[D]eclining brain power is a real worry for some people as they age, but new research from England suggests a fun and healthy way to keep your mind sharp, no matter how old you get – sex. According to the study, frequent sexual activity has been linked to improved brain function in older adults, adding yet another health benefit to everyone’s favorite activity.
The study, published online in The Journals of Gerontology, Series B: Psychological and Social Sciences, found that people who had sex more frequently scored higher on tests to measure their verbal fluency and their ability to visually perceive objects and spaces between them. This suggests that sex can act as a sort of exercise for the brain, helping to keep it sharp as we age, though researchers aren’t sure exactly why.
“We can only speculate whether this is driven by social or physical elements — but an area we would like to research further is the biological mechanisms that may influence this,” Lead researcher Dr Hayley Wright said in a recent statement on ScienceDaily. “Every time we do another piece of research we are getting a little bit closer to understanding why this association exists at all, what the underlying mechanisms are, and whether there is a ’cause and effect’ relationship between sexual activity and cognitive function in older people.
For the study, the team from Coventry University and Oxford University interviewed 73 people between 50 and 83 years old about their sex lives. The volunteers were asked to fill out a questionnaire which asked how often they had sex, as well as other general questions about their health and lifestyle. The volunteers also took a standardized test that measured different aspect of their cognitive function, such as their ability to pay attention and remember facts, as well as their language and visuospatial skills. Results revealed that increased sexual activity was linked to increased verbal fluency and visuospatial skills. However, sexual activity seemed to have no affect on their attention skills, memory, or language.
This isn’t the first study to look into the benefits of sex in older individuals. For example, in 2016, the same team found that the protective effects of sex on the brain were stronger in men than women. The team speculate that sex may help protect the brain through the release of dopamine and oxytocin, two hormones that not only cause good feelings, but are also vital to brain function by improving connectivity between certain parts of the brain.
Regardless of why sex is helpful for the brains of older individuals, these results suggest that sex is an important part of our health and shouldn’t be discarded just because you age.
“People don’t like to think that older people have sex — but we need to challenge this conception at a societal level and look at what impact sexual activity can have on those aged 50 and over, beyond the known effects on sexual health and general wellbeing,” said Wright.
The basic human need of intimacy does not disappear as we age however in aged care planning it is mostly overlooked and often regarded as inappropriate.
by Annie Waddington-Feather
[C]ouples in aged care facilities are being given little to no privacy in their intimate and sexual relationships, and it’s often the staff who prevent couples from having this intimacy.
A UK study involving residents, non-resident female spouses of residents with a dementia and 16 care staff, carried out last year, found feedback very different from the stereotypical assumption of older people not been sexual.
Carried out by a research team for the Older People’s Understandings of Sexuality (OPUS), some participants denied their sexuality, others expressed nostalgia for something they considered as belonging in the past, and some still expressed an openness to sex and intimacy.
More recently a New Zealand pilot study carried out by Associate Professor Mark Henrickson, from the School of Social Work, and School of Nursing senior lecturer Dr Catherine Cook explored attitudes to sexuality in aged residential care facilities.
They found the need for better understanding of the intimacy needs of older people and a significant number of staff, families and residents are managing complex situations without clear processes to protect residents’ rights and safety.
Intimacy in a care home setting is complicated. Issues include querying consent for someone who is in cognitive decline, staff managing adult children who deem their parent’s behaviour as wrong, and a lack of privacy for couples. Plus, there is a stereotype to overcome – for many sex and intimacy is associated with youth, not older people.
“We are a microcosm of an ageist culture,” says Australian expert Dr Catherine Barrett, Director, Celebrate Ageing.
Dr Barrett’s views go beyond a person’s sexuality and importance of sex, believing there should also be a focus on non-sexual physical intimacy. She highlights a study by the University of Queensland where babies were found to recover quicker if they are touched.
“We need to focus more broadly,” she says. “Some people have sexual relationships because they’re lacking skin on skin touch. Known as ‘skin hunger’ (also known as touch hunger) it is a need for physical human contact, and this can be mistaken as a need for sex.”
She cites one example of a male resident who behaved very inappropriately to any females in the room. “A massage therapist came once a week and he stopped doing what he was doing,” she says. While some residential homes do access sex workers, Dr Barret says in some cases it’s simply for a person to come over and cuddle.
Aged care advocate Anne Fairhall, whose husband of over 50 years is living with dementia and is in a care home says they both missed skin contact. And it wasn’t just between the two of them. “In an aged care home, everyone puts on rubber gloves,” she points out.
Ms Fairhall believes people living with dementia respond very well to love, affection and intimacy. “We’d gone from sleeping in one bed to sleeping in two different locations, and he asked me ‘do you still love me?’; he couldn’t comprehend why I’d put him in a home.” she says. “But it’s not just about holding his hand; it’s about having some privacy.”
“It’s also about eye contact, an arm around the shoulder and stroking his skin. It’s giving him the body language message I’m connecting with him,” says Ms Fairhall. “I’d go in later in the day, sit close to him at dinner and after he’d eaten, get him into his pyjamas, kiss, cuddle and put cheek to cheek.”
Just lying beside her husband is comforting. “Staff are surprised if they walk in and they are a bit embarrassed at first– less so now as they get to know you,” she says.
Dr Barret is calling for more training and education to be given. “We can’t point the finger and say ‘not good enough’ to aged care homes – we need to be asking how we can help,” she says.
To this end, through the OPAL (Older People And SexuaLity) Institute, Dr Barret has developed a set of tools and resources for service providers and organisations. This includes holding workshops and helping develop policies and procedures around sexuality and intimacy.
After attending one of the workshops, Victorian provider Cooinda is in the process of implementing a sexuality policy template.
“This is an important step forward in what we do and the care we give,” says April Betheras, community support, Cooinda. “We talk a lot about person centred care and we have ideas about sexuality and intimacy, but the big thing is being able to think about the whole picture. It’s about identifying with the person and having the conversation.”
She says there is more communication with residents about the subject now, but acknowledges not all residents want to participate. “While some feel that [sexual] part of their life has gone, there are other ways of being close,” says Ms Betheras. “A partner can participate in aspects of care. This is what keeps them close and feeling connected still.”
Training in sexuality and intimacy is also now compulsory for staff. “Staff feel confident in speaking about and dealing with issues. For instance if someone wants access to a sex worker, what would you do that? Who would you go to?,” says Ms Betheras. “LGBTI is also incorporated so we can consider all particular needs.”
Those age 70 and up are having more sex and enjoying it more than younger people. But they don’t kiss and tell.
A study published in March in the Archives of Sexual Behavior noted a decline in sexual frequency among Americans of all ages. The sole exception: people over 70.
By Kevyn Burger
[G]ray-haired customers sometimes sidle up to Smitten Kitten owner Jennifer Pritchett and say with a smile, “Bet you don’t get someone my age in here often.”
The owner of the south Minneapolis adult store smiles right back. “And then I say, ‘Well, you’re wrong. We see people your age every day,’ ” said Pritchett.
Conventional wisdom holds that couples in their golden years prefer to limit their affection to holding hands, a peck on the cheek, maybe a little nighttime cuddle. But a growing body of research reveals that America’s seniors are plenty active between the sheets.
A study published in March in the Archives of Sexual Behavior noted a decline in sexual frequency among Americans of all ages. The sole exception: people over 70.
In the most recent survey for the study, which has been conducted since 1972, millennials and Gen X’ers showed a drop in the number of times they have sex per year, compared with previous years. But the baby boomers and their parents are having sex more often than their cohorts reported in the past.
The study and others like it seem to indicate that the quality — not just the quantity — of sex improves with age. The National Commission on Aging reported that the majority of the over-70 set find sex to be more emotionally and physically satisfying than when they were middle-aged.
Those conclusions are in line with a 2015 British study that found half of men and almost a third of women above 70 reported having sex at least twice a month. It was the first British study on sexual health to include octogenarians. It documented that a sizable minority of those in their 80s still masturbate and have sex.
Many people are, especially younger people.
“We see a consistent disbelief that older people are sexually active,” said Jim Firman, president and CEO of the National Council on Aging.
But Firman is adamant that those antiquated, ageist attitudes shouldn’t put a damper on the love lives of older Americans.
“We can’t let expectations of younger people control what we do,” he said. “Physical contact is a universal need and should be normalized and encouraged as part of aging. We should break those taboos or exceptions that say otherwise.”
Different, but ‘still hot’
Pritchett is all about breaking taboos.
