We’re in Our 70s. This Is What Our Sex Life Is Like

“My sex life is better than at any other time, even during the ‘free love’ era of the 60s and 70s.”

by Mark Hay

Joel Kann, 70, knew he was aging when other grey-haired men started offering him their seats on the bus. Bonnie Nilsen, 71, knew it when she looked in the mirror one day and saw her mother. Still, neither of them ever felt old—like they’d gone through some major shift in their physical, mental, or sexual selves. But both say they’ve had people look at them, or hear their ages, and clearly instantly mentally write them off as desexualized beings.

That is not surprising given the fact that, for well over a century, American culture has embraced and perpetuated the idea that, as we age, our sexualities naturally wither away. As such, we rarely depict older people as sexual. When we do, it’s usually as a joke. The image of the sexless elder is so widespread that even medical professionals often omit older people in studies on sexuality and neglect to talk about sexual health during check ups. (Is it any wonder why STI rates among older adults are so high?) Perhaps the only time most people think about the intersection of sex and old age is viagra commercials—or when we hear reports about the (sadly common) phenomenon of elder caregiver and nursing home sexual abuse. And that is far from an affirming recognition of senior citizens’ sexual lives and selves.

As people age, their bodies usually do change in ways that affect sex. Those with penises tend to lose sensitivity. Their erections often get less firm and frequent and may take more stimulation to achieve or maintain, and their ejaculations are often weaker. Those with vaginas may take longer to get aroused and produce less natural lubrication, which can make sex less comfortable. Across the board, libidos tend to decrease and orgasms may feel less intense.

Non-sexual health conditions from arthritis to depression to heart disease can compound these issues, or lead to chronic pain, fatigue, or other symptoms that make sex difficult to have. Treatments for these conditions can likewise have side effects that take a toll on sex drive or capacity. On top of all of that, changes in skin appearance, muscle tone, and weight that often accompany aging can lead to body image issues that put a crimp in many people’s sexual confidence.

A few studies suggest that people aged 60 to 82 tend to engage in physical intimacy less often than their younger peers. Yet several studies also suggest that many older adults still have and value sex—some more than they did as middle-aged adults. Most sexually active seniors say the sex they’re having is as good as, if not better than, the sex they had earlier in life. (People often report they have more confidence and fewer distractions in life in general, freeing them up to truly focus on and enjoy sex.) Many older adults believe a vibrant sex life is important to their overall wellbeing. Quite a few also wish they could have more sex, and note that their sex lives are often limited not by health issues, but because they lack a partner.

In an effort to push back on the desexualization of older people, VICE recently spoke to Bonnie and Joel, who have been having sex with each other on and off since college and became a couple eight years ago, about how they navigate sex and sexuality in their 70s. Bonnie and Joel are the first to admit that they may not be typical seniors. The polyamorous and sexually adventurous couple recently had sex on camera for porn performer and producer jessica drake and sex educator Joan Price’s Guide to Wicked Sex: Senior Sex educational adult video. Yet for all that is unique about their story, it still touches on many experiences that will resonate with older adults of all stripes.

Bonnie: [When we first had sex in college,] we had this immediate connection—I don’t know what happened there. Part of it was sexual but there was something else going on there.

We actually only had sex twice [in college]: the one time at my apartment and the one time at your apartment when your wife was away. Our sex was the typical 20-year-olds looking at each other and ripping off each other’s clothes and falling off the bed [type of sex].

We stayed in touch on and off through the early 70s, but then lost track of each other.

Bonnie: In 2008 I put a couple of websites up about myself. I am a self-taught web developer. I guess he found me. [That fall I was 60 and] I went to the east coast for my father’s funeral and stayed at my brother’s house in New Jersey for a few weeks as we sorted through my parents’ house. And I invited Joel to come up. It was just immediate—I looked at him and said, “oh my god…”

Joel: I was living in North Carolina and she said, “do you want to come up and meet?” I thought really meet—go out for coffee. I showed up and she was standing outside with her overnight bag.

Bonnie: We’d already talked about getting a hotel room!

Joel: No, I don’t think so! And she jumped into my car with her bag and said, “Let’s go!”

Bonnie: We had one night together.

Joel: That was the first time that I had sex with you and you squirted. I’d never been with a women who squirted before. I was like, whoa, what’s this? I don’t know what it is, but it feels good.

Bonnie: Because Joel was still married, he backed off. He didn’t want to hurt his wife—totally understandable. He was, I think, kind of shocked that we had connected again. So for the next couple of years we stayed in touch on Facebook, writing emails to each other. Then in 2011, I was getting on with my life up in British Columbia and got a message from Joel saying, “Hey, would you be interested in going to a medical conference with me in Victoria, on Vancouver Island?”

Joel: I’d realized there was something there. I really liked her. My marriage was pretty much over. It was not an angry, terrible marriage. It had just died. I hadn’t had sex with my wife in almost 10 years. So I looked for a conference near her and Victoria was a close one. I said, let me see if she’ll come. We met up there and spent five days [together].

Bonnie: Which was amazing. We both fell in love again.

Joel: We met at the airport, went to the hotel lounge, said some nice things, then said, “okay, up to the room.” A soon as the door closed, clothes started coming off. We fucked over a chair by a window overlooking the parking lot and imagined that other people were looking at us.

We fucked twice that night, [then] once or twice a day [thereafter]. Bonnie started taking out lingerie and sex toys and rope and I said, “this is going to be interesting!” I ended up tying you to the rafters in the hotel room. [I was in my early 60s and] it was, I think, the first time I had anal sex in my life.

We both cried when we had to separate because we hadn’t really made any plans other than that. It was like: What are we going to do? This feels so good. We’re in love. Now I have to go back and decide if I’m going to leave my wife for you. And I eventually did. Then Bonnie eventually moved [to Raleigh, North Carolina] to be with me.

Bonnie: When we got back together [in 2008], our sex drive was good and the sex felt amazing. It still is. But it has changed.

I have had fibromyalgia for over 20 years and that hits you. You’re going through life in your 40s and suddenly [you feel like] you’re in your 80s. Everything hurts. If you turn or move too quickly, you’ll strain a joint. It can put me in bed for a day. But then get up the next day like, okay, here we go again.

Joel: As I’ve gotten older, I have joints that ache a bit more. I tend to ignore that. But certainly, I can’t perform on the same level as I did when I was younger. I’m not quite as acrobatic as I was.

And when you’re young, you can get several erections in a day, no problem. But as you get older, that gets to one a day, sometimes once every couple of days. If the stimulus is good, I can get them a couple times a day. But to ejaculate a couple times a day is rare. Sometimes [my erections] are a little soft, particularly if I’m using a condom or with new partners or having sex in public.

I’ve used Cialis and Viagra with new partners. But when Bonnie and I are together, I don’t have real problems [with erections]. Usually they are spontaneous, or [develop] with a little bit of stimulation.

will [sometimes] have an orgasm and no or little ejaculate will come out. [It’s called] retrograde ejaculation because of swelling in the prostate—the ejaculate goes into the bladder instead of out through the urethra. Then it slowly comes out the next couple of times you urinate. The first couple of times it happened, it was like, wow, what’s that?

Bonnie: My sexual desire is definitely lower than it was [as well]. I could have sex one time a week. But we usually wind up having sex two to three times a week. That’s usually because Joel approaches me. And that’s fine. I’m not being forced into it. I’m more like, oh, okay, this is fun.

Joel: Eight years ago, we were having sex every day, sometimes a couple of times a day. Even now that her libido has dropped a bit, Bonnie is still more sexual than any woman I’ve ever [been with], at any age.

Bonnie: I’ve been thinking lately that I hardly ever masturbate. I used to masturbate almost every day. If I reminded myself to masturbate more, it would probably get my sex drive up again.

Joel: I also enjoy when she masturbates, whether I’m there or not. Just hearing about it is a turn on.

Things are different. Sometimes it takes more planning to have sex. It’s not always spontaneous.

Bonnie: The biggest thing between us is that we communicate well and have a sense of each other.

Joel: She told me about her fibromyalgia and how when [an attack] hits you, you wouldn’t be sure whether you’d want me to touch you for a day—whether you’d want me to hold you or stay away. We talked about that a lot—how that doesn’t mean you’re rejecting me. She warned me when we got back together: “You’re starting a relationship with someone with chronic pain. Are you sure you know what you’re getting into?” As a physician, I’d dealt with people with chronic pain and chronic fatigue, but not personally—not on this level. So it was learning what to do, what works, what doesn’t work, and communicating a lot: “What position are you comfortable in? How are you feeling now compared to the last time we had sex? What are you up for? What are you not up for?”

Bonnie: For me, it’s been learning to say. “no, I’m not into it right now.” If Joel wants to have sex, I’d love to. But my body sometimes [doesn’t].

Joel: Or [she’ll say], “I need to be on my side.” Or, “I don’t know if I can be on top for long.”

I had to learn how to feel comfortable being the one who more often than not initiates sex, but [also to] not be afraid when she can’t or doesn’t want to [have sex]—to not take that personally. It helps that she has such a great libido and is so adventurous. It wasn’t like I wasn’t getting any sex.

Bonnie: We’ve basically tried everything. And we still do. Just a lot less [often than we used to]. We just recently went to a Halloween party in Durham. It was a BDSM party.

Joel: I tied her to a cross and flogged her in front of a bunch of people. And we were into swinging for a while. Then we got into polyamory—this fits us better, getting to know someone and bringing them into our lives rather than just a quick hookup and then never seeing people together again.

