Here's Looking at You, Dear

Here's Looking at You, Dear

Sex will change, but it need not cease with aging

Crowing older doesn't mean giving up a sex life. To the contrary, some of the most satisfying sexual experiences may come in later life. Dr. Robert N. Butler, professor of geriatrics at Mount Sinai Medical Center in New York and co-author of Love and Sex after 60 (with Myrna I. Lewis, Ballantine, revised 1993) answered some questions about sexuality and aging.

What physical changes can people expect during sexual activity as they grow older?

Reaction time to auditory and visual stimuli increases as we age. It also takes longer for sexual arousal to occur and it takes longer to complete intercourse. The time needed between sexual encounters is usually longer, too. But assuming good health and the presence of a partner who interests you and with whom you have a good relationship, desire remains strong and does not decline as a consequence of aging per se.

But isn't illness likely to interfere with sexual desire?

People of any age have to make adjustments during illness, and there are more likely to be illnesses the older we get. Illness saps energy and causes worry, which in turn makes people less preoccupied with sexuality. Some specific diseases have particularly adverse effects on sexuality. Diabetes is often associated with problems, for example, as is atherosclerosis, where fatty plaques in arteries and vessels reduce the supply of blood to the genital area in both men and women. This is determined because sexual excitation is dependent upon blood engorgement in the genitalia.

Sex will change. Photo by Elena

In addition, important therapeutic medications like antihypertension prescriptions may take away sexual capability to some degree. These problem areas can be improved, however, with appropriate medical care. An older patient who is interested in sexuality should read up on the subject and bring up issues with a doctor. If the doctor doesn't seem comfortable, the patient may need to talk with a different doctor.

Are there benefits to maintening an active sex life?

Social pressure tends to be negative toward sexuality and aging, and our society tries to deny that older people have any interest in sexuality. That attitude is built into the culture and with it comes kidding and jokes, anxious humor, and nervous laughter. But the desire for closeness and intimacy is very profound and goes on right through the end of life.

Older people often comment that no one ever touches them and they never have the change to touch anyone else. That's especially true of older women because they tend to marry men three years older and they outlive men by about seven years. When somebody else thinks well of you, is attracted to you, and wants to be with you physically, it affirms your personhood.

There are physical benefits, too, but they're trickier to pinpoint because money hasn't exactly been poured into research. It seems as though the pain of arthritis, for example, may be relieved at least temporarily with sexual activity. And just as runners have highs that probably are related to endorphins in the brain, sexual activity, too, may produce a kind of high related to the central nervous system neurotransmitters.

How can older couples maintain their interest in sexual activity?

The way to keep the music playing, as the song goes, is for people to be concerned about each other and to remain interesting to their partners by continuing to learn and grow. Never downplay romance. People living together tend to take each other for granted and not date and not have fun, when they could go dancing, have an intimate dinner, or take trips together.