In addition to its selection of vibrators, lubricants and videos, Smitten Kitten maintains a lending library. The books that fly off the shelves the fastest are about sex in later life.
“That’s kind of telling about how hungry people are for this information,” Pritchett said. “Sex ed in school is based around reproduction. When you’re older, family planning is not part of your sexuality. What’s left is pleasure.”
The most popular of the books on the store’s shelf were written by Joan Price, who bills herself as an “advocate for ageless sexuality.” Her bestsellers include “The Ultimate Guide to Sex After 50,” “Naked at Our Age: Talking Out Loud About Senior Sex” and “Better Than I Ever Expected: Straight Talk About Sex After Sixty.”
“My mission is to help people maintain or regain a satisfying sex life, with or without a partner” said Price, 73, who lives in California and regularly lectures, blogs and offers webinars on topics such as senior-friendly sex toys and satisfying sex without penetration.
Price said she got interested in creating content about sexuality for underserved seniors when, at 57, she met a man and “had the best sex of my life.” The longtime health and fitness writer couldn’t find any resources that reflected her experience, so she tackled the subject herself, becoming an erotic cheerleader for her cohorts.
“Sex has no expiration date, but things change — our bodies, our hormones, our relationships,” she said. “Expectations have to change. Responses are slower, we need more sensation, more stimulation to be aroused. We may have to redefine or reframe sex, but it can still be hot.”
Price, who’ll lead workshops at Smitten Kitten on June 4-5, preaches about the importance of communication between older partners.
Silenced by sex shaming
For Carol Watson, 67, flexibility is the key.
Still bawdy about her body, the Minneapolis woman is semiretired from her work at a nonprofit but retains a full-time interest in intimacy.
Starting when she went to college in 1967, she said, she’s “cut a wide swath.”
“That was the Summer of Love, the year birth control pills became readily available,” said the married mother of two adult children. “There was no AIDS, no Hep-C, nothing that couldn’t be solved with a shot of penicillin. We were the generation that could have sex without consequences — and we did. I’ve had many partners and no regrets.”
When her libido flagged a decade ago, Watson asked her doctor for an estrogen prescription for both a patch and cream.
“I’m happy sex is still part of my life. It keeps me young,” she said. “It’s stress relief, validation. It’s about joy.”
Describing herself as “on the far end of the bell curve,” Watson enjoys sex several times a week, within her marriage and with other partners, and said she has no plans to slow down.
“My mother died at 92 and Dad lived to be 96. I’m going to live to be 120 and I’m not willing to let sex fade into the distance.”
Watson’s frankness makes her a bit of an outlier.
While sex may be more common among older adults than younger ones, talking about senior sex still seems off limits. And that only perpetuates the myth that seniors have little interest in it.
“It’s still a sex-shaming society for older people and they internalize that,” said Pritchett. “It’s too bad because the shame keeps seniors in the dark. Old bodies are just as worthy of pleasure as young ones.”
[I]f you are drinking your morning coffee while reading this, then perhaps this article should come with a warning. There are going to be phrases that we tend not to discuss much in public such as vaginal dryness, loss of libido and erectile dysfunction. However, they are a natural part of life, and if we want to continue to be active sexual people well into middle age and beyond, then we have to acknowledge and then address them, because turning the trials and tribulations of middle-age sex into the joy of sex is not difficult.
Sex is important to all of us, regardless of age. Not only is it excellent for getting the blood pumping and putting a youthful spring in your step, it has a number of other benefits too, such as reducing stress, strengthening your immune system, boosting self-esteem, and relieving depression.
The famous manual, The Joy of Sex, still has some salient advice for middle- aged and older people even though it was written nearly 50 years ago. It’s author Alex Comfort wrote: “The things that stop you enjoying sex in an old age are the same things that stop you from riding a bicycle – bad health, thinking it’s silly and no bicycle”.
Well, we can pump up a flat tyre, add some lubricating oil, and still be having sexual enjoyment with no partner. As recent research has shown, and despite an ageist societal view on the topic, our sexuality doesn’t die with middle and growing age. Our sexual needs and levels evolve and change over the years, and the particular issues that might arise from menopause, for example, do not mean we should give up on it. We just need to learn to adapt.
Emily Power Smith may be Ireland’s only clinical sexologist, and talks to large numbers of middle-aged women in her clinics and at talks around the country. “I’ve spoken and written more on this topic than any other related to sex, and the main driver for women coming to me with an issue is poor education. Generally women are very misinformed about what they should be expecting and are very quick to blame themselves.”
If we look at sexual activity as a life-long issue, there can be plenty of interruptions to the normal flow, including illness, childbirth and child rearing, loss of confidence, menopause, and hormonal fluctuations. Low libido, erectile dysfunction, and vaginal dryness are all just normal challenges that can affect our sexual lives, but importantly, ones that can be easily addressed.
“We do specific menopause consultations and counselling for women who start experiencing changes and want to know that they are a normal part of the ageing process,” says Dr Shirley McQuade, medical director of the Dublin Well Woman Centre. “Many women come in with a specific symptom thinking it’s all over, but in fact nearly all issues can be addressed. You just need to realise that your, and your partner’s body changes.”
So what are the main issues and what can be done about them?
Peri-menopausal symptoms
Menopause can effect every aspect of your being, and symptoms including hot flushes, not sleeping, and poor concentration levels, can affect how you feel about yourself.
“Hormonal changes can mean your libido and sex drive go, as well and the emotional havoc they can play,” explains Dr McQuaid. Mood swings, empty nest syndrome, trying teenagers, or work/life balance can weigh in to make us feel less than energetic about sex.
“It is really important to take the time for yourself when you are peri-menopausal, to take stock and adjust to the changes that are happening. I see lots of women who have reached senior career level or have lots of people depend on them and it can be difficult because they feel overwhelmed and aren’t giving enough time to themselves to deal with how they feel.”
The advice is to take pressure off yourself, and try and cull some of the responsibilities. Exercise, eat and sleep well and acknowledge that you can seek help if you need it. “I’ve seen women go to cardiologists because they think they have heart problems when they wake up sweating in the night, or go to rheumatologists with joint pain, when in fact they are just the symptoms of hormonal change.”
Hormone Replacement Therapy
HRT is a common treatment for women who are suffering from continued and difficult symptoms, and it only takes two or three weeks to find out if it will work for you. According to the National Institute for Health and Care Excellence (NicE) in their 2015 recommendations, the benefits of HRT, available in tablet form, gels, and patches far outweigh any risks.
According to Dr McQuaid, it is a positive option to take. “About 15 years ago there were scares about risks relating to heart disease and cancer, but the studies were seriously flawed. For women who take it through their 50s, the benefits are significant.”
HRT is available for as long as your symptoms last, with the average duration being eight years. Despite scaremongering to the contrary, there are no withdrawal symptoms or problems when you stop taking the drug, as long as you leave it long enough for your natural menopause to conclude. HRT masks the symptoms, so if you stop before they have fully receded, they will return.
Not all women experience menopausal symptoms, and for women who do, they do eventually pass.
Vaginal dryness
It is completely normal for most women in menopause to experience dryness. The drop in your body’s oestrogen levels means the vaginal membranes become thinner and drier which can makes for uncomfortable dryness. As a result, thrush and Urinary Tract Infections (UTI) are also more common. Lubrication is widely available and will transform your sexual experience if dryness is a problem. Dr McQuaid also recommends treating the underlying issue rather than just the symptom. A prescription product, licensed in Ireland as Vagifem, provides low levels of oestrogen to the local area, and if taken over the longer term can alleviate all symptoms of dryness. Regular sexual activity or stimulation from masturbation also promotes vaginal health and blood flow.
Erectile dysfunction
For men who may identify their every maleness with work and sexual ability, a lowering of libido or erectile dysfunction can be catastrophic. However, accepting that this will happen occasionally, and seeing it a normal part of the ageing process and hormonal changes may encourage them to seek help. The advice is to go to your GP to get checked out to make sure erectile dysfunction is not related to vascular changes and bold pressure / diabetes, and then again there is a simple medication solution.
Painful intercourse
Again this can be a common change in sexual experience, usually due to vaginal dryness. However, other reasons could be a prolapse of the uterus or front wall of vagina which can cause discomfort, so the first port of call for any pain is to get examined by your GP or at the Well Women clinics. All issues can be addressed with medication or procedures.