Bonnie: [I don’t have many sexual relationships with other people these days.] With fibromyalgia, it’s like: Here’s somebody else who’s going to have to learn what to do with my body. I don’t really want to get into that. But I’m fine with Joel having other partners.

Joel: My sex life is better than at any other time, even during the “free love” era of the 60s and 70s.

Bonnie: When you were hitchhiking and fucking everybody you met on the road.

Joel: [One thing we want to say to other older people is:] Don’t let preconceived notions define you. You don’t have to act a certain way just because you’re getting older. There are things that change. Try to understand, physiologically, what’s going on and how you can adapt to that.

If you can’t get an erection, there are many ways to please your partner. With your hands. With your mouth. You don’t have to concentrate on penis-in-vagina sex to have a good sex life.

Bonnie: People like us are out here saying, “you can still have a great sex life in spite of changes.”

Joel: In spite of aches and pains.

Complete Article HERE!

The 7 types of sugar daddy relationships

University of Colorado Denver

It turns out being Sugar Daddy isn’t a one-size-fits-all gig. While it occasionally lives up to the stereotype of a wealthy, middle-aged man lavishing gifts and money on a young woman in return for her companionship, there’s more to it in the U.S.

Drawing from 48 in-depth interviews, sociologist Maren Scull, PhD, assistant professor at University of Colorado Denver, has identified seven types of these “sugar” relationships: sugar prostitution, compensated dating, compensated companionship, sugar dating, sugar friendships, sugar friendships with benefits and pragmatic love.

The results of her study were published in Sociological Perspectives.

“Whenever I read an article about Sugar Daddies or Sugar Babies, I often saw the same sensationalistic slant: the women are desperate, starved college students engaging in prostitution,” said Scull. “As someone who studies deviance, I knew there were more important nuances to these relationships.”

Sugaring in the U.S.

Sugar relationships are based on companionships, intimacy or other forms of attention in exchange for personal benefit (financial support, material goods, professional advancement). These kinds of agreements are hardly new–in the 1750s, Geishas were seen as socially respected entertainers even though they were paid to amuse men, usually without sex. During the first two World Wars, soldiers paid women to join them for a night out of dinner and dancing.

But the bulk of modern-day research focuses on transactional and survival sex in sub-Saharan Africa, and compensated dating in East and Southeast Asia. There was a black hole of research in the U.S.

To understand how “sugaring” works in the U.S., Scull spoke with 48 women about their experiences as Sugar Babies. She explored the kind of activities the women were involved in, whether sex was involved and whether their lives were intertwined with their benefactors.

She found that 40% of the women had never had sex with their benefactors and the ones that did often had genuine, authentic connections with the men. She also found that most forms of sugaring aren’t a play-for-pay arrangement.

“I didn’t have the intent of creating a typology, but there was so much variety that I knew I had to highlight the different nuances and forms that sugar relationships can take,” said Scull.

The 7 types of sugar relationships

Scull labeled the first “sugar prostitution,” a form of sugaring absent emotion and purely the exchange of gifts for sex. “Compensated dating,” popular in Asia, involves a monetary or material compensation for grabbing a coffee, a meal or attending a specific event together. “Compensated companionship” involves wider scope of activities and often involve the woman becoming more intertwined in the man’s life. Neither compensated dating nor compensated companionship involves anything sexual for most people.

“Sugar dating,” the most common form of sugaring, combines the intertwined life of companionship with sex. In this case, most women receive an allowance on a weekly, monthly or as-needed basis. The sums could range from $200 to several thousands of dollars a month.

“Sugar friendships are a mutually beneficial relationships with someone the women consider a friend. In fact, these benefactors are often a part of the women’s lives already or soon become a part of it. “Sugar friendships with sexual benefits” is more unstructured. In some cases, benefactors pay for all living expenses for the women, including rent, cell phone bills, clothing, cars and vacations.

Finally, Scull found that some of these relationships involved two people who hoped to end up together, with the woman taken care of for the rest of her life, in a category she named “pragmatic love.”

“When we lump sugar relationships together as prostitution, it deviantizes and criminalizes these relationships,” said Scull. “We were missing how they are often organic and involve genuine, emotional connection. Many of the women didn’t intend on having a benefactor. They just happened to meet someone at work or during a catering gig who wanted to take care of them. These relationships can last decades.”

Why painful sex can plague women at any age

By Erin Blakemore

Your brain may be ready for sex. But what if your body refuses to cooperate? Women desiring intimacy with their partner sometimes experience pain instead of pleasure. Painful intercourse can happen even without other health issues — and it’s more common than you might think.

In a nationally representative 2013 survey, 1 in 5 women reported vulvar pain or discomfort during sex in the previous 30 days, and about 30 percent of women in a similar 2012 survey reported pain during their most recent sexual contact. Sometimes the pain is brief. But in others, it’s persistent.

Painful sex, known medically as dyspareunia, can have a variety of causes. Most affect women of all ages, although some women experience its onset during or after menopause. A variety of conditions, including endometriosis and a thinning of the vaginal wall, can be to blame — and sometimes, the pain has no discernible cause.

The pain can range from the discomfort of vaginal dryness to painful pelvic contractions or burning vulvar pain during penetration. Physical causes range. A lack of arousal or low estrogen can cause vaginal dryness and soreness. Infections or inflammation can lead to painful contractions of the pelvic muscles or burning pain during penetration. Birth control pills have also been linked with vulvar pain and uncomfortable intercourse.

Endometriosis, which is thought to affect up to 11 percent of American women of reproductive age, can be the culprit. In a nationally representative 2012 survey, 29.5 percent of women with endometriosis reported dyspareunia, too. The condition, which causes the cells that line the inside of the uterus to grow in other parts of the body, can cause bleeding, stabbing pain or cramping that can last for days after sex.

Other women experience vulvodynia: genital pain that burns, stings or throbs and makes sex uncomfortable or impossible. Although it’s correlated with past vaginal infections and pelvic floor weakness, the disease is still not well understood and there is no known cause. Treatments range from psychological interventions to pelvic floor therapy and vestibulectomy, a surgery that removes painful tissue along the vestibule, which surrounds the openings of the vagina and urethra.

A history of sexual trauma is also linked to painful intercourse, including genito-pelvic pain or penetration disorder. Previously known as vaginismus, the condition can involve painful vaginal spasms when something enters the vagina and is thought to be caused by a fear of penetration.

For many women, painful sex begins with menopause. During menopause, the ovaries produce less estrogen, the hormone that helps ensure vaginal lubrication and keep the lining of the vagina flexible and thick. Decreased estrogen can cause painful dryness, thin the vaginal walls and even shrink vaginal tissue. Those changes are known as vaginal atrophy. Vaginal estrogen therapy can help; so can vaginal moisturizers and the use of silicone-based lubricants during sex.

Azmia Magane, a 34-year-old social worker from Orlando, experienced painful intercourse early in her marriage. A variety of symptoms made sex challenging and, often, impossible. During and after sex, pain would shoot through her abdomen or radiate from her bladder. Sometimes, uterine polyps led to painful bloating after sex. And vaginal dryness made seemingly pleasurable acts feel more like torture.

In Magane’s case, endometriosis, polyps and other chronic health challenges were to blame. Vaginal dryness was one of the biggest obstacles between her and physical intimacy with her new husband, she says. “It just feels like shards of glass,” Magane says. “It’s very, very uncomfortable.”

Painful intercourse can affect self-esteem, body image and relationships. But despite its prevalence and importance, says Leah Millheiser, its highly personal nature means it can go unspoken and untreated. Millheiser, a clinical assistant professor at Stanford University and director of the female sexual medicine program there, says social taboos can get in the way of diagnosis and treatment.

“Some people are just uncomfortable talking about that area,” she says.

No matter the cause, self-esteem and relationships can start to hurt along with sexual intercourse. In a 2014 survey, 58 percent of postmenopausal women with vaginal discomfort said they avoid intimacy; 78 percent of their male partners agreed. Thirty percent of women surveyed said vaginal pain caused them to stop having sex entirely.

“It has caused some strain on my relationship,” Magane says. “It can really destroy your self-confidence.”

Silence in the doctor’s office can make matters worse, delaying treatment or causing women to seek out unproven treatments on their own.

“[Doctors] need to learn to step outside of our comfort zone and really address the issue of sexual function with our patients,” Millheiser says.

The conditions that can make sex painful are common — vulvovaginal atrophy, for example, affects up to 50 percent of postmenopausal women. Yet only 7 percent of women receive treatment for the condition.

Women who experience uncomfortable sex may also feel uncomfortable bringing up their complaints during a routine appointment. Doctors can share that discomfort, or not think to ask about sexual health, Millheiser says.

They can also minimize or ignore symptoms of sexual pain. It can take years for patients to receive a diagnosis of conditions that affect sexual health; with endometriosis, for example, patients wait an average of 6.7 years.

That’s what happened to Magane, who experienced excruciating pain, unsympathetic providers, and a botched laparoscopy before she was diagnosed with endometriosis. She recommends that women look for sympathetic providers — and that they insist on answers.

“I know my body,” she says. “I am an expert in my body. [Doctors] may have a medical degree, but I’ve lived in my body for 34 years and I know what’s normal and what is not. Painful intercourse absolutely is not normal — sex shouldn’t hurt.”

Millheiser says women shouldn’t suffer in silence. Patients may not think painful sex is worth bringing up, or worry that they’ll offend their health-care provider by discussing sex.

