the potential to damage a person’s sexual health. Each of these health disorders can damage the circulatory system in multiple organ systems. If chronic diseases are left unchecked, poor circulation will lead to shortness of breath during intimacy, erectile dysfunction, significant fatigue, or discouragement — all of which will lead to low libido.

When a non-sexual person surrenders to true romance, they must let go of all pressures to perform.

Both genders are affected by chronic illness in differing ways. Women often lose touch with their sexual prowess because of symptoms associated with perimenopause or menopause. Men of all ages can develop testosterone deficiency syndrome, which causes them to experience reduced libido and difficulties with erectile dysfunction.

These organic changes result in couple pause, the term used to describe inadequate sexual functioning inside relationships. When organic changes diminish either partner’s libidinal urges, sexual boredom occurs. Treatments must address the needs of both partners since the blame for low libido cannot be assigned to only one partner.

When it comes to orgasms or sexual arousal, some individuals might not experience either satisfactorily. Menopause often leads to Female Cognitive Arousal Disorder, which causes mental distress about never feeling aroused or having the physical desire to engage in sex. On the other hand, male partners can develop Lost Penis Syndrome (LPS), which causes a loss of penile sensation during intercourse. LPS leads to the inability to ejaculate, achieve orgasm or maintain an erection.

People can also develop low libido because of medication side effects. Many antidepressants, antipsychotics, prostate enlargement, and blood pressure medications commonly diminish desire. Yet, low libido should not be a reason to abruptly discontinue prescription medicines unless discussed with your primary health care provider.

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Boomers are bringing ‘summer of love’-style change to sex in their older years

Sex in retirement years: the rewards and risks

By Jessica Hall

When Lisa Noll, 67, got divorced two years ago after 35 years of marriage, she thought relationships, romance and sex were a thing of the past. Now, she’s in a relationship with a man 10 years younger and has what she calls “a rich sex life.”

“I didn’t think people had sex any more. I thought people got old and just stopped. It’s like a big secret,” said Noll, who splits her time between Colorado Springs, Colo., and Merida, Mexico. “I’m floored that I am having sex and a relationship and that it’s as good as it is. I’m a lot more confident now and know what I want.”

When Lisa Noll, 67, got divorced two years ago after 35 years of marriage, she thought relationships, romance and sex were a thing of the past. Now, she’s in a relationship with a man 10 years younger and has what she calls “a rich sex life.”

“I didn’t think people had sex any more. I thought people got old and just stopped. It’s like a big secret,” said Noll, who splits her time between Colorado Springs, Colo., and Merida, Mexico. “I’m floored that I am having sex and a relationship and that it’s as good as it is.

About 40% of people between ages 65 and 80 are sexually active, according to a survey from the National Poll on Healthy Aging, sponsored by AARP and the University of Michigan.

A Pew Research Center study found that the number of older Americans between ages 55 and 64 who had used an online dating website or app doubled between 2013 and 2015. Some dating sites, such as those run by AARP and OurTime, cater specifically to singles 50 years and older. Given that 45% of Americans older than 65 are divorced, separated or widowed, according to AARP, there’s a lot of potential customers.

“The baby boomers had to break down sexual barriers in the 60s and 70s and they’re silently doing it now. There’s a notion that if you turn 55, 60, 70, sex goes away. But it doesn’t. People are living longer and they’re having sex longer,” said John Portmann, author of the book “The Ethics of Sex and Alzheimer’s” and a professor of religious studies at the University of Virginia. “There are celebrities like Jane Fonda who say they’ve never stopped having sex. I think she sees herself as trying to liberate women and say that sex doesn’t stop.”

Daniel Reingold, President and CEO of RiverSpring Living, the parent organization of the Hebrew Home at Riverdale, realized in the mid-‘90s that his organization needed a sexual expression policy when a nurse came up to him, rattled that a couple was having sex in a room and asked him what to do.

Reingold’s organization then did a national survey of nursing homes on the topic of sex, created a policy and a staff training video that could be used by other nursing homes and assisted living centers. Since then, the policies have evolved and now include more discussion on LGBTQ+ issues.

“What’s so shocking to me is that 25 years later, so many organizations and people are putting their heads in the sand on this topic of sex,” Reingold said. “The big issue in the room is ageism. People think that desire and libido go away at a certain age and to me that’s so ageist. Most of us think our parents are virgins and the idea of them having sex is disgusting to us. That’s just so wrong.”