Heavy periods
A common complaint for women entering peri-menopause is very heavy periods, which are caused by the womb being uncomfortable and bulky. Some women from the age of 40 develop fibroids which make the womb heavier and along with hormonal fluctuations, combine to make structural and hormonal changes that affect the flow of periods. Some women have low iron levels, because heavy periods are the main reason for low iron which makes you tired, so it’s important to keep a medical check on your body while going through the menopause.
Traditionally this was often treated by a hysterectomy, whereas today women can access the pill or coil. All countries where the coil has been introduced have seen a significant reduction in hysterectomy operations.
Change of mind
Addressing specific symptoms is only one way of evolving our sexual lives. Changing the way we have sex is another. “I meet women who have only ever used one position, and now that that proves painful they are at a loss,” explains Dr McQuaid. “It’s useful to experiment and change. It’s more interesting too!”
What we need to remember is that sex is not just about intercourse. There is a variety of sensual, loving, exciting activities that can bring joy and satisfaction. For women experiencing menopause especially, they might need and want more touching and foreplay than before, but after years of marriage, it can be more difficult to change. Asking for what you need is important. Tantric sex – slightly ridiculed in the press after Sting and Trudie Styler admitted to it – is encouraged by many counsellors as it focuses on the sensual intimacy rather than an orgasmic goal.
Whatever the issue with sex may be, Dr McQuaid advises you start with a medical to check to make sure everything is okay. Once that is done, it’s just about dealing with specific issues. “I’ve had a 78-year-old woman come to me recently having a little bit of trouble because her partner has been given Viagra. So she went on Vagifem and has no more problems,” says McQuaid. “I have lots of women come to us for help and they’re happy and healthy and they certainly don’t stop having a sex life. Nor should they.”
Psychologically however, it is also important to rise above the social conditioning that we lose our sexiness as we get older. “There is just no scientific evidence to back this up,” explains Power Smith. “Irish women are very quick to blame themselves and feel guilty for not being better, not feeling enough or good enough. In part we are brought up to feel this way with magazines and media, and then when middle age hits, physical things happen to compound that.” She has three golden rules for women in their middle age with regards to keeping their sex lives healthy and functioning: masturbation, lubrication and communication.
So while the number of potential causes of sexual changes and challenges during menopause and middle ageing can seem overwhelming, there are just as many strategies and treatments for overcoming them.
[S]eventy-nine-year-old Jane Fonda is doing for vibrators what 44-year-old Jane Fonda did for aerobics videos: mainstreaming them.
And not a moment too soon.
The new season of her critically acclaimed Netflix series, “Grace and Frankie,” co-starring Lily Tomlin, sees the two women launch a business selling sex toys for women. If you happen to drive down Vine Street in Hollywood, you might see a giant billboard of Fonda and Tomlin holding ribbed, purple objects under the words “Good vibes” — in case there was any confusion about what they’re holding.
And if you watch “The Ellen DeGeneres Show,” you may have happened upon Fonda unveiling a vibrator on daytime TV. (Take that, “The View”!)
“Use it or lose it, right?” Fonda says to DeGeneres, who seems uncharacteristically bewildered.
“Was this something you knew about before the character?” DeGeneres asks. “Before you researched it, was this something you knew about, I mean, were familiar with? Used?”
Fonda offers an emphatic “yes,” before explaining that she owns one vibrator that doubles as a necklace. “It looks like a beautiful piece of silver jewelry.”
Until it doesn’t.
“I applaud her,” said Lauren Streicher, medical director of Northwestern Memorial Hospital’s Center for Sexual Medicine and Menopause. “I’ve been trying to talk about this on daytime TV for years, and no one will have any part of it.”
Fifty-two percent of American women use a vibrator, Streicher said, according to a 2009 study published in the Journal of Sexual Medicine. And women over 60, in particular, need to know about their benefits.
“Sometimes nerve endings aren’t as sensitive as they used to be, so what did it for you before isn’t going to necessarily do it anymore,” said Streicher, who wrote “Sex Rx: Hormones, Health, and Your Best Sex Ever” (Dey St.). “In addition, you have a lot of medical conditions — diabetes, cardiovascular disease, multiple sclerosis — that can cause a desensitization of nerve endings, so there is a need for increased stimulation.”
Which may explain why the Carol Wright Gifts catalog — known mostly for its compression support knee-high socks, bunion bandages and denture liners — features a two-page spread of “personal massagers” with such names as Couple’s Raging Bull and The Amazing Butterfly Kiss.
There should be no shame in the vibrator game.
“It’s really just an acknowledgment that women are entitled to pleasure,” Streicher said. “It’s OK for men to have sex and pleasure and to desire that until the day they die, but when you look at women in their 70s talking about sexuality, that’s been something mainstream media has absolutely no interest in.”
Maybe Fonda will help change that.
“I hope so,” Streicher told me. “When I teach medical students, I tell them: Don’t ever say to a woman, ‘Do you have a vibrator?’ That is the wrong question. What you say is, ‘When you use your vibrator …'”
She continued: “When I ask a patient, as part of her history, ‘Are you able to have an orgasm?’ and she says no, I say, ‘How about when you use your vibrator?'”
It lessens the stigma and leads to a more honest discussion, Streicher said.
“We know, at best, maybe 25 percent of women are able to have an orgasm through intercourse alone,” she said. “If men weren’t able to have orgasms and there was a device that made it happen, there would be nothing taboo about it.”
And if Fonda has her way, there won’t be for much longer.
[I]magine living in an aged care home. Now imagine your needs for touch and intimacy being overlooked. More than 500,000 individuals aged 65+ (double the population of Cardiff) live in care homes in Britain. Many could be missing out on needs and rights concerning intimacy and sexual activity because they appear to be “designed out” of policy and practice. The situation can be doubly complicated for lesbian, gay, bisexual or trans individuals who can feel obliged to go “back into the closet” and hide their identity when they enter care.
Little is known about intimacy and sexuality in this sub-sector of care. Residents are often assumed to be prudish and “past it”. Yet neglecting such needs can affect self-esteem and mental health.
A study by a research team for Older People’s Understandings of Sexuality (OPUS), based in Northwest England, involved residents, non-resident female spouses of residents with a dementia and 16 care staff. The study found individuals’ accounts more diverse and complicated than stereotypes of older people as asexual. Some study participants denied their sexuality. Others expressed nostalgia for something they considered as belonging in the past. Yet others still expressed an openness to sex and intimacy given the right conditions.
Insights
The most common story among study participants reflected the idea that older residents have moved past a life that features or is deserving of sex and intimacy. One male resident, aged 79, declared: “Nobody talks about it”. However, an 80-year-old female resident considered that some women residents might wish to continue sexual activity with the right person.
For spouses, cuddling and affection figured as basic human needs and could eclipse needs for sex. One spouse spoke about the importance of touch and holding hands to remind her partner that he was still loved and valued. Such gestures were vital in sustaining a relationship with a partner who had changed because of a dementia.
Care staff underlined the need for training to help them to assist residents meet their sexual and intimacy needs. Staff highlighted grey areas of consent within long-term relationships where one or both partners showed declining capacity. They also spoke about how expressions of sexuality posed ethical and legal dilemmas. For example, individuals affected by a dementia can project feelings towards another or receive such attention inappropriately. The challenge was to balance safeguarding welfare with individual needs and desires.
Some problems were literally built into care home environments and delivery of care. Most care homes consist of single rooms and provide few opportunities for people to sit together. A “no locked door” policy in one home caused one spouse to describe the situation as, “like living in a goldfish bowl”.
But not all accounts were problematic. Care staff wished to support the expression of sex, sexuality and intimacy needs but felt constrained by the need to safeguard. One manager described how their home managed this issue by placing curtains behind the frosted glass window in one room. This enabled a couple to enjoy each other’s company with privacy. Such simple changes suggest a more measured approach to safeguarding (not driven by anxiety over residents’ sexuality), which could ensure the privacy needed for intimacy.
Conclusions
Our study revealed a lack of awareness by staff of the need to meet sexuality and intimacy needs. Service providers need guidance on such needs and should provide it to staff. The information is out there and they can get the advice they need from the Care Quality Commission, Independent Longevity Centre, Local Government Association and the Royal College of Nursing.
Policies and practices should recognise resident diversity and avoid treating everyone the same. This approach risks reinforcing inequality and doesn’t meet the range of needs of very different residents. The views of black, working-class and LGBT individuals are commonly absent from research on ageing sexuality and service provision. One care worker spoke of how her home’s sexuality policy (a rare occurrence anyway) was effectively a “heterosexuality policy”. It may be harder for an older, working-class, black, female or trans-identified individual to express their sexuality needs compared to an older white, middle-class, heterosexual male.