These days, Magane supplements her treatment with meditation and yoga. She has found some relief through pelvic floor therapy, too. It’s a form of physical therapy that can reduce pelvic pain and make physical intimacy more pleasurable.

“I actually had my husband come to one of my appointments,” she says. “It kind of gave him a visual of what I was going through.”

Although her ordeal has been painful, she says it has reminded her that “intimacy is about more than intercourse. Continuing to nourish the other intimate aspects of your life is important.”

Nonetheless, she says, women should experience everything their bodies are capable of. “Sex is a really important part of the human experience,” she says.

Millheiser agrees. “Sexual health is as important as any other part of your health. It’s about relationships. It’s about self-esteem.”

And luckily, she says, “there are effective treatments out there.”

Complete Article HERE!

Sex in 2019

Your guide to safety

By Dr. Lisa Lanning

Older adults live longer now than in previous generations. In 2019, retired adults might have 20 or 30 years of life ahead and might find they have a lot more free time and freedom than they did when younger.

In your case, perhaps you have lost a spouse or a previous relationship has ended. Perhaps you haven’t dated in a long time, but now you’ve met someone new and are considering becoming physically intimate with that person.

What should you know to keep your own health in great shape and reduce the risk of serious sexually transmitted infections (STIs)?

Use it or lose it: Health benefits of an active sex life

Many older adults crave the physical and emotional closeness of having a regular sexual partner. As we age, it’s common to lose partners to disease, death and divorce, and many older adults grieve the loss of their previously active sex lives.

It is understandable that when one loses a partner, he or she would still desire to express their sexual feelings, and it’s entirely natural to seek a new partner.

Most adults in our culture recognize that sex is an effective way to reduce stress and improve overall well-being. Baby Boomers – those born between 1946 and 1965 – reached maturity during the 1960s-1980s, a much more sexually liberated period than the formative years experienced by their parents and grandparents.

Many vibrant older adults equate better health with better (and more) sex and expect to have sex well into their golden years.

A 2007 New England Journal of Medicine survey of 3005 seniors’ sexual activity found that:

Three-fourths of seniors ages 57-64 were sexually active.
More than half of ages 65-74 were active.
More than one-fourth of those 75-85 years old remained sexually active.

So how do we navigate finding a new, healthy and safe partner later in life?

Older is not (necessarily) wiser

Although older adults are having more sex and with more partners, they are not necessarily protecting themselves from infections. The advent of drugs designed to treat erectile dysfunction and other performance-based sexual disorders has increased the opportunity to participate in sexual activity while also increased exposure for men and women to STIs.

Studies show that many older adults do not use condoms, and physiologic changes in the aging body (such as vaginal dryness and thinner vaginal tissue) increase the likelihood of injury and tear from sexual intercourse and other sex play. This can increase the risk of receiving and transmitting an STI. Men who have sex with men and women who have sex with women are also at risk of STIs and need to be aware of how to protect themselves and their partners while enjoying their sex life fully throughout their life span.

What’s the risk?

Something we don’t often discuss is that part of the natural aging process is a less robust immune system. Older adults are often prescribed medications that also suppress the immune system including many arthritis medications and other medicines for chronic conditions.

Seniors are also more likely to have diabetes, heart disease and chronic kidney disease which increases the chance of picking up an infection.

Between 2007 and 2014, diagnosed cases of syphilis increased 52 percent among older adults, cases of chlamydia increased 32 percent and new diagnoses of HIV also increased according to a global STI study on emerging challenges to senior health.

That same report found that between 2007 and 2014, 24 percent of HIV-positive persons were more than 50 years old, and more than 15 percent of new HIV/AIDS diagnoses were among adults over 50. It’s also notable that, according to an American Journal of Public Health article, the risk of STIs is higher among recently widowed men than for women ages 67-99.

It’s time to be smart. We can no longer follow “Don’t ask, don’t tell” when being sexually active as older adults. Ignorance is truly dangerous and can be lethal.

If you are concerned that you might have been exposed to an STI, please bring it up with your primary care provider. We aren’t very good mind readers, and while we SHOULD ask about your sexual health, studies show we don’t ask nearly as often as we should, and patients don’t bring it up either.

How can you decrease your risk of contracting an STI?

Condoms help – both the everyday male condom and the less well-known female condom. These barriers reduce exposure to potentially infectious body fluids and protect the delicate older tissues. Lubricants help reduce trauma to sexual organs by decreasing friction and thus tears and other injuries that can increase the likelihood of developing an infection after sex.

It’s also important to simply TALK ABOUT IT! Although these can be uncomfortable conversations, it’s critical that older adults embarking on sexual relationships have “the talk” with their partners.

Here are a few key points:

  1. Be nonjudgmental and approachable. Just ask: How is your sexual health? Let’s face it – you’re preparing to share something extremely intimate and satisfying together – it will be better if you can discuss your past experiences openly. Feel free to ask about past infections or other sexual health concerns and how you plan to manage the risk of future infections.
  2. Go get tested together. See your family doctor, internist, OB/GYN, PA or NP. Ask for advice. A little-known fact is that Medicare covers screenings for STIs, although less than 5 percent of seniors take advantage of this benefit.
  3. Laugh about it. Share freely with your partner what you do and don’t like. Don’t compromise your values. If you are both open to new experiences and trying something you haven’t tried before, go for it!
  4. Learn about sex! We are never too old to learn something we didn’t know yesterday. The internet is a fantastic resource, although it can be overwhelming. A particularly excellent website is the American Sexual Health Association, ashasexualhealth.org.
  5. Lastly, check out this entertaining and educational rap video by family doctor Shannon Dowler, “STDs Never Get Old”  You can share it with your partner to help you start a conversation.

Complete Article HERE!

Overcoming intimacy challenges after 50

By Julie Pfitzinger

Confidence: “The quality or state of being certain.” That’s the Merriam-Webster definition, but for many people who are starting to date again after 50, confidence can falter and it can be difficult to be certain about anything.

For those who have lost a spouse or partner to death, divorce or a break-up, a feeling of being vulnerable may begin to settle in, leading to concerns about finding intimacy, as well as about when and how to fully open up to another person.

In the Dating After 50 series on Next Avenue, we’ve covered several topics including online dating and dating etiquette, which have provided tips and suggestions for the “how” on ways to start dating again.

But there’s another kind of how — how to make yourself emotionally, and physically, available to someone new. Taking a risk to share yourself and everything you have to offer at this stage of your life. Accepting and acknowledging what potential partners are offering you. Being confident about what will happen next. And knowing that even though it might not be easy, you are certain that you are genuinely ready to find fulfillment and happiness with another person.

Are You Ready to Move On?

Experts like Lisa Copeland, an author, speaker and dating coach in her fifties, say the first step to tackling that feeling of vulnerability and to start building confidence is to properly grieve the end of a marriage or relationship, whether through a break-up, divorce or death, before you even think about moving on.

For those who have divorced, Copeland says the best way to tell if you are truly ready to date is to gauge if “you’re feeling fairly neutral about your former partner.” She notes, “If you don’t feel that way yet, you are going to bring that [experience] right into the new relationship.”

The situation is different for widows or widowers. “If they had a good marriage, they are wanting to repeat the same relationship with a different person,” Copeland says. The lost spouse is also often brought into a new relationship, but that person frequently becomes “like a saint,” she says, which can be counterproductive to establishing an authentic connection with another person.

Before opening yourself up to dating, start by building a new social circle. The first step, says Copeland, is “to get out of the house.”

“Make friends. Take classes. Get involved with activities. When you are involved in doing things you love, you will light up,” she explains.

Taking that first step to put yourself out there can be uncomfortable. Copeland is a big fan of Meetups, which she says are “an amazing way to connect with others.” In her view, going into a Meetup gathering with a mindset of simply making new friends is best.

“If you meet someone, that’s just a bonus,” she says.

Different Ideas About Sex

Fast forward a bit: You’ve met someone, the two of you have found common ground and the relationship is progressing well. But what comes next could produce the biggest crisis of confidence you’ve had, well, in years: the thought of a sexual relationship.

“People often approach sex with very different ideas,” says writer and speaker Walker Thornton, who is in her 60s and the author of Inviting Desire: A Guide for Women Who Want to Enhance Their Sex Life. “The basic question most everyone starts with is: ‘Am I going to get naked with this person? And then what do I do?’”

The first roadblock is often body image, which Thornton says is typically more of an issue for women than men, although men are definitely not immune to concerns.

“Women are more concerned about sags and folds,” she says. “But men are worried about getting an erection or about satisfying a woman.”

When it comes to sex, Thornton encourages women “to share the valuable information” they have about what they like and don’t like with a partner.

“What we desired at thirty is different from what we desire at fifty,” she says, adding that she understands that for many women, the conversation about likes and dislikes is uncomfortable.

“But if you can’t even ask [a partner] about sex, how are you going to do it?” Thornton wonders.

The Myth of STDs and STIs

One particular conversation that is vitally important is around the topic of STDs and STIs, explains Thornton, and it really is non-negotiable.

“Here’s the simplest way to couch that conversation: I care about your health, so I will be tested. If you care about my health, I ask you to do the same,” she says. “Offer to send him or her a copy of your test results and ask them to send theirs in return.”

The conversation shouldn’t stop there. Thornton goes on to say that if a partner is unwilling to use a condom, for example, “they aren’t showing you that they respect your health and well-being.” If that is the case, Thornton says, “be prepared to say ‘No’ to sex, and say that this refusal makes you question their commitment to being in a relationship.”