Touch tends to be among the last senses to decline, Reingold said, so the power of touch is incredibly rewarding for residents in assisted living, nursing homes or other facilities.

“Whether it’s holding hands or snuggling or sex, the person is not looking at the other person as old and wrinkled. They’re looking at it as young love. The pleasure of touch can be the thing that makes a resident want to get up in the morning to see their girlfriend at breakfast, to continue to thrive,” Reingold said.

Safer sex later in life

Of course, there’s not just the rewards of intimacy, there’s also risks associated with sex in retirement years.

According to the Centers for Disease Control and Prevention, between 2011 and 2015, chlamydia infections in Americans aged 65 and over increased by nearly 50%, and gonorrhea by 102%. Medicare offers free STD screenings for seniors, yet only 5% of those who are eligible for the service have chosen to use the service.

Meanwhile, users of erectile dysfunction (ED) drugs have two-to-three times higher rates of STDs than do nonusers, Harvard researchers at Massachusetts General Hospital have found after analyzing insurance records of more than 1.4 million U.S. men over age 40.

According to a National Survey of Sexual Health and Behavior, condoms are used in about 40% of sexual encounters among college-age Americans. But among those 61 and older, condoms are only used in about 6% of sexual encounters.

“If you have to be institutionalized and your adult child strongly informs the home that they don’t want you having sex, it’s oddly analogous to parents and teenagers. But the roles are reversed. Middle-aged people don’t like the idea of their parents having a sexual life or getting an STD. It’s a very confusing area for people.” Portmann said.

Questions of consent

There are more risks than STDs. At what point does age and mental and physical health collide to the point that sex is no longer safe due to an inability to provide consent due to a dementia or Alzheimer’s diagnosis?

In 2015, a longtime Iowa legislator and retired farmer was acquitted after being charged with sexual assault for having sex with his wife, who had Alzheimer’s disease and was in a nursing home.

That case and others, however, have raised the notion of the ability of a person to consent to sex and the responsibility held by the nursing home to protect patients and report any assaults as mandatory reporters.

“Sexual abuse and unwanted sexual activity is a real issue with dementia patients. Enough of it is going on that it is a pretty prevalent problem,” said Minneapolis-based attorney Mark Kosieradzki, who has tried several cases of sexual abuse in nursing homes.

State laws vary about the ability to consent.

Reingold said memory issues are increasingly a concern in assisted-living programs as people try to age at home as long as possible and tend to go to a residential program needing a much more advanced level of care.

“If there’s any doubt in our minds about the ability to consent, we look at the rights to intimacy against the right to prevent unwanted touching and we will err on the side of protecting against unwanted touching every time. We have to,” Reingold said.

The best way to protect against unwanted touch is to talk about the idea of sex and aging and air out the topic as much as possible, Kosieradzki said.

“I do believe there is a bias. Claims of sexual assault by the elderly are not taken seriously because there isn’t an understanding of older sexual drives or there’s a bias about why would someone have sex with an 88-year-old,” Kosieradzki said.

“There’s not an easy solution. It’s not one of those things that you can’t talk about. It should be thought about and discussed frequently as people get older and have different caregivers or live in different residential communities,” Kosieradzki said.

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Apparently, the Best Sex Won’t Happen in Your 20s

Jane Fonda has a word.

Jane Fonda has paved the way for fearless, sex-positive young women from fitness to self-love. But her stance on sexuality might divide younger crowds.

In a radio interview with Andy Cohen, Fonda revealed that sexual wisdom is real and it develops with age. She told host Cohen, “You know, we waste way too much time not wanting to say, ‘Wait a minute, hold, hold it, hold it. No, no, no. Slow down. And a little to the left” in fear of upsetting some partners. As young femme’s — especially those who were reared as women — we’ve been raised to prioritize the feelings of our male counterparts, even when it means neglecting our own.

According to Fonda, not being vocal about what you like is a recipe for the worst sex. In her experience, that kind of sexual wisdom and stellar communication came as she got older. “Women, I think tend to get better because they lose their fear of saying what they need,” she said. The concern with not emasculating cis male partners when providing feedback no longer takes precedence because pleasure becomes more important.

However, although Fonda is more sexually-wise now, she’s not currently open to partnered sex. Apparently, at this point in her life, she’s prioritizing solo sex and boldly shared, that she may be open to dating a younger man.

Want to hear more? Tap into Jane Fonda’s conversation with Radio Andy below.