Care homes need to provide awareness-raising events for staff and service users on this topic. These events should address stereotyping and ways of achieving a balance between enabling choices, desires, rights and safeguarding. There is also a need for nationally recognised training resources on these issues.
Older people should not be denied basic human rights. This policy vacuum could be so easily addressed over time and with appropriate training. What we need now is a bigger conversation about sex and intimacy in later life and what we can do to help bring about some simple changes in the care home system.
[I]t is a common assumption that once a couple ties the knot, sex goes out the window. Indeed, the actress Zsa Zsa Gabor, who said “I do” nine times, once quipped: “I know nothing about sex, because I was always married”.
Yet new research indicates that most couples in long-term relationships remain happy well into their sixties.
While it is not uncommon for couples to disagree about how often they should have sex, this does not necessarily alter their commitment to the relationship, scientists at the British Sociological Association’s annual conference in Manchester will hear on Wednesday.
Levels of sexual desire
Researchers surveyed more than 5,000 heterosexual, lesbian, gay and bisexual people aged 16 to 65 to discuss their relationships.
Around 60 per cent of respondents believed that sex was an important part of their relationship while 15 per cent disagreed. The remainder neither agreed nor disagreed.
One third (33 per cent) of women reported that their partners wanted sex more frequently than they did, while a larger proportion, 40 per cent, said this was not the case.
Only 10 per cent of men said that their partners wanted sex more frequently than they did, compared with nearly two thirds (60 per cent) who said they did not.
‘Part and parcel’ of relationship cycle
The research, conducted by Professor Jacqui Gabb, of the Open University, and Professor Janet Fink, of the University of Huddersfield, and presented in Manchester on Wednesday, reveals that differences in sexual desire are not considered “particularly significant”.
“Couples are saying that differences in sexual frequency and desire are just part and parcel of the relationship cycle and are accepted as not particularly significant,” Professor Gabb said.
Still going strong
The study also found that many older participants continued to derive pleasure from their sex lives even when sexual activity was less frequent than it had once been.
One older woman who participated in the research described sex as “one of the prerequisites of a relationship” for her.
However, she added: “There are other areas of a relationship which I think need a lot more work and are far more important, like trust, money, love [and] teamwork.”
Long-term love
Professor Gabb said of the findings: “Fluctuations in desire are inexorably tied into other life factors, but it is the sharing of a life together, the investment in that joint venture and the acceptance of change as an integral part of this shared life which enables couples to weather the ebbs and flows that characterise sexual intimacy and the passage of time in long-term relationships.”
She added: “The longevity of partnerships seems to be connected with couples’ capacity to negotiate changing circumstances. For older couples, the first blush of a new relationship may have worn off but the relationship has not tarnished.”
[A]fter Alice Radosh’s husband of 40 years died in 2013, she received, in addition to the usual condolences, countless offers of help with matters like finances, her car and household repairs. But no one, not even close friends or grief counselors, dared to discuss a nagging need that plagues many older women and men who outlive their sexual partners.
Dr. Radosh, 75 and a neuropsychologist by training, calls it “sexual bereavement,” which she defines as grief associated with losing sexual intimacy with a long-term partner. The result, she and her co-author Linda Simkin wrote in a recently published report, is “disenfranchised grief, a grief that is not openly acknowledged, socially sanctioned and publicly shared.”
“It’s a grief that no one talks about,” Dr. Radosh, a resident of Lake Hill, N.Y., said in an interview. “But if you can’t get past it, it can have negative effects on your physical and emotional health, and you won’t be prepared for the next relationship,” should an opportunity for one come along.
Yes, dear readers of all ages and the children of aging parents, many people in their golden years still have sexual urges and desires for intimacy that go unfulfilled when a partner becomes seriously ill or dies.
“Studies have shown that people are still having and enjoying sex in their 60s, 70s and 80s,” Dr. Radosh said. “They consider their sexual relationship to be an extremely important part of their lives. But when one partner dies, it’s over.”
In a study of a representative national sample of 3,005 older American adults, Dr. Stacy Tessler Lindau and co-authors found that 73 percent of those ages 57 to 64, 53 percent of those 65 to 74 and 26 percent of those 75 to 85 were still sexually active.
Yet a report published by the United Kingdom’s Department of Health in 2013, the National Service Framework for Older People, “makes no mention of the problems related to sexual issues older people may face,” Dr. Radosh and Ms. Simkin wrote in the journal Reproductive Health Matters. “Researchers have even suggested that some health care professionals might share the prejudice that sex in older people is ‘disgusting’ or ‘simply funny’ and therefore avoid discussing sexuality with their older patients.”
Dr. Radosh and Ms. Simkin undertook “an exploratory survey of currently married women” that they hope will stimulate further study of sexual bereavement and, more important, reduce the reluctance of both lay people and health professionals to speak openly about this emotionally and physically challenging source of grief.
As one therapist who read their journal article wrote, “Two of my clients have been recently widowed and felt that they were very unusual in ‘missing sex at my age.’ I will use your article as a reference for these women.”
Another wrote: “It got me thinking of ALL the sexual bereavement there is, through being single, through divorce, through disinterest and through what I am experiencing, through prostatectomy. It is not talked about.”
Prior research has “documented that physicians/counselors are generally uncomfortable discussing sex with older women and men,” the researchers noted. “As a result, such discussions either never happen or happen awkwardly.” Even best-selling memoirs about the death of a spouse, like Joan Didion’s “The Year of Magical Thinking,” fail to discuss the loss of sexual intimacy, Dr. Radosh said.
Rather than studying widows, she and Ms. Simkin chose to question a sampling of 104 currently partnered women age 55 and older, lest their research add to the distress of bereaved women by raising a “double taboo of death and sex.”
They cited a sarcastic posting from a woman who said she was not a good widow because “a good widow does not crave sex. She certainly doesn’t talk about it…. Apparently, I stink at being a good widow.”
The majority of survey participants said they were currently sexually active, with 86 percent stating that they “enjoyed sex,” the researchers reported. Nearly three in four of the women thought they would miss sex if their partner died, and many said they would want to talk about sex with friends after the death. However, “76 percent said they would want friends to initiate that discussion with them,” rather than bringing it up themselves.
Yet, the researchers found, “even women who said they were comfortable talking about sex reported that it would not occur to them to initiate a discussion about sex if a friend’s partner died.” The older the widowed person, the less likely a friend would be willing to raise the subject of sex. While half of respondents thought they would bring it up with a widowed friend age 40 to 49, only 26 percent would think to discuss it with someone 70 to 79 and only 14 percent if the friend was 80 or older.
But even among young widows, the topic is usually not addressed, said Carole Brody Fleet of Lake Forest, Calif., the author of “Happily Even After” who was widowed at age 40. In an interview she said, “No one brought up my sexuality.” Ms. Fleet, who conducts workshops for widowed people, is forthright in bringing up sex with attendees, some of whom may think they are “terrible people” for even considering it.
She cited “one prevailing emotion: Guilt. Widows don’t discuss the loss of sexual intimacy with friends or mental health professionals because they feel like they’re cheating. They think, ‘How can I feel that?’ But you’re not cheating or casting aspersions on your love for the partner who died.
“You can honor your past, treasure it, but you do not have to live in your past. It’s not an either-or situation. You can incorporate your previous life into the life you’re moving into. People have an endless capacity to love.”
However, Ms. Fleet, who remarried nine years after her husband died, cautioned against acting precipitously when grieving the loss of sexual intimacy. “When you’re missing physical connection with another person, you can make decisions that are not always in your best interest,” she said. “Sex can cloud one’s judgment. Maybe you’re just missing that. It helps to take sex out of the equation and reassess the relationship before becoming sexually intimate.”
Dr. Radosh urges the widowed to bring up grief over the loss of sexual intimacy with a therapist or in a bereavement group. She said, “Even if done awkwardly, make it part of the conversation. Let close friends know this is something you want to talk about. There is a need to normalize this topic.”
[I]nadequate sex and relationships education (SRE) in schools is creating “a ticking sexual health time bomb”, councils are warning, amid concern over high numbers of sexually transmitted infections (STIs) among young people.
The Local Government Association (LGA), which represents 370 councils in England and Wales, has joined the growing clamour urging the government to make sex education compulsory in all secondary schools. Currently it is mandatory in local authority-maintained schools, but not in academies and free schools which make up 65% of secondaries.