It’s a myth that older adults don’t get STDs or STIs such as syphilis and gonorrhea; condoms can protect from genital herpes, which while not life-threatening, can be very uncomfortable and more so for women than men, says Thornton.

Make a List of What You Need

Other health issues may also come into play in sexual relationships between older adults. “Sometimes, you have to broaden your definition of sex,” says Thornton. “Focusing on pleasure, in ways inclusive of orgasm or not.”

Chronic illness can be an issue, as can cancer treatment, which often results in hormonal changes; other challenges may include fatigue or muscle/movement problems. “That can lead to a discussion about a time of day that’s better for sex, or accommodations that are needed for a bed,” explains Thornton. “Again, the best way to address all of these issues is through conversation.”

Thornton, who most frequently speaks to groups of women, often suggests making a list of just what you are looking for when it comes to a sexual relationship in midlife and beyond.

“If you have sex with someone, do you anticipate that this will be an exclusive relationship? Or if your partner decides he or she doesn’t want a sexual relationship, is that okay? Maybe it is,” says Thornton. “For you, is sex merely a goal or a natural progression of becoming intimate with another person?”

‘You Have More Freedom’

Copeland, who has been divorced twice and is now in a relationship, says there is often healing to be done before people are ready to fully open themselves up to a new person. Still, she adds, it’s vital “to know your value and know that you are worthy of someone.”

“One thing that’s often overlooked when it comes to dating after fifty is that you have more choices. You have more freedom than you did when you were younger,” she says. “You can have companions or lovers, or be in a committed relationship.”

However, Thornton — also divorced and in a relationship — understands how some might not perceive this place in life as a place of freedom.

“If we think our time is limited, we can feel more vulnerable,” she says. “But it’s really all about going into dating with an open attitude. Be willing to take the risk.”

The biggest reason older women have less (enjoyable) sex

Just 22.5% of women over 50 surveyed were sexually active

by

Women are more likely than men to be affected by age-related sex issues — challenges like hot flashes, night sweats, and vaginal dryness.

Now, a new study by the North American Menopause Society reveals a major reason for women having less sex as they age: the lack of a partner, most often because of widowhood.

In fact, just 22.5% of postmenopausal women surveyed were sexually active. And of the 65% who did have significant others, just over 34% were sexually active in the past 30 days.

The study looked at roughly 4,500 women in the United Kingdom who were enrolled in a trial for ovarian cancer screening. As the trial continued, the women reported having less sex and that it was less enjoyable over time.

Only 3% of participants described positive sexual experiences, whereas only 6% sought medical help for sexual problems, despite the availability of effective therapies, ScienceDaily.com reports.

Most studies look at the physical reasons for a decline in satisfactory sex during and after menopause (usually captured from a checklist of complaints). This one instead examined free-text data to try to understand why women feel the way they do about sex.

“Sexual health challenges are common in women as they age, and partner factors play a prominent role in women’s sexual activity and satisfaction, including the lack of a partner, sexual dysfunction of a partner, poor physical health of a partner, and relationship issues,” NAMS medical director Dr. Stephanie Faubion wrote.

And there are a variety of psychosocial factors that come into play, too: body-image concerns; self-confidence; and perceived desirability, stress, mood changes, and relationship issues. The study also cited how their partner’s physical condition, as well as their own health, played a major role.

The bottom line: Having an intimate partner with whom you share good physical health are key to sexual activity and satisfaction.

Complete Article HERE!

Do You Need Pelvic Floor Physical Therapy?

by Vanessa Marin

You’ve probably never heard of pelvic floor physical therapy before, and that’s a shame: It’s an extremely helpful treatment option for a variety of difficult medical conditions. Your pelvic floor drapes across your pelvic area like a hammock, and supports the pelvic organs (the uterus, bladder, and rectum). It also assists with urinary and anal continence, and serves a role in core strength and orgasm. People of all genders have a pelvic floor.

To help me learn more about pelvic floor physical therapy, I spoke with Heather Jeffcoat, a physical therapist and the owner of Femina Physical Therapy in Los Angeles, and author of Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve. Here’s what you need to know about pelvic therapy and how it can help you.

How pelvic floor physical therapy works

A lot of things can weaken the pelvic floor, including pregnancy, childbirth, and aging, resulting in pelvic pain as well as bladder, bowel, and sexual dysfunctions.

The first step of pelvic floor physical therapy is gathering the client’s history, ascertaining their goals, and providing education about how the pelvic floor works. This is followed by a manual examination. From there, physical therapists use a combination of manual therapy, pelvic floor exercises, biofeedback, and/or vaginal dilators. Patients are seen for regular appointments, and are given exercises to complete at home.

 
You can find therapists by searching American Physical Therapy Association and the International Pelvic Pain Society. Many PTs, including Dr. Jeffcoat, also offer telemedicine appointments if you’d prefer to get started that way or you can’t find a PT in your area.

What pelvic floor physical therapy can treat

Pelvic floor PT can be effective at treating a wide array of conditions, including:

  • Painful sex
  • Pain with tampon insertion or OB/GYN examinations
  • Vulvar pain
  • Vulvar itching
  • Urinary urgency and frequency
  • Recurrent UTIs
  • Urinary incontinence
  • Bowel incontinence
  • Pelvic and/or lower abdominal pain

Dr. Jeffcoat says, “I like to tell physicians that if they have been searching for a cause of someone’s pain between their ribs and their hips/pelvis and they have been medically cleared, they should be referred to a skilled PFPT.”

Pelvic floor PT can also be used to prepare transgender patients for gender confirmation surgery, and to facilitate healing post-surgery.

Pelvic floor physical therapy and sexual pain

Recently, researchers at the Center for Sexual Health Promotion at Indiana University found that 30% of women experienced pain during their last sexual encounter. Even though sexual pain is widespread, it often takes a very long time for a woman to get diagnosed with a sexual pain condition. I have heard horror stories from clients who were told by their doctors that their pain was “all in their head” or that they needed to “just have a glass of wine.” I’ve heard of doctors recommending a shot of alcohol or an anti-anxiety medication right before sex. Dr. Jeffcoat has heard the same stories, and says most traditional physicians are ill-equipped to deal with sexual pain even though the reality is that there’s almost always a physical cause.

If you try to talk to your doctor about your sexual pain and get met with an infuriating response like “just relax,” finding a pelvic floor physical therapist in your area could be a much better bet. A good PT will work with you to uncover the root of your pain and discomfort, and develop a targeted game plan for relief. I’ve worked with a lot of clients with sexual pain, and they’ve all sung the praises of pelvic floor PT.

Keeping your pelvic floor in shape

Even if you’ve never heard of pelvic floor physical therapy before, you’ve probably heard about the field’s most popular exercise: kegels. There has been an explosion of articles about kegels (also known as PC exercises) in the last few years, and there are also a ton kegel trainers on the market purporting to help you get your kegel muscles into tip-top shape. Kegel exercises can have great benefits, including stronger orgasms and greater urinary control. But Dr. Jeffcoat advises a bit of caution. She shared that about half of all women are doing kegels incorrectly, and around 25% are doing them in a way that could make their other symptoms worse. She’s not a fan of vaginal weights or trainers because, she says, they can worsen incorrect form.

Dr. Jeffcoat says that if you’re currently experiencing sexual pain, urinary urgency or frequency, bladder pain, urge incontinence, constipation, rectal pain or any pelvic pain, avoid kegels and check in with a PT first.

If you don’t have bowel or bladder symptoms, Dr. Jeffcoat recommends doing a mix of longer holds and shorter pulses. To find your PC muscles, cut off your flow of urine before your bladder is empty. The muscles that you have to use to do so are the ones you want to target. For the longer holds, gently squeeze your PC muscles for 3-5 seconds, then gradually release. For the shorter pulses, squeeze your PC muscles, then immediately release. If you want to ensure you’re doing kegels correctly, or want a customized game plan, definitely check in with a PT.

If you feel embarrassed about what’s involved in pelvic floor PT

Yes, your PT will be directly manipulating your muscles through the walls of your vagina or anus. But Dr. Jeffcoat assured me that a good pelvic floor physical therapist is passionate about their work, and about helping their clients feel comfortable. Pelvic floor issues are very common, and PTs want to help remove the stigma around getting help. Dr. Jeffcoat’s standard initial visit is 90 minutes, a good chunk of which is spent talking and helping you feel more comfortable. You also have the option to postpone the physical examination until a later session.

It may also help to think about the positive effects of pelvic floor physical therapy. I asked Dr. Jeffcoat about some of her favorite patient success stories, and she told me about seeing patients consummate their marriages for the first time ever. One case was after 19 years of marriage. She also wrote, “I’ve had so many women that are able to get pregnant without fertility treatments because they can have pain-free sex. I’ve seen women gain a new sense of empowerment by reaching a goal they truly never thought would never happen.” There can also be something incredibly validating about knowing that the pain isn’t “in your head.” The bottom line: pelvic floor physical therapy can be life-changing.

Complete Article HERE!

Sex: Getting back in the saddle after a dry spell

What to do, what not to do, and what to stop worrying about

Let’s talk about sex.

More specifically, let’s talk about getting back in the groove after taking some time off. Becoming sexually active again after a dry spell can seem intimidating, confusing, or even embarrassing.

Whether the time away from the bedroom was the result of the passing of a partner, menopause, or just a natural decrease in libido, it’s easy to jump to imagining a world without any sex going forward.

But for older women who want more, a gap in sexual activity certainly doesn’t have to mark the end of the road.

Just because it’s been underrepresented in popular culture, assuming that older people aren’t interested in sex is incorrect. Indeed, it can be downright dangerous if the health concerns associated with sex aren’t addressed in people over a certain age.

For women, it can be especially embarrassing to try to discuss sexual health with doctors, but it’s important to engage in any sexual activity safely and healthily.

In a recent poll conducted by the University of Michigan Institute for Healthcare Policy and Innovation, 40% of people aged 65 to 80 said they’re sexually active, with plenty of older people reporting that sex has only gotten better as they’ve aged.

So what should older women keep in mind if they’re ready to jump back between the sheets?

As Dr. Kameelah Phillips, an obstetrician/gynecologist in New York, told Considerable, “It is important that women prepare themselves to have sex before jumping right in. Often menopause has changed the vagina, and sexual experiences can be uncomfortable. This discourages further exploration.”

Instead of becoming discouraged if sex is initially different than it was pre-menopause, Dr. Phillips recommends that older women take some time to become reacquainted with their bodies and their sexuality.

“I highly encourage women to use lubrication,” she said. “I especially like silicone or hybrid lubrications to decrease friction. I also encourage them to masturbate, [which] can be quite taboo in the senior population. This helps return blood flow to your pelvis, especially to the vagina and clitoris. It can also alert you to any narrowing the vagina has experienced. Self-pleasure also helps remind women that intimacy with a partner can be pleasurable.”

Dr. Anika Ackerman, a urologist in New Jersey, has a lot of older female patients who are sexually active. She has some recommendations about what to do when topical and over-the-counter lubricants aren’t cutting it.

“The tissues of the vagina are thinner after menopause when [women] no longer have the female sex hormones,” she explained to Considerable. “[This] can lead to pain with intercourse. Topical estrogen creams are helpful in these cases to revitalize vaginal tissues. We also have CO2 lasers for vaginal rejuvenation. These treatments, like the estrogen cream, increase vaginal lubrication, restore vaginal epithelium, and increase tissue thickness.”

Medical professionals acknowledged that many women’s libidos decrease after menopause — but they emphasized that sexuality doesn’t always switch on and off. As psychotherapist Jacob Brown told Considerable, “Just because [post-menopausal women] may not want to do it as often doesn’t mean [they] don’t want to do it at all.”

At any age, sex can be difficult to discuss, especially for people experiencing pain or discomfort. But as Brown put it, “Open and honest communication is the most effective tool for working through changes in sexual experiences as we age.”

And on the upside: A lot of insecurities of youth are long gone, and if an older person is revisiting sex with a partner they’ve been with for decades, they ideally have the advantage of years of trust built with that person.

And though pregnancy is no longer an issue after menopause, it’s important for older people to remember to practice safe sex and use protection if they have a new partner or partners. The risk of STDs and STIs is still very much present — in fact, these diseases are rampant in assisted-living facilities.

Sex is a healthy and fulfilling part of many older people’s lives. While navigating new physical challenges like achy joints or decreased libido might make sexual activity trickier than it was in younger years, these hurdles don’t mean that a fulfilling sex life has to be a thing of the past.

Communication about any aches or concerns with both a doctor and one’s sexual partner is key, and will lead not only to healthier sex, but a better experience for both parties involved.

Complete Article HERE!

5 Ways Seniors Can Get Back To Having Great Sex Lives

By Kelly Gonsalves

Sex is good for your health, and some research suggests it might be particularly beneficial to older people: It keeps your body physically active, keeps the mind sharp, encourages intimate connections with others, and instills a sense of joy and excitement into your life.

Despite the cornucopia of benefits, we don’t talk a lot about seniors having sex. Part of it simply has to do with cultural narratives about sexuality: The dominant image we all carry of what sex “looks like” (as told to us on screens big and small) always involves people who are young, thin, able-bodied, physically fit, and conventionally attractive. The lack of representation or conversation about other types of people having sex contributes to an unspoken assumption that those folks just aren’t doing the deed.

But the truth is, racking up years doesn’t mean your sexual needs automatically vanish into thin air. Sure, your sexual preferences and appetite might shift as you get older, but there’s no reason to believe all people over the age of 60 just suddenly prefer celibacy.

Are 60-year-old, 70-year-old, and older people sexually active?

Yes! They certainly can be, and many are. The 2017 National Poll on Healthy Aging found 40 percent of men and women between ages 65 and 80 are sexually active. Among people in relationships, that rate bumps up to 54 percent. Some studies suggest there might be differences between men’s and women’s sexual interest: One U.K. study found 60 percent of men between ages 70 and 80 are having sex, compared to 34 percent of women in that age group. That said, women over 70 years old report that their sex lives are way more pleasurable now than when they were in their 40s.

Of course, some people as they get older do just become less interested in explorations of the flesh. For many, that has to do with health: Your hormones, sexual responses, and general physical condition may shift with age, making some sexual activities a lot more difficult or just exhausting than they used to be. For others, losing a spouse to death or divorce later in life can also make sex seem less enticing or accessible.

Other than consent and physical safety, there are very few “shoulds” when it comes to sex. If you want to be having sex after 60, 70, 80, or 90 years old, you have every right to pursue an enjoyable and fulfilling intimate life.

The importance of talking about your sexual needs.

A recent study published in the journal PLOS ONE found nearly 60 percent of older people are unhappy with their sex lives. One big reason why? They weren’t talking about it. But those who had asked for support from others, from their doctor to their spouse, were much more likely to be sexually active and sexually satisfied.

Here’s the thing: Most things in life get easier the more we talk about them. When it comes to sex—something that carries so much stigma on its own, let alone the added invisibility of seniors having sex—talking becomes especially important. Moreover, if physical ailments, a sense of isolation, or something about your environment is keeping you from having the sex life you want, it’s important to seek help from others. There’s absolutely nothing shameful about advocating for your sexual well-being: It’s a vital part of your physical, mental, and spiritual health.

If you’re of a certain age and looking to reconnect with your sexuality or simply give a little more attention to your sex life, here are a few ways for you to get started:

1. Ask your doctor.

Especially if you’ve got a lot of other health problems to deal with, your sex life might feel like a pretty low priority and perhaps nor worth bringing up at your next doctor’s appointment. But the truth is, your doctor knows your health condition well and can offer up specific suggestions for how to help improve your ability to have sex, whether that’s prescribing medications or adjusting your health plan in a way that keeps your sexual functions thriving.

2. Find a sex therapist or other professional who works with people in your age group.

If talking to your main health care provider doesn’t feel right to you or doesn’t bear a lot of fruit, try a sex therapist or another professional who can help you feel comfortable and safe exploring your sexual needs. You might be surprised what kinds of services exist out there—sex coaches, sex educators, tantra teachers, sexual healers, some doulas, and many other professionals can all guide you and give you support exploring this part of your life.

3. Open up to your friends and romantic partners about sex.

Communication about sex, both with your partner and with others, can lead to a more satisfying sex life. If you have a romantic partner right now—even if it’s someone you’ve been with for decades—consider speaking with them about how they feel about your sex life right now and whether they’d be interested in reprioritizing it. Tell them what you’ve been thinking about, what the health benefits are, and ways that you’d like to start dabbling in this area again.

Additionally, talking about sex with your friends has been shown to improve sexual confidence and sexual self-efficacy. As you develop comfort talking about this intimate part of your life, you’ll also find it easier to talk about your needs and ask for what you want.

4. Find a community or retreat to help you explore.

If you don’t have close friends who you want to share this stuff with, seek open-minded communities of people in your age group with whom you can engage in more dialogue about sex. Intimacy retreats and workshops can be a great way to learn, reconnect as a couple, and find others who are on a similar journey. (Bonus: If you or your partner feel uncomfortable, embarrassed, or shy about the idea of exploring sexually, these types of events can be very welcoming, approachable spaces to help you open your mind, get more comfortable, and shed some of your apprehensions.) If you’re not sure which events are right for you, you can always reach out to the organizer to get a sense of the target age groups.

The internet is also a vast and wonderful resource for finding such communities in your neighborhood: Google around, look through Meetup.com, or post in social media spaces you feel comfortable with. You can also try asking people in real life who are your age to see what resources they know about. While putting this article together, I spoke with several people who run private groups in their own neighborhoods for discussing senior sexuality.

5. Do some reading!

There are many excellent resources that can provide you with endless ideas, inspiration, and resources about exploring your sexuality at any age. Try these for starters:

6. Expand your definition of what sex means.

This one’s important! As we get older, some types of sex that might’ve been exciting in the past are just less feasible—but that doesn’t mean all sex now needs to be off the table. For example, if sex in the past meant a lot of thrusting and acrobatics, consider exploring other types of sexual expression and activities: Focus totally on using your hands, arms, and mouths, for example, to give and receive pleasure. Plenty of sexual acts will still yield those blissful neurochemical rewards. Cuddling is associated with significantly more sexual pleasure and more sexual satisfaction, for example, and even the brain can be a sex organ. Reading, watching, and creating erotica can be excellent ways to stimulate sexual energy.

There are so many ways to share passion, intimacy, and pleasure, both alone and with a partner, that have little to do with making the headboard shake. Find something that fits with your lifestyle, abilities, and interests.

Complete Article HERE!

We Need To Talk More About Older People’s Sex Lives

— Here’s Why

By Kelly Gonsalves

People in their senior years deserve satisfying sex lives just like anyone else, but oftentimes a combination of physical impediments and social stigmas can get in the way of being able to pursue that. A new study published in the journal PLOS ONE found nearly 60 percent of older people are unhappy with their sex lives, and the researchers are urging health care providers to step up to the plate when it comes to helping this age group with their most intimate needs.