Izzi Seccombe, chair of the LGA’s community wellbeing board, said it was a major health protection issue. “The lack of compulsory sex and relationship education in academies and free schools is storing up problems for later on in life, creating a ticking sexual health time bomb, as we are seeing in those who have recently left school.
“The shockingly high numbers of STI diagnoses in teenagers and young adults, particularly in the immediate post-school generation, is of huge concern to councils.
The LGA appeal came as the government was reported to be close to making an announcement regarding SRE and PSHE (personal, social, health and economic education), after the education secretary, Justine Greening, flagged up the issue as a priority for government.
Campaigners hope the announcement will be made during the next stage of the children and social work bill, which is passing through parliament. An amendment with cross-party support was tabled last week which, if carried, would would amount to the biggest overhaul in sex education in 17 years, but it is not yet clear what the government announcement will amount to, and crucially whether it will make SRE compulsory.
Seccombe said: “We believe that making sex and relationship education compulsory in all secondary schools, not just council-maintained ones, could make a real difference in reversing this trend, by preparing pupils for adulthood and enabling them to better take care of themselves and future partners.”
The LGA says while SRE should be made compulsory for secondary school children, with statutory guidance on key issues including sexual health, parents should still be given the option of taking their children from the lessons.
Tory MP Maria Miller was among those proposing the amendment to the bill last week. It followed an inquiry by the women and equalities committee, chaired by Miller, which heard that most children have seen online pornography by the time they leave primary school and two thirds will have been asked for a sexual digital image of themselves before they leave secondary school.
According to Miller, research has shown that just one in four children at secondary school receives any teaching on sex and relationship issues, and Ofsted has said that when it is taught the quality of teaching is often poor.
“Different interest groups cannot agree on a way forward that suits them and in the meantime we are letting down a generation of children who are not being taught how to keep themselves safe in an online, digital world,” said Miller.
“We are not teaching them that pornography isn’t representative of a typical relationship, that sexting images are illegal and could be distributed to child abuse websites and how to be aware of the signs of grooming for sexual exploitation.
[A]lthough Valentine’s Day is often criticised as a cynical creation by florists and the greeting cards industry, it is a useful focal point for considering love and sexuality as elements of human wellbeing that often escape attention in healthcare.
This neglect is most marked in later life, when popular discourse on late life romance is dominated by simple notions of asexuality or by ribald jokes
There are many reasons why healthcare professionals need to learn more about human love and sexuality, not least of which is a fuller understanding of the nature and meaning of ageing.
exuality is a core element of human nature, encompassing a wide range of aspects over and above those related to genital functions, and the medical literature has rightly been criticised for taking too narrow a vision of sexuality.
We need to open up to the continuing significance of love and sexuality into later life
This narrow vision is paralleled by a steady trend in the neurosciences of “neuroreductionism”, an over-simplistic analysis of which parts of the brain light up in sophisticated scanners on viewing photos of a loved one.
We need to open up to the continuing significance of love and sexuality into later life, understanding that sexuality includes a broad range of attributes, including intimacy, appearance, desirability, physical contact and new possibilities.
Studies
Numerous studies affirm sexual engagement into the extremes of life, with emerging research on the continuing importance of romantic love into late life. There is also reassuring data on the persistence of romantic love in long-term relationships, unsurprisingly associated with higher levels of relationship satisfaction.
A growing literature sheds light on developing new relationships in later life, with a fascinating Australian study on online dating which subverts two clichés – that older people are asexual and computer illiterate.
The challenge in ageing is best reflected in the extent to which we enable and support intimacy and sexuality in nursing homes. Although for many this is their new home, the interaction of institutional life (medication rounds, meals), issues of staff training and lack of attention to design of spaces that foster intimacy can check the ability to foster relationships and express sexuality.
For example, is the resident’s room large enough for a sofa or domestic furnishings that reflects one’s style, personality and sense of the romantic? Are sitting spaces small and domestic rather than large day rooms? Do care routines allow for privacy and intimacy? Is there access to a selection of personal clothes, make-up and hairdressing?
Granted, there can also be complicated issues when residents with dementia enter new relationships and the need to ensure consent in a sensitive manner, but these should be manageable with due training and expertise in gerontological nursing and appropriate specialist advice.
Supports
A medical humanities approach can provide useful supports in education from many sources, ranging from literature ( Love in the Time of Cholera), film ( 45 Years or the remarkable and explicit Cloud 9 from 2009) or opera (Janácek’s Cunning Little Vixen, a musical reflection of the septuagenarian composer’s passion for the younger Kamila Stösslová).
We, as present and future older Irish people, also need to take a step back and consider if we are comfortable with a longer view on romance and sexuality.
The Abbey Theatre did us considerable service in 2015 with a wonderful version of A Midsummer Night’s Dream set in a nursing home. We were struck by a vivid sense of the inner vitality of these older people, suffused with desire, passion and romance.
This contemporary understanding of companionship and sexuality in later life was enhanced by casting Egeus as a son exercised about his mother’s romantic choices instead of a father at odds with his daughter.
We can also take heart from an early pioneer of ageing and sexuality, the late Alex Comfort. Best known for his ground-breaking The Joy of Sex, he was also a gerontologist of distinction, and wrote knowledgeably about the intersection of both subjects with characteristic humour.
He wrote that the things that stop you having sex with age are exactly the same as those that stop you riding a bicycle: bad health, thinking it looks silly or having no bicycle, with the difference being that they happen later for sex than for the bicycle.
His openness and encouragement for our future mirror Thomas Kinsella’s gritty poem on love in later life, Legendary Figures in Old Age, which ends with the line: ‘We cannot renew the Gift but we can drain it to the last drop.’
Women’s sexuality doesn’t die with age, but the level of their desire is diverse.
By Margaret Jennings
[S]he seemed to have it all: a loving family, successful career and beautiful home.
Then Yvonne Carmichael jeopardised everything by having a torrid affair with a random stranger, ripping apart the cosy trajectory of her life.
Yvonne is the lead character in a BBC1 mini-series currently steaming up our TV screens, called Apple Tree Yard.
And while the storyline takes us from the joys of lust to the darkness of rape, it’s rare to see a 50-something female take centre stage in such scenes.
Midlife affairs are usually the reserve of testosterone-driven, crisis-ridden males — as if females have no such needs — or so the media world would have us believe.
Apple Tree Yard, a dramatised version of a novel by Amanda Coe, challenges pre-conceived ideas about middle-age sex.
It not only affirms that it’s OK for older women to be sexually expressive, it annihilates the myth that we become “invisible” and asexual just because we are ageing.
The four-part psychological thriller has prompted a lively debate on this issue and 50-year — old actress Emily Watson, who plays Yvonne, has commented: “Your sexuality doesn’t die with your age. You don’t have to apologise for it.”
The idea that our sexuality can be compartmentalised as non-existent, especially as we are living longer more vital lives, seems absurd.
While Yvonne’s torrid affair illustrates this explicitly, it also raises the issue of how our latent sexual urges are perfectly ripe to be reignited at this stage of life, depending on our circumstances and responses.
“Many women of 50 and beyond succumb to a flagging libido, more difficult arousal and maybe a stale, longtime relationship, by retreating from sex.
“Then they meet someone new and — bam — they feel the excitement that they thought they had left far behind,” says Joan Price, a US author and blogger on senior sexuality.
“They feel on fire. Their sex drive — which they thought was dormant — goes into overdrive. It can be quite an amazing and delicious experience. It can also be bewildering and guilt-filled, if a woman has an affair when she’s in a committed, monogamous relationship.”
Price, now 72, has first- hand experience of this herself: “I was 57 when I met the man who would become my husband and great love. I had been single for decades, with occasional relationships that didn’t go anywhere — and long dry spells.
“It was distressing, because I knew I was a vibrant, sexual being, but after menopause I seemed invisible to the men I met. Many women report that they feel the same. How glorious it is then, when we meet the right person and that person is as electrified as we are!”
The on-screen electricity between research scientist and grandmother-to-be Yvonne, and her handsome lover, Mark Costley (played by Ben Chaplin), is an endorsement of this passionate potential, but is there something missing in our relationship if we yearn to seek those sparks elsewhere?
Sex in relationships is not just about sex, but about the connect between a woman and her partner, says Lisa O’Hara, a couple counsellor with Dublin-based clinic Mind and Body Works.
“If lack of libido is an issue for a couple attending for counselling, it can be part of a wider discontent than just the sexual connection. There may be a loss of closeness in general and resentments by the woman towards the partner that have built up over years, which have gone unaddressed.