What stands in the way of older people having a great sex life?

Researchers analyzed health and lifestyle data on over 3,000 people between ages 55 and 74, in addition to interviewing them in person to get a sense of what their sex lives were like and what factors affected it. They found 54 percent of women and 62 percent of men were sexually active in the past six months, and 42 percent of men and women reported being satisfied with their sex lives.

What separated people with happy sex lives from those with less fulfilling ones?

Some findings were fairly obvious: The folks who had been having sex were more likely to say they were happy with their sex lives, and people in steady relationships were way more likely to be having sex and to be sexually satisfied, as were people who reported being in good health. Indeed, 27 percent of men and 17 percent of women reported having a health condition that impaired their sex lives.

The most important finding? Older people who had support from others regarding their sex life were much more likely to be sexually active (and thus satisfied). For men, being able to use medication to boost their sex life made a big difference. For women, “finding it easy to talk to their regular partner about sex” made them more likely to have it. For both men and women, seeking advice and getting help regarding their sex life also tended to boost their sexual activity—yet just one in four had actually done so.

“We identified that not many people who reported experiencing problems or lack of satisfaction sought help,” said Bob Erens, lead author of the study and a researcher and professor with the London School of Hygiene & Tropical Medicine, in a news release. “Although this could be an individual choice or because of a perceived lack of support, it is vital that individuals feel able to make enquiries with health care professionals. In particular, discussing problems can often lead to identification of underlying medical conditions.”

Sexual satisfaction is important for your health—especially for older adults.

Sex comes with loads of physical and mental health benefits: It reduces your risk of heart attacks and certain types of cancer, boosts your memory and other cognitive functions, reduces your blood pressure, strengthens your immune system, and can actually make you live longer. For older adults especially, a lot of those are precious assets.

Cardiologist and mbg Collective member Joel Kahn, M.D., all but prescribes sex for optimal health: “Although discussing frequent sex may bring up issues of legal, moral, and religious guidelines—not to mention other health concerns associated with sex itself—the act itself appears to be quite healthy and possibly a path to extending life span and avoiding common diseases,” he writes at mbg. “The ability to successfully engage in sex and orgasm indicates a healthy cardiovascular system, and it can be a form of exercise.”

There’s also the social component: Sex makes you get intimate with others and floods your system with bonding hormones, all of which can make you feel closer to your partner and reduce feelings of loneliness. Past research has found having sex improves older adults’ well-being, making them have more joy in their lives.

Sex is for everyone.

It’s important to note that some older people (like people of any age) aren’t having sex because they don’t want to be having sex. Indeed, for women in particular, the study noted, “Health problems provided a welcome respite from sex.” If that’s you—more power to you! No need to push at something you’re just not interested in.

But if your age, health, or stigmas about older people having sex have deterred you from exploring your intimacy, there’s no time like the present to change that. Talk to your doctor or any trusted health provider about your sexual needs. Many people in the study mentioned feeling like they had so many other health problems to worry about, and they didn’t want to bother their doctor by asking about sex. Nonsense! Your sexual well-being is a part of your health, no matter your age, and having a satisfying sex life can contribute to your overall physical, mental, and relationship well-being.

If you’ve got a health problem that’s been making sex difficult for you, talk to your doctor about the options—or find a sex therapist, sexual healer, or other professional you trust to talk through your intimacy needs. Everybody deserves to have a satisfying sex life, whatever that might mean for you.

Complete Article HERE!

Sexual satisfaction among older people about more than just health

Communication and being in a happy relationship, along with health, are important for sexual satisfaction among older people, according to new research published in PLOS ONE.

Sexual expression is increasingly recognised as important throughout the life course, in maintaining relationships, promoting self-esteem and contributing to health and well-being. Although are being urged to be more proactive in helping achieve a satisfying sex life, there is a distinct lack of evidence to help guide practitioners.

Led by the London School of Hygiene & Tropical Medicine (LSHTM), the University of Glasgow and UCL, the study is one of the first to look at how health, lifestyle and relationship factors can affect sexual activity and satisfaction in later life, and examine how people respond and deal with the consequences.

The researchers carried out a mixed methods study combining from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) and in-depth interviews with older men and women. Out of nearly 3,500 people aged between 55-74, the survey found that one in four men and one in six women reported having a health problem that affected their sex life. Among this group, women were less likely than men to be sexually active in the previous six months (54 percent vs 62 percent) but just as likely to be satisfied with their sex life (42 percent vs 42 percent).

Follow up interviews with a sample of participants revealed that older people found it difficult to separate the effects of declining health from those of increasing age. Ill health impacted sexual activity in many ways but most crucially it influenced whether individuals had a partner with whom to have sex. Some older people were more accepting of not having a sex life than others.

For those in a relationship, was strongly associated with both the quality of communication with their partner and contentment with their relationship. The impact of health issues was not always negative; some men and women found themselves having to experiment with new ways of being sexually active and their sex lives improved as a result.

Natsal-3 is the largest scientific study of sexual health and lifestyles in Britain. Conducted by LSHTM, UCL and NatCen Social Research, the studies have been carried out every 10 years since 1990, and have involved interviews with more than 45,000 people to date.

Bob Erens, lead author and Associate Professor at LSHTM, said: “Looking at the impact of health on sexual activity and satisfaction as we age is important, however few studies have examined the between the two.

“Health can affect an individual’s sex life in various ways, from having or finding a partner, to physical and psychological limitations on sexual expression.

“We identified that not many people who reported experiencing problems or lack of satisfaction sought help. Although this could be an individual choice or because of a perceived lack of support, it is vital that individuals feel able to make enquiries with health care professionals. In particular, discussing problems can often lead to identification of underlying medical conditions.”

Although some individuals the research team spoke to were not affected by not being sexually active, it seemed to be important that health professionals make sensitive enquiries for patients who might want to access help, which can lead to significant improvements in their wellbeing and quality of life.

Kirstin Mitchell, co-author and Senior Research Fellow in Social Relationships and Health Improvement at the University of Glasgow, said: “We’re seeing numerous, interconnected factors influencing sexual activity in older people. Not being in good health can influence mood, mobility and whether a person has a partner, which in turn impact on . Medication taken for health conditions often compounds the problem.

“The study findings suggest that pharmacological approaches, like Viagra, do not always help to resolve sexual difficulties, which need to be seen in the wider context of ‘s lives.”

The authors acknowledge the limitations of the study, including that Natsal had an upper age limit of 74 years, and so the study is unable to describe the sexual health and wellbeing of people at older ages.

Natsal-3 is the largest and most comprehensive study of sexual attitudes and lifestyles in the world, and is a major source of data informing sexual and reproductive health policy in Britain.

Complete Article HERE!

Dead Bedrooms:

Ten things you should know about your waning sex life

By

In a 2014 survey by the Austin Institute for the Study of Family and Culture, it was found that 12 percent of married people hadn’t had sex for at least three months. Six and a half percent of married women and almost five percent of married men reported that they hadn’t had sex with their spouse in over a year.

A lack of sex in marriage or otherwise committed long-term relationships is something that’s joked about all of the time. In general, though, married couples do have more sex than people who are single or dating.

However, for the not insignificant minority of committed couples who have lost the sexual side of their relationship, it is anything but funny.

It is important to note that regular sex is not an imperative part of life or of some relationships. If you’re both happy with anniversary sex, or never sex, then we’re happy for you.

For those of you that aren’t happy, for those of you who feel stuck, confused, resentful, guilty or scared, we talked to two experts—Amy Bucciere, a certified sex and relationship therapist practicing in Pittsburgh, and Dr. Erika Evans-Weaver, the director of the Center for Human Sexuality Studies’ Sex Therapy Clinic at Widener University—to find out what you should know.

1. Rule out physiological causes.

Both experts agree that it’s important to first rule out medical conditions that could be causing changes in your libido or bodily function.

“Diseases or conditions like diabetes, high blood pressure or cancer—any of those conditions can impact your sex drive,” said Evans-Weaver.

2. Don’t assume that you know how your partner feels.

Simply put, the only way to find the cause of the problem is to look for the cause of the problem. We all have a tendency to assume that the way our partners are acting is directly related to how they feel about us. In many cases, this isn’t the truth.

Bucciere says that’s why it’s important to stay curious about what’s causing the sexual problems in your relationship, instead of coming to a conclusion on your own.

“[Ask yourself] is this actually true or is this something that I’m assuming? What is genuinely going on here? And it can be a lot of work to get an accurate answer to that question,” Bucciere said.

3. Remember that things are always in flux.

As your life circumstances change, so will the circumstances of your relationship. One of the hardest times is what Evans-Weaver refers to as the “sandwich generation,” which is when a couple is caring for both their young children and their aging parents.

“You’re exhausted, so you might want to be sexual, but at the same time you might say ‘I’d like to just cuddle up and take a nap,’” she explained. “And that’s real and fair.”

You may think that the root of your problem is that your partner has a different sex drive than you, and you could be right. But, that’s a reality in most relationships and it, too, can change over time.

“What are the chances that two people are going to be 95 percent in the same place when it comes to desire and arousal and availability to be intimate?” Bucciere said. “So it’s kind of a given that somebody is going to be higher and somebody is going to be lower, and you may go through different seasons…It’s not a stable position.”  

4. Be mindful of the story you tell yourself.

“The most important thing is that if my goal is to assign blame and to alleviate myself of doing the hard things then what happens is nothing changes,” Bucciere said.

Believing that you are right and your partner is wrong is easy and convenient, and it doesn’t get you any closer to a solution.

“It’s in our ability to make a conscious, painful decision to say, ‘I wonder what’s really happening here because if the story I’m telling myself is somehow a reductionist story about my goodness and your badness’ or something like that, then that’s the story I’m going to end up with,” Bucciere continued.

5. Talk to your partner, not everybody else.

To get more familiar with this issue, I dove into some online forums for people in sexless relationships. What I found was a lot of people commissorating about their problems, while encouraging a lot of vitriolic behavior.

“Everybody wants to let off some steam, but you’ve got to let it off with the person that’s driving you batty, not everybody else,” said Evans-Weaver.

“The folks that you are commiserating with validate you, so you feel right, and by the time you get ready to actually have the interaction with your partner, it’s still [the same] issue but not necessarily one that you have the same motivations to confront because you already felt this validation,” she continued.

So whether they’re your friends, or strangers on the internet, it’s often best to avoid airing out your grievances with people who aren’t your partner. Consider going to your partner first.

6. Don’t lose sight of the ‘us’ in your relationship.

A lot of people end up sitting with and dissecting this problem for a while, and in that time the frustration, desperation and resentment have been piling up. It’s easy to lose sight of the point of it all.

“What happens is you end up neglecting what I have come to refer to as the ‘physics of the relationship’ and you’ve become solely focused on ‘me’ and ‘you,’ and I’m neglecting the ‘us’ that exists between us and it’s in that misfocus that we end up trekking down a long and painful road,” Bucciere cautioned.

7. It’s not all about intercourse.

Evans-Weaver said that sometimes the problem can be due to boredom because the societally-driven focus on penetrative sex isn’t satisfying to one or both partners.

“[People] get stuck in these really basic sexual scripts that are no longer pleasurable for them, but they don’t know how to communicate about creating something different that is fun and invigorating to them,” she said.  

“We have to expand our perspective on what it means to be sexual with our partners because it can be anything from a sensual massage to mutual masturbation. Or it can be oral sex. It could be just touching. And it could be penetrative intercourse, but doesn’t have to be.”

And it isn’t all about orgasm, either. Making sex too goal-orientated can kill sex drive. According to Evans-Weaver, the focus should be pleasure and fun.

8. Affection and connection.

Sometimes you need to create the space for sex in your relationship though affection and re-establishing a connection.

“I remember working with folks and saying, ‘alright, what’s going on here is that one of you just wants more expression of affection and one of you actually wants to be more sexual with one another. Two different things, but the more that you express affection it’s going to also titillate your partner which might increase their desire to be sexual,’Evans-Weaver said.  

Bucciere emphasizes that feeling truly connected to your partner can change your whole approach to the issue for the better.

“It’s this idea that if we’re really feeling connected and the space between us feels safe and warm and open and loving, from there we’ll be able to figure it out,” she said.

9. Relationships take work. And they can work, if you do.

Start from a place of understanding that lasting relationships don’t happen because there’s no conflict or messiness, they last because both partners have decided that they’re going to work through the bumps.

“If people are genuinely looking to one another to say ‘I want this to get better,’ the implications of that are life-giving and tremendously healing and just a shit ton of work,” Bucciere said.

If you can develop a healthy method that you use to handle problems in your relationship, that’s a tool you’ll be able to come back to again and again.

“I genuinely, 100 percent believe that when two people are truly committed to making a process work, that it will,” Bucciere said. “If we can have our process down about how we work on this stuff, then we’re ultimately going to be able to handle whatever comes down the pike.”

10. Get help if you need it.  

This is a complicated problem. There are professionals out there, like Bucciere and Evans-Weaver, who can help. Whether you need a mediator, an idea-generator or a fresh set of eyes to look at your situation, therapists are trained to assist you.

“My approach is: listen, nobody has all the answers, right? I don’t have all the answers to fixing the problems in my own life. So my role is not to tell you, ‘well, you’ve been doing this wrong all your life,’” Evans-Weaver said.

“It’s really just to ask insightful questions that provide you with an unbiased opportunity to examine what it is that you want to do and how do you want to get there.”

Complete Article HERE!

For elders and others, drugs are available that aid sexual experience.

But insurers and Medicare won’t pay for them.

A tablet of Pfizer’s Viagra, left, and the company’s generic version, sildenafil citrate.

By Michelle Andrews

For some older people, the joy of sex may be tempered by financial concerns: Can they afford the medications they need to improve their experience in bed?

Medicare and many private insurers don’t cover drugs that are prescribed to treat problems people have engaging in sex. Recent developments, including the approval of generic versions of popular drugs Viagra and Cialis, have helped consumers afford the treatments. Still, for many people, paying for pricey medications may be their only option.

At 68, like many postmenopausal women, Kris Wieland, of Plano, Tex., experiences vaginal dryness that can make intercourse painful. Her symptoms are amplified by Sjogren’s syndrome, an immune system disorder that typically causes dry eyes and mouth, and can affect other tissues.

Before Wieland became eligible for Medicare, her gynecologist prescribed Vagifem, a suppository that replenishes vaginal estrogen, a hormone that declines during menopause. That enabled her to have sex without pain. Her husband’s employer plan covered the medication, and her co-payment was about $100 every other month.

After she enrolled in Medicare, however, her Part D plan denied coverage for the drug.

“I find it very discriminatory that they will not pay for any medication that will enable you to have sexual activity,” Wieland said. She plans to appeal.

Under the law, drugs used to treat erectile or sexual dysfunction are excluded from Part D coverage unless they are used as part of a treatment approved by the Food and Drug Administration for a different condition. Private insurers often take a similar approach, reasoning that drugs to treat sexual dysfunction are lifestyle-related rather than medically necessary, said Brian Marcotte, chief executive of the National Business Group on Health, which represents large employers.

So, for example, Medicare may pay if someone is prescribed sildenafil, the generic name for Viagra and another branded drug called Revatio, to treat pulmonary arterial hypertension, a type of high blood pressure in the lungs. But it typically won’t cover the same drug if prescribed for erectile dysfunction.

Women such as Wieland may encounter a similar problem. A variety of creams, suppositories and hormonal rings increase vaginal estrogen after menopause so that women can have intercourse without pain. But drugs that are prescribed to address that problem haven’t generally been covered by Medicare.

Sexual-medicine experts say such exclusions are unreasonable.

“Sexual dysfunction is not just a lifestyle issue,” said Sheryl Kingsberg, a clinical psychologist who is the chief of behavioral medicine at University Hospitals MacDonald Women’s Hospital in Cleveland. She is the immediate past president of the North American Menopause Society (NAMS), an organization for professionals who treat women with these problems. “For women, this is about postmenopausal symptoms.”

Relief may be in sight for some women.

Last spring, the federal Centers for Medicare and Medicaid Services sent guidance to Part D plans that they could cover drugs to treat moderate to severe “dyspareunia,” or painful intercourse, caused by menopause. Plans aren’t required to offer this coverage, but they may do so, according to CMS officials.

The NAMS applauded the change.

“Dyspareunia is a medical symptom associated with the loss of estrogen,” Kingsberg said. “They had associated it with sexual dysfunction, but it’s a menopause-related issue.”

For men who suffer from erectile dysfunction, treatment can confer both physical and emotional benefits, sexual health experts said.

“In my clinical work, I see a lot of older couples,” said Sandra Lindholm, a clinical psychologist and sex therapist who is also a nurse practitioner in Walnut Creek, Calif. “They are very interested in sex, and they feel like they’re able to embrace their erotic lives. But there may be medical issues that need to be addressed.”

About 40 percent of men over age 40 have difficulty getting or maintaining an erection, studies show, and the problem increases with age. A similar percentage of postmenopausal women experience genitourinary syndrome of menopause, a term used to describe a host of symptoms related to declining levels of estrogen, including vaginal dryness, itching, soreness and pain during intercourse, as well as increased risk of urinary tract infections.

Low sexual desire is another common complaint among women and men. A drug called Addyi was approved in 2015 to treat low sexual desire disorder in premenopausal women. But many insurers don’t cover it.

Unfortunately, medications that treat these conditions may cost people hundreds of dollars a month if their insurance doesn’t pick up any of the tab. A 10-tablet prescription for Viagra in a typical 50-milligram dose may cost more than $600, for example, while the price of eight Vagifem tablets may exceed $200, according to GoodRx, a website that publishes current drug prices and discounts.

In recent years, much more affordable generic versions of some of these medications have gone on the market.

Generic versions of Viagra and Cialis, another popular erectile dysfunction drug, may be available for just a few dollars a pill.

“I never write a prescription for Viagra anymore,” said Elizabeth Kavaler, a urogynecologist at Lenox Hill Hospital in New York City. “These generics are inexpensive solutions for men.”

There are generic versions of some women’s products as well, including yuvafem vaginal inserts and estradiol vaginal cream.

But even those generic options are often relatively pricey.

Some patients cannot afford $100 for a tube of generic estradiol vaginal cream, said Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive medicine at Yale School of Medicine.

“I’ve asked, ‘Did you try any of the creams?’ And they say they used up the sample I gave them. But they didn’t buy the prescription because it was too expensive,” she said.

— Kaiser Health News

More Sex Can Improve Later Years

Study shows life enjoyment is linked to intercourse for men, kissing and connection for women.

Physical contact and sexual activity may be key to contentment.

By

According to research published online on December 13, 2018, in the journal Sexual Medicine, frequent sexual activity can mean a more enjoyable life for older adults. Both men and women who reported any type of sexual activity in the previous year indicated greater happiness than people who did not. Feeling emotionally close to one’s partner during sex was also correlated with a more positive perspective for both genders.