“If these are addressed in therapy and things improve, sex may be back once again.”
However, some of her midlife female clients do develop a stronger curiosity about their own desires and fantasies, once free of fear of pregnancy or of other lifestyle issues that had got in the way, says O’Hara.
“Some say ‘I’m out of here’. It totally depends on their unique circumstances and how they feel about themselves.”
The myth that we become less sexual as we age was recently explored in research among women aged 55 to 81, titled Sex, Desire and Pleasure: Considering the experiences of older Australian Women.
Research author Bianca Fileborn, a lecturer in the School of Social Sciences at the University of New South Wales, tells Feelgood: “One of the key findings from our research was that women are really diverse — there’s certainly not one way that older women are ‘doing’ sexuality and sexual desire in mid to later life.
Emily Watson’s as character Yvonne Carmichael in the BBC production of ‘Apple Tree Yard’.
“In fact quantitative research carried out in western countries pretty consistently shows that a significant number of older people remain sexually active — usually a majority — at least until they reach ‘deep’ old age, in their 80s and 90s. But even then, a large minority still have sex.
“Another key finding for us was that women’s desire for sex didn’t depend necessarily on how older they were, but what else was going on their lives that influenced them.”
Irish sexologist Emily Power Smith says she knows women of all ages who, although they’re living with chronic illness and pain, are “determined to find ways to feel sexual”.
“Women who enjoy sex will have sexual desire right to the end of their lives and will find creative ways to keep that spark. But I also work with a number of women in their 50s and above, who want to know what all the fuss is about, because they could quite easily never have sex again.
“Inevitably it transpires that they have never really enjoyed sex. As they begin to discover their ability to feel sexual pleasure and arousal, their drives tend to increase.”
ONCE we are leading healthy lives low libido seems more related to the kind of sex we are having, rather than our age, she says.
“I know many young fertile women who hate sex and many older women, post menopause, who love it. Increasingly, there is research to show that older women embarking on new relationships report no reduction whatsoever in their sexual desire.”
Whatever about the complex rich reality of older women’s everyday sex lives, the screening of Apple Tree Yard may nudge the film and media world towards a more rounded representation of the mature female in all her sensual glory.
And perhaps even encourage women to explore their own sexuality more.
There is a growing posse of sexy women in their 50s and older decades, gracing the fashion and beauty world, in recent times, apart from the fact that some of the original supermodels of the ’90s, such as Cindy Crawford, Elle Macpherson and Linda Evangelista are already past the half century mark.
This year’s Pirelli calendar also sees photographer Peter Lindbergh tap into the zeitgeist, describing the make-up free portraits of his subjects as a “cry against perfection and youth”.
Some of the high-achieving women he chose to feature were actresses Julianne Moore, 56, Charlotte Rampling, 70, and Helen Mirren, 71.
However, despite this celebration of our vitality as we age, we still may have some catching up to do as individuals, says Power Smith.
“Women do a lot of self-policing when it comes to behaviour, dress and dating over a certain age. I think we are so conditioned to believe our lives are over once we’re 50 — though this is changing slowly — we get very troubled at the thought of our peers wearing short skirts, or dating younger people. But the rules don’t serve us. They never did.
“Only now some of us have the financial freedom, confidence and ability to create new norms. So come on! Let’s break some rules!”
Apple Tree Yard, BBC One, Sunday February 5, 9pm
10 ways to feel sexy
Senior sexpert, author and blogger, Joan Price, gives us these 10 tips for hot sex after 50:
1. Slo-o- o-w- w down. It takes longer for us to warm up, and this intensifies as we get older. Make the warm-up phase of sex play last hours… or days.
2. Appreciate, decorate, and celebrate your body. Jewellery, lingerie, feathers, fringe, silk, velvet, massage oil, candlelight — whatever looks good and feels good. If you know you look sexy, you’ll feel sexy.
3. Learn what you like. Explore, experiment. If you’re partnered, communicate what you like.
4. Do sexy things on your own to get in the mood long before you get naked. Work out. Swim. Dance. Fantasise a sexy scene. Spend some time humming with a vibrator, reading erotica, or watching porn — or all of these.
5. Have sex during high energy times, when your arousal is strongest, whether solo or partnered.
6. If you’re partnered, kiss and kiss. Kiss sweetly, passionately, quickly, slowly, contentedly, hungrily, lightly. All kinds of kisses help you bond with your partner, warm up, and enjoy the moment.
7. Explore sex toys and other erotic helpers, alone and/or with a partner. Lucky for us that sex toys are easy to find, fun to try, and wow, do they work!
8. Use a silky lubricant. There are many different lubricants made specifically for sex that feel great and enhance (or bring back) the joy of friction. Make applying lubricant an erotic part of sex play.
9. Enjoy the afterglow. If you’re partnered, indulge in quality snuggle time.
Solo, don’t get back to your daily life right away — bask in your feelings of wellbeing.
10. Laugh a lot. Laughter is joyful, ageless — and sexy.
A more satisfying sex life may be only a good night’s sleep away for women over 50, new research finds.
Researchers led by Dr. Juliana Kling of the Mayo Clinic in Scottsdale, Ariz., tracked data from nearly 94,000 women aged 50 to 79.
The investigators found that 31 percent had insomnia, and a little more than half (56 percent) said they were somewhat or very satisfied with their sex life.
But too little sleep — fewer than seven to eight hours a night — was linked with a lower likelihood of sexual satisfaction, the findings showed.
“This is a very important study since it examines a question which has tremendous potential impact on women’s lives,” said Dr. Jill Rabin, who reviewed the findings. She’s co-chief of the Women’s Health Program at Northwell Health in New Hyde Park, N.Y.
Age played a key role in outcomes. For example, the study found that older women were less likely than younger women to be sexually active if they slept fewer than seven to eight hours per night.
Among women older than 70, those who slept fewer than five hours a night were 30 percent less likely to be sexually active than women sleeping seven to eight hours, Kling’s team found.
The findings highlight how crucial sleep is to many aspects of women’s health, medical experts said.
“Seven hours of sleep per night will improve sexual satisfaction and has been shown to increase sexual responsiveness,” said Dr. JoAnn Pinkerton, executive director of The North American Menopause Society.
Besides putting a damper on sex lives, she said, poor sleep is also tied to an array of health issues, such as “sleep apnea, restless legs syndrome, stress and anxiety.” Other health problems linked to insomnia include “heart disease, hypertension [high blood pressure], arthritis, fibromyalgia, diabetes, depression and neurological disorders,” Pinkerton added.
Dr. Steven Feinsilver directs sleep medicine at Lenox Hill Hospital in New York City. He reviewed the new findings and stressed that they can’t prove cause and effect. “It certainly could be possible that many underlying problems — for example, illness, depression — could be causing both worsened sleep and worsened sex,” he noted.
Rabin agreed, but said there’s been “a paucity of studies” looking into links between sleep and sexual health, especially during menopause.
“We know that obstructive sleep apnea and sexual dysfunction are positively correlated,” she said. “Other factors which may lead to a decreased sleep quality include: a woman’s general health; various life events, which may contribute to her stress; chronic disease; medication; and degree and presence of social supports, just to name a few,” Rabin explained.
And, “in menopause, and due to the hormonal transition, women may experience various symptoms which may impact the duration and quality of their sleep patterns,” Rabin added.
We and our patients need to know that quality sleep is necessary for overall optimum functioning and health, including sexual satisfaction, and that there are effective treatment options — including hormone therapy — which are available for symptomatic women,” she said.
The study was published online Feb. 1 in the journal Menopause.
[S]exuality encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction and what we think, feel and believe about them. It has been a research focus for over a hundred years, and highlighted as an important part of the human experience. Since the first studies on human sexuality in the 1940s, research has consistently demonstrated that sexual interest and activity are sustained well into old age. However, only a fraction of the research has explored sexuality in the later years of life.
Most of the early research on sexuality and ageing looked at the sexual behaviours and biology of older adults, generally ignoring the wider concept of sexuality. When researchers did discuss sexuality more broadly, many referred to sexuality as the domain of the young, and emphasised this was a major barrier to the study of sexuality in older adults.
Sexuality in later life ignored
Towards the end of the 20th century, research expanded to include attitudes towards sexual expression in older adults, and the biological aspects of sexuality and ageing. Consistently, the research showed sexual expression is possible for older adults, and sustained sexual activity into old age is more likely for those who had active sex lives earlier in life.
By the late 1980s, there was a strong focus on the biological aspects of ageing. This expanded to include the reasons behind sexual decline. The research found these were highly varied and many older adults remain sexually active well into later life.