These results are not surprising, says Pelin Batur, MD, associate professor of medicine in obstetrics and gynecology for the Women’s Health Institute at the Cleveland Clinic in Ohio, who was not involved in the research. “We know connection and intimacy are important for people throughout all stages of life,” says Dr. Batur. “It is important to remember that people who are healthier are more likely to engage in sexual activity. Therefore, it may be the better state of health which contributes the most to the increased life satisfaction, as opposed to just the sexual activity itself,” she says.

Searching for a Link Between Well-Being and Sexual Trouble

The study set out to investigate possible associations between sexual activity, problems, and concerns, and how those factors might influence well-being in older adults. Researchers looked at 3,045 men and 3,834 women living in England whose ages ranged from 50 to 89, with an average age of 64 for men and 65 for women. 74 percent of the men and 60 percent of the women were married or living with a partner, and 95 percent of the study participants were Caucasian.

Frequent Kissing, Contact, Key for Women’s Well-Being

After allowing for sociodemographic and health-related issues, researchers found that among sexually active men, frequent intercourse as well as frequent kissing, petting, or fondling were associated with greater enjoyment of life. For women, frequent kissing, petting, or fondling was linked to greater life enjoyment, but frequent intercourse was not. Frequent masturbation wasn’t associated with greater life enjoyment for either sex. “Frequent” was defined as two or more episodes a month.

Measuring People’s Enjoyment of Life

Enjoyment of life was assessed with the pleasure subscale of the CASP-19 (control, autonomy, self-realization, and peasure), which has been used in previous research to measure happiness and contentment for older adults. Subjects were asked how much they resonate with statements such as “I enjoy the things that I do,” “I enjoy being in the company of others,” and “I feel full of energy these days.”

Is Sexual Intercourse More Important for Men’s Well-Being Than for Women’s?

“The most interesting finding for us was that among sexually active men, frequent intercourse or kissing, petting, or fondling were associated with greater enjoyment of life,” says Lee Smith, PhD, an epidemiologist with expertise in physical activity and exercise medicine at Anglia Ruskin University in Cambridge, England, and a coauthor of the study. “However, among sexually active women frequent kissing petting or fondling were associated with greater enjoyment of life, but not intercourse,” says Smith. “It therefore appears that sexual intercourse may be more important for men than for women in terms of promoting well-being, whereas women’s enjoyment is more closely linked to other sexual activities.”

Insights Into Future Treatment for Age-Related Sexual Problems

These results could help improve the way that women’s sexual health drugs are developed and measured, says Batur. “In the past, these medications were judged based on how much increased sexual activity resulted from the use of these medications. If there were only one to two additional sexual acts over the course of the month, these medications were considered a failure,” she says.

Considering Desire, Satisfaction, and Future Treatments for Sexual Dysfunction

Studies like this highlight that it is not simply having sex that contributes to fulfillment, says Batur. “Moving forward, medications should look at sexual desire, satisfaction, pain, and other domains of sexuality that are important to women when judging whether potential new medications are helpful. Subjective quality of life benefits for women are probably more important than how often sexual activity occurs after initiation of medication,” says Batur.

The study found that sexual issues, such as difficulty having and maintaining an erection or achieving orgasm, were associated with less life satisfaction. Concerns about lack of desire and frequency of sex also had a negative connection with life enjoyment.

“Health professionals should acknowledge that older adults are not asexual and that a frequent and problem-free sex life in this population is related to better well-being,” said Dr. Smith in a statement. “However, encouragement to try new positions and explore different types of sexual activities is not regularly given to aging populations,” he added.

Making generalizations about either sex is hard to do from the survey results, says Batur. “What we do know is that sexuality is different for each individual and can vary throughout the lifetime for the better or worse, depending on circumstances,” she says. “Each person that we see in the office has their own story of what they are looking for in life and what makes them happy. One key point, on which we can all agree, is that the healthier a person is, the more they are likely to look for fulfilling relationships, including sexual ones,” says Batur.

Promoting overall wellness in later life is a public health priority, said Sarah Jackson, PhD, a senior research associate at the Institute of Epidemiology and Health at University College London in England, and coauthor of the study. “We know that psychological well-being is intricately linked with physical health, and as the population continues to age, the burden on health services increases,” she said in a statement. Encouraging and supporting people to continue to enjoy a healthy sex life in old age could have benefits both for the individual’s health and for the sustainability of health services, said Dr. Jackson.

Complete Article HERE!

Think teens need the sex talk?

Older adults may need it even more!

By &

Humans are sexual beings. This urge does not stop when the clock strikes 60. Or even 90.

Young adults may deny older relatives are having sex, but sexual activity is a strong indicator of healthy aging and vitality. In fact, sexual activity is roughly equal to climbing two flights of stairs.

Sex education and research use a medical model of sexual health focusing mainly on pregnancy, sexually transmitted infections (STIs), and sexual dysfunctions. However, sexuality is complex. Beyond genitals and Kama Sutra-like positions, it considers sexual and gender identity; sensuality; sexual response; intimacy; and positive and negative ways we use our sexuality.

Our research has explored sexuality among older adults experiencing healthy aging and also aging with health challenges. We found that older adults who routinely talk with health care providers about sexual matters are more likely to be sexually active, despite sexual dysfunctions or other health issues. These conversations become more important considering high HIV/AIDS and STI rates, even among older adults in the U.S.

Sexuality is complex

As we age, the complex interplay among biological, psychological, cognitive, socioeconomic, religious and even societal factors, contribute to changes in our roles and responsibilities. For example, changes in physical or cognitive health over time can create differences in analytical thinking, mobility, and health care needs. We also experience changes in work, social and family roles and responsibilities over time. Examples include transitions from working to retirement, parenting to empty-nesting, child-rearing to caring for aging parents or partners.

These changes may alter our sexual desires, expression and the frequency in which we engage in sexual activities with partners. For example, sexual functioning and activity may decrease over time, but having open communication with a partner who is responsive to our needs can increase our feelings of intimacy and desire, and in turn stimulate sexual activity.

Evolving social support and activities may change opportunities for sex and intimacy. Partners may disappear through death or moving away, or appear, such as when meeting new people after moving to an aging community. Over one-third of adults over age 65 use social media or internet technologies. These tools may expand sexual interest or activities by increasing access to sexual aids and partners.

Sex after 60

There are myths, misconceptions and stigma associated with aging and sexuality that hinder older adults’ ability to openly communicate with family, friends and health care professionals. This misinformation limits their access to sexual education, health care, and ultimately, their sexual rights.

The first myth is that older adults are not as sexually attractive or desirable as their younger counterparts. While an 80-year-old may not be as appealing to an 18-year-old, he or she may be very desirable to peers. More importantly, he or she may feel more sexually desirable and confident than their younger self.

A second myth is that older adults lack interest in and desire for sexual activity – and that they are somehow asexual. Research from ongoing national surveys support the ideas that sexual interest, desires and behaviors can decrease over the life course. For example, among women ages 57 years and older, over 80 percent of participants expressed interest in having sex, but less than two-thirds of women surveyed perceived sex as “important,” and fewer than half reported having sex in the previous year. However, the reality is that these trends are not universal among older adults. Results from another recent survey found that 39 percent of men and 17 percent of women ages 75 to 85 years are sexually active.

Another myth is that older adults are so medically fragile that sexual activity is dangerous. This is simply not true in many cases. Recent studies have shown that healthy older adults are more likely to have sex. Even when chronic illnesses are present, sexual abstinence is not a foregone conclusion. For example, a 2012 American Heart Association statement contains evidence-based recommendations about sexual activity among patients with specific cardiovascular conditions. The recommendations generally advise assessing risks with a doctor and disease management, rather than abstention.

There are well-documented relationships between common medical conditions such as heart disease or diabetes and treatment-related effects on sexual functioning. Yet, older adults and their health care providers are not discussing sexual concerns during routine care. Missed opportunities during visits deprive older adults of access to newer treatments and other best practices in sexual medicine, which can impact their mental and physical health.

A bigger problem may be ageist attitudes among providers and internalized ageism in their patients that may interfere with sex education and application of newer standards. The result is that many believe older adults are uninterested in, or lack desire for, sexual activity and cannot engage in these activities.

Love has a lot to do with it

There is more to sexuality than physical acts. While much of the existing research focuses on sexual activity and intercourse as predictors or outcomes, most older adults also desire companionship, intimacy and closeness. Non-intercourse-focused activities, such as hand-holding, cuddling and massage, have not been studied as much as intercourse. Yet, there is reason to believe that they can enhance intimacy. Research about physical and mental health outcomes resulting from older adult sexual activity reveals additional benefits, including reduced cognitive decline, loneliness and depression, and improved reported health status, physical functioning, and other aspects of quality of life.

Recent studies also reveal that sexually active older adults are more likely to communicate needs and concerns with health care providers and have them addressed. Providing high-quality sexual health care requires providers to take comprehensive sexual health histories from older patients and engage in direct, positive communication concerning gender and sexual identity, and sexual knowledge, beliefs and practices.

Discussions should promote understanding about sexual risk behaviors for STIs and effects of physical and cognitive or psychological aging on sexual health and sexuality. To maintain or improve older adults’ sexual health and well-being, health care providers should provide safe and welcoming environments for patient-provider collaboration, resources and interdisciplinary referrals to clinical social workers, sex therapists, physical therapists and other allied health specialties.

Complete Article HERE!