But despite evidence adults continue to desire and pursue sexual expression well into later life, both society in general and many health professionals have inadvertently helped perpetuate the myth of the asexual older person. This can happen through an unintentional lack of recognition, or an avoidance of a topic that makes some people uncomfortable.
Why does this matter?
These ageist attitudes can have an impact on older adults not only in their personal lives, but also in relation to their health needs. Examples include the failure of medical personnel to test for sexually transmissible infections in older populations, or the refusal of patients to take prescribed medications because of adverse impacts on erection rigidity. We need more health practitioners to be conscious of and incorporate later life sexuality into the regular health care of older adults. We still have a long way to go.
By ignoring the importance of sexuality for many older adults, we fail to acknowledge the role that sexuality plays in many people’s relationships, health, well-being and quality of life. Failure to address sexual issues with older patients may lead to or exacerbate marital problems and result in the withdrawal of one or both partners from other forms of intimacy. Failure to discuss sexual health needs with patients can also lead to incorrect medical diagnoses, such as the misdiagnosis of dementia in an older patient with HIV.
It’s not about ‘the deed’ itself
In a recent survey examining sexuality in older people, adults aged between 51 and 89 were asked a series of open-ended questions about sexuality, intimacy and desire, and changes to their experiences in mid-life and later life. This information was then used to create a series of statements that participants were asked to group together in ways they felt made sense, and to rank the importance of each statement.
The most important themes that emerged from the research encompassed things such as partner compatibility, intimacy and pleasure, and factors that influence the experience of desire or the way people express themselves sexually. Although people still considered sexual expression and sexual urges to be important, they were not the focus for many people over 45.
Affectionate and intimate behaviours, trust, respect and compatibility were more important aspects of sexuality than intercourse for most people. Overall, the message was one about the quality of the experience and the desire for connection with a partner, and not about the frequency of sexual activities.
People did discuss barriers to sexual expression and intimacy such as illness, mood or lack of opportunity or a suitable partner, but many felt these were not something they focused on in their own lives. This is in line with the data that shows participants place a greater importance on intimacy and affectionate behaviours such as touching, hugging and kissing, rather than intercourse.
These results help us challenge the existing stereotype of the “asexual older person” and the idea intercourse is necessary to be considered sexually active. They also make it clear researchers and health practitioners need to focus on a greater variety of ways we can improve the experience and expressions of sexuality and intimacy for adults from mid-life onwards beyond medical interventions (like Viagra) that focus on prolonging or enhancing intercourse.
More people are dating in middle age, but are they looking after their sexual health?
A regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life
By Alana Kirk
[W]ith more middle-aged people dating, or starting new relationships than ever before, are we taking enough care and consideration of our sexual health?
When we think of the faces behind recent statistics that are showing a rise in sexually transmitted diseases (STDs), we probably picture someone young. Those irresponsible students and twentysomethings playing around and not thinking through the consequences of their actions. But not so much. It is becoming clear that a large proportion of people contributing to those statistics are in fact, middle-aged. The Irish Family Planning Association (IFPA) annual report highlighted an increase in women aged over 50 coming to the clinics for sexual health services, including sexually transmitted infection screening and menopause check-ups.
The association said there was a perception that once women reached menopause, that they no long needed sexual health services. But that’s not the case. Minding our sexual health all through our life is as important as looking after our physical and mental health.
Unplanned pregnancies
For many women, perhaps coming out of a long marriage or relationship, they perhaps don’t seem to think they have to go back to the good old days of contraception and protection. Yet there are more unplanned pregnancies in the 40-plus age group than the younger ages.
“We definitely see an innocence and a lack of knowledge in middle-aged women seeking our services,” says Caitriona Henchion, medical director of the IFPA. “We see women not knowing if they need emergency contraception or whether they are experiencing menopausal symptoms. They’re not sure even in their late 40s and early 50s whether they still need contraception.”
The recommendation for contraception is very simple, yet perhaps not widely known. Until you have not experienced periods for two full years and you are under the age of 50, or one full year without periods after the age of 50, you need to still consider contraception. Amid constant talk of falling fertility as we age, many women are confused about their contraception needs.
This lack of knowledge about sexual health needs is apparent not just in the number of unplanned pregnancies in older women, but the rise of STDs in that age group as well. According to Henchion, advice from GPs can sometimes vary in quality and quantity, and so any sexually active woman over the age of 40 needs to seriously consider both her health risks and contraception needs.
Regular screening
The recommendation is that anyone who is sexually active needs regular screening. This seems to be something that many women feel unable to do. But emerging from a marriage or long-term relationship where the partner may have had other sexual partners means that STD screening is imperative.
“Discovering an unfaithful partner is a really common reason that we see older women coming to our clinics for screening,” says Henchion. “Our advice would be that the first thing to consider when starting with new partners is to ensure you have safer sex with condoms.”
But condoms don’t protect against everything, so the recommendation from the IFPA would be that if in sexual relationships you need to have testing twice a year.
“Obviously the people I see are a self-selecting group who are sexually active and attending our services, but certainly I would see a lot more people in the 50-plus [group] who are openly talking about their wants and needs and their problems with it, which is great,” explains Henchion. Who they do not see are the men and women not seeking sexual health services, or asking openly about their needs
One of the reasons there is a rise in general of STDs is because far more tests are being carried out, and therefore, more positive results. The tests are better now for chlamydia and gonorrhoea, so whereas a few years ago tests had less than 75 per cent detection rate, today it is 99 per cent. The tests themselves are simple. For men with no symptoms it is a straightforward urine sample and blood test, and for a woman, a vaginal swab and blood test in a nurse-led clinic.
Simple rule
According to Henchion, “the simple rule would be if you have a new partner for a few weeks, get tested.” But for many people, we perhaps don’t even know what to look for.
The top three STDs in terms of prevalence would be chlamydia, warts and herpes, and although many of the symptoms are obvious such as bleeding or physical warts, in more than 50 per cent of cases there are no symptoms. How many cases are picked up is through automatic testing when going for certain contraception options such as the coil.
Henchion believes we need better sex education and awareness for all generations. “I see 21-year-olds coming in with no understanding of how STDs such as herpes and warts can still be spread even though they are using condoms. And for sexually active people in middle age, there is often a significant lack of knowledge.”
For now, until sexual health education is more widely available, there are plenty of support services including GPs, well woman/well man sexual health clinics and the Guide Clinic at St James’s Hospital. The IFPA offers free advice, and there are plenty of online services such as HealthyIreland.ie.
“The key message is that early detection makes a huge difference in reducing risk of pelvic infection and obviously reducing the risk of passing it on,” warns Henchion. “Anyone, whatever age, who is sexually active needs to mind their sexual health.”
Middle-aged, single and on fire – or talking ourselves celibate?
For many women who have reached the supposed sexual prime of their 40s and 50s, their body image is shattered along with their energy. A recent survey suggested some women in this age bracket have the lowest confidence of any other age group regarding body image, and it’s affecting their sex lives. Yet another survey highlighted the fact that some women in middle age are having the best sex of their lives. If both surveys are right, is it all just down to attitude, and can changing your attitude change your sexual mojo?
In the two decades since the iconic shenanigans of the “man-eater” Samantha shocked a nation in Sex and the City (while women everywhere sniggered at the delight of it), middle-age sex is becoming mainstream. The BBC were at it with Happy Valley, and even Cold Feet caught up. First time round, Adam and co were in their youth, but now that they are heading towards 50, who is the one having all the sex? Karen. Middle-aged, single and on fire. Now that ordinary middle-aged women are being shown to be – gasp! – sexual, it begs the question: what does this mean for us? Is this liberating or intimidating?
It seems your answer to that question is the difference between having an active sex life in and beyond middle age and putting away the sexy knickers and taking out the comfy slippers.
Like tight skin and fashionable clothes, sex used to be the domain of the young. But now middle-aged women can have tight skin, fashionable clothes and sex as well. It all depends on your attitude. If you think your sex life is over at 50, it will be.
“Attitude is so important,” says sex therapist Kate McCabe. “I see women challenging traditional values and beliefs that you are past it sexually after a certain age. Women are having babies later, new relationships later, are mentally and physically healthier and anxious to be active and participate fully in every aspect of their lives.”
In fact, a regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life. This generation of middle-aged women have opportunities to redefine what stereotype they fit into, experiencing greater sexual, financial, social and intellectual freedom than at any previous time. Contraception has meant we are not overburdened with childbearing, and openness about sex means that issues which might have caused discomfort and difficulty can be addressed. The increase in divorce and separation now means that middle-aged dating is an acceptable social norm.
So why are all middle-aged women not taking advantage of the chance to flirt their 50s away and sex up their 60s
“Sex must be worth it,” explains McCabe. “I see women who come into therapy to see how they can best improve their sex life, even to the extent that they’ll bring in their partners and manage to engage in that conversation.
And it’s women of all ages. McCabe has clients in their 60s and 70s. “They are definitely getting out there, and they want really good, honest information on how to make the most of their sexual potential.”
But what about those women who are talking themselves celibate because of lack of confidence? Media plays a huge part in how women can often rate themselves. According to McCabe, feeling sensual has nothing to do with how you look.
“Finding intimacy is a brave step. Overcoming hang-ups to really explore our own sensuality is vital. And much of it relies on getting the right attitude.”
[Z]hang Guowei, a 76-year-old bisexual veteran, is relishing his twilight years. “I couldn’t be happier with my life post-retirement,” says Zhang, who was a doctor in the army until 1994.
As a former military officer, Zhang’s monthly pension is 10,000 yuan ($1,440) — five times the average pension in Changde, the small city in central China’s Hunan province where he lives with his boyfriend. Zhang divorced his wife in 2003 and met the love of his life — Wu, who is 40 years younger — a year later on the internet. “I expect him to accompany me through the remainder of my life,” Zhang tells Sixth Tone after finishing his daily exercise routine.
Zhang says he is bisexual but prefers men. He gained support and understanding from his ex-wife and two daughters when he came out to them in 2003. When he passes on, his assets will be divided equally among his daughters and his boyfriend. “My kids have no problem sharing with Wu because they know he is the one taking care of me in my final years,” he says.
The May-December couple have been living together since 2005 in an apartment provided by the government for retired army cadres and their families. The 10-story building houses a dozen veterans in their 60s through 90s, some living alone and others with their spouses.
When Wu first moved in, Zhang told his neighbors that Wu was his gan erzi, or adopted son, whom he met online. (The Chinese concept of gan erzi allows for a sort of informal adoption of adults, with no legal or religious implications.) “I had this vague idea that they might be gay,” says 74-year-old Lu Shize, who lives downstairs. “But it’s none of my business to ask about his private life,” Lu adds.
Last year, following in other veterans’ footsteps, Zhang wrote a 218-page autobiography — including his experiences of recognizing his sexuality — and shared it with his fellow cadres. His neighbors were very understanding. “Everyone knows about us, and no one gossips or gives us a hard time,” Zhang says.
Lu, who had never before met any out gay or bisexual men, says he admires Zhang’s courage. “Being gay or not, it doesn’t change the way I see him,” Lu says. “We are in our 70s; what’s more important than being happy and healthy?”
China’s population is rapidly aging. The proportion of the population aged 60 or older was more than 16 percent at the end of 2015, according to the Ministry of Civil Affairs, and that number is only set to increase. The nation’s changing demography brings with it challenges for managing welfare and health care, especially as fewer seniors are able to count on their families for support.
Two older men hold a symbolic wedding ceremony in Beijing, Jan. 30, 2013.
Decades of family-planning restrictions mean that even seniors who have children often must become self-reliant, as children born during the one-child policy can’t afford to support two parents and four grandparents. As a result, for many elders, being childless is no longer a major concern or an unusual occurrence.
Wen Xiaojun, 56, is single and childless. Immediately after he retired in November from working as a civil servant, he rented an apartment in Sanya, on the southern island of Hainan, where he is spending six months avoiding the cold of his hometown in the eastern province of Zhejiang. “I still feel young and restless,” Wen tells Sixth Tone. “Being childless makes it easy for me to travel after retirement.”
Like other older people, LGBT seniors want to have rich, fulfilling, and independent lives. They hope that retirement will give them the opportunity to focus on what they truly love.
Wen enjoys his slow-paced life in Sanya. He goes to exhibitions, takes walks along the beach, plays volleyball with locals, and sometimes meets up with men he contacts through Blued — a popular gay social app, on which he hopes to find a long-term boyfriend.
But dating isn’t easy for older gay men. “Younger generations can build a relationship quickly by kissing or having sex soon after they meet offline,” Wen explains. “But we want something more spiritual and stable.”
Similarly, 62-year-old Ah Shan, as he’s called within the gay community, says that finding a partner is his biggest problem these days. His finances are secure, as he owns his apartment in Guangzhou — capital of southern China’s Guangdong province — and receives a monthly pension of about 5,000 yuan, but he has been single for four years and is ready for that to change. In the meantime, he is renting out one of his bedrooms to gay friends so he has some company at home.
Ah Shan poses for a picture in Guangzhou, Guangdong province, 2013.
Most gays, lesbians, and bisexuals of Ah Shan’s generation knew little about their sexual orientation until internet access became available at the turn of the millennium. Even when Ah Shan was working in the U.S. in the late 1980s, he refused to consider himself gay because the only information he’d heard about gay topics in China was AIDS-related or implied that homosexuality was shameful or immoral. “I think I was brainwashed,” Ah Shan laughs.
Over the last two years, Ah Shan has been working on a gay oral history project, recording the stories of older gay men in Guangzhou. He has talked to more than 60 gay men aged from 60 to 90, who have experienced some of China’s most critical historic moments, from the Cultural Revolution to the nation’s opening-up era. “If we don’t record them now, part of the important history of LGBT in China will be gone,” he says.
Many of the men are married and choose not to come out to their families. “They go to this particular park to chat with other gay men in the daytime to release their emotions, but when the sun goes down, they have to return home to bear their family responsibilities,” Ah Shan says with a sigh.
Ah Shan’s own parents passed away before he was brave enough to tell them the truth. His mother died in 2000, a year before homosexuality was declassified as a mental illness in China.
Compared with gay and bisexual men, older women find it even more difficult to disclose or discuss their sexual orientation. Since 2010, 45-year-old Yu Shi from Chengdu, the capital of Sichuan province, has been working on an oral history project for older same-sex-attracted women across China, but she says the process of locating participants and persuading them to share their stories is tough.
“Chinese women are in a weak position in the family, which doesn’t allow them to speak out for themselves,” Yu says, adding that of the 30 or so lesbians who have taken part in the project over the last six years, only one has come out to her family. Many won’t divorce their husbands even if they have female partners. “Chinese people are very concerned with saving face, and they think it’s a loss of face to get a divorce if you’re already a grandparent,” she says.
Yu and her 40-year-old girlfriend have lived together for over a decade, but despite their enduring, loving relationship, they can’t enjoy the security of a formal union, as same-sex marriage is not yet legal in China. Some issues can be resolved by making a will, but others — like legal or medical power of attorney — remain a problem.
According to Yu, some LGBT seniors who are single and childless have considered building their own retirement estate where they can live together and take care of one another. Although they aren’t opposed to regular nursing homes, Yu says “they prefer to live in a place where they can open their hearts and share their experiences with others in the same circumstances.”
A lesbian couple kiss each other during an event in Shanghai, Dec. 22, 2013.
As more and more seniors live separately from their children, retirement facilities in China have struggled to meet growing demand. The government encourages investment in privately owned nursing homes, but so far none have been established exclusively for members of sexual minority groups.
Little public attention is given to the needs of older LGBT people, but to Wang Anke, a 50-year-old bisexual woman from Beijing, these individuals don’t do enough to stand up for themselves, either. “We are almost invisible,” she says.
Wang married her husband in 1990 and plans to spend the rest of her life with him. Though Wang considers herself happy and fortunate, she says that most older lesbian and bisexual women she knows are pessimistic about their senior years. “They’re lonely and lack emotional care,” Wang says, adding that many would rather live alone than move into a nursing home where they fear they can’t be themselves. “Loneliness will go to the grave with them.”
But while some LGBT seniors advocate dedicated nursing homes, Ah Shan opposes the idea of separate services. “In the long run, LGBT people shouldn’t lock ourselves in a so-called safe place,” he says. “What we really need is for the overall environment to allow us to live comfortably in the community.”
When Wu first moved in, Zhang told his neighbors that Wu was his gan erzi, or adopted son, whom he met online. (The Chinese concept of gan erzi allows for a sort of informal adoption of adults, with no legal or religious implications.) “I had this vague idea that they might be gay,” says 74-year-old Lu Shize, who lives downstairs. “But it’s none of my business to ask about his private life,” Lu adds.
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