I went on a date one evening, I say on the dating app that I am much older than stated and want someone that doesn’t care about age at all. When I share my age, there will be “sticker shock” so be prepared. Ha.
One gent asked me out on that app. So, he supposedly read my profile. At dinner, he inquired how old I was. When I told him he squinted, then swore, then gulped and inquired if everything still worked “down there”. Ha.
Many people, especially in our culture, make seniors seem like doddering fools. Seniors are portrayed on TV in sitcoms, in movies, and in novels, as having poor memory, aching joints, and cobwebs covering southerly regions. Nothing can be further from the truth for many of us.
No Expiration Date
There is, as an accurate article entitled in Medscape says it all, “No Expiration Date for Sex.”
For health professionals, the thought that our parents and grandparents don't have sex — or didn't — might be comforting. They might not want to talk to elderly patients about “down there”. Especially young doctors still green behind their ears.
However, the reality is that for a significant proportion of our older patients, sex has no use-by date. Humans are potentially sexual beings throughout their entire lives. Yet, our American youth-worshiping culture has concealed this reality.
According to Hollywood, sex is only for the young, the healthy, and the beautiful.
For the medical profession, sex consists mainly of risks or dysfunctions.
The results of these biases? Many middle-aged people fear their later sexual life. Many seniors accept that they should not be having a sex life. And medical professionals rarely ask about sex in the doctor’s inner sanctum office. That failing can be harmful. And sad.
Sexuality and intimacy are essential elements for a quality life, with clear physical, emotional, and relational benefits. At any age.
What does the data say?
A 2015 UK national research on sexuality found a link between age and a decline in various aspects of sexual activity — but not a zeroing-out. In men aged 70-79, 59% reported having had sex in the past year, with 19% having intercourse at least twice a month and 18% masturbating at least that often. Above age 80, those numbers dropped respectively to 39%, 6%, and 5%.
Why these declines? A combination of taboo, fear of disease, use of medications or other interventions that disrupt sexual function or cause disfigurement, and a little bit of age itself. But less of age than other factors, especially such as side effects of medications. For example, most anti-depressants severely ding desire. In both genders.
Women? Among women ages 70-79, 39% said they'd had sex in the past year, with 6% having intercourse at least twice per month and 5% masturbating two times or more monthly. Above age 80, those numbers respectively were 10%, 4.5%, and 1%.
Driving the fall-off in women were the same factors as for men, plus the sad reality that many heterosexual women become widowed because their older male partners died earlier. PS This makes a huge case for older women to be with younger males, rather than how we now support that idea the other way around. Also, way too many are not offered hormonal therapies which help reboot sex drive and enjoyment.
Why? Hormonal therapies are no longer taught in most medical, osteopathic, and naturopathic colleges since the first Women’s Health Initiative (WHI) scary conclusions, published in 2002, got most docs and patients in the US frightened of hormones.
Yet the same authors that published the first WHI’s recommendations completely revised them in a reanalysis of the WHI in 2019. The entire first study was found to have severe methodological flaws.
In fact, the reanalysis conclusions found hormones to protect breasts against breast cancer.
At the Chicago conference where I just taught 100 doctors, all the OBGYN docs present admitted they had NO idea about any WHI reanalysis.
The 2019 WHI reanalysis completed reversed the first false WHI 2002 recommendations. The WHI reanalysis - by the very same authors that originally ran and published the data - now said that estrogen replacement protects breasts against breast cancer.
And if you have been on estrogen replacement for an average of 5 years, and you get breast cancer, it protects you from dying from the disease.
In other words, the same original authors now said that if you are on estrogen replacement, and you get breast cancer, you are in better shape.
You are less apt to die from it. With a reduced fatality rate of 44%. Nothing else has ever protected breast tissue and life from breast cancer, as estrogen therapies have now been found to do so. In healthy women.
NONE of the OBGYN docs at this symposium had ever heard about a WHI reanalysis.
Why might this be? These docs are gynecologists. They depend on ACOG, the American College of Obstetrics and Gynecology, to keep them updated and informed.
But ACOG’s website still cites the first WHI’s recommendations. It does not mention the reanalysis at all. Thus, these well-intended docs had NO idea about this emerging reality of estrogen therapies. This all contributes to too many seniors missing out on hormonal therapies. This means that too many seniors miss out on hormones that would have further assisted them in living and enjoying a life that still includes the gift of intimacy.
The male-female difference in lower levels of intimacy also reflects lower levels of testosterone in women. Which suggests if you do desire to try hormone therapies, you might request a little testosterone be added.
And, because women say they value intimacy more than performance, we have two explanations for their lower frequency of masturbation. After all, a lot of intimacy occurs without either intercourse or masturbation.
Surprisingly the amount of reported sexual problems in young American women.
At age 18-44, 11% of US women report sexual distress;
At age 45-64, the figure was 15%;
And at age 65 and up, 9%.
Lots of women, especially younger, have sexual distress, or problems performing and/or enjoying intimacy. Although dyspareunia or erectile problems affect many in long-standing relationships, neither is a reason to abstain from sexual pleasure.
In many couples, oral sex will replace vaginal intercourse, and if urinary or fecal incontinence are occurring, couples can waive oral sex in favor of cuddling, kissing, digital stimulation, and other forms of intimacy.
Going back to my date. How long can we expect to be able to enjoy intimacy, if we want to? A long, long time.
Research from Nils Beckman and colleagues found that the “sex drive persists” even as people (and men in particular) reach their “100th” year.
Centenarians still do it!
Beckman's group interviewed 269 Swedish seniors, all without dementia, at age 97.
Sexual desire was affirmed by 27% of men and 5% of women in the survey.
Among the men, 32% said they still had sexual thoughts, compared with 18% of women.
Meanwhile, 26% of the men and 15% of the women said they missed sexual activity.
What should we do with this data?
According to the 97-year-old Swedes, most want to talk to their docs about intimacy. Docs should start talking about sex with their senior patients.
On the other hand, patients should take a breath, and ask away themselves. They should jump-start these conversations, if docs don’t.
Seniors are not fearful when it comes to talking about sex. They have been around a long time and are open if their docs are open. Sometimes the solution is the conversation itself. Many patients are relieved to merely discuss intimacy. Sex is valuable and we should not leave it out of healing conversations.
Research on hugging reveals it can reduce the concentrations of pro-inflammatory cytokines, and kissing positively influences cholesterol levels. Every little bit of intimacy counts.
There are definitive benefits for seniors making love. I discuss a lot of these in SEXY BRAIN, where I explain that when we make love, nature has our bodies release many brain-protective hormones in both the male and female body.
Nature wants our brains to stay healthier. Intimacy is one way to do so. When seniors continue to make love, this delays the onset of dementia.
Senior sex has been linked to longevity, with men benefitting a bit more than women from going through the entire process, including an orgasm, whereas women appear to gain from having a "satisfying" sex life, which does not always require an orgasm.
Intimacy is a gift from Nature that none of us should miss out on. Don’t let the media that shows a silly and degrading picture of aging and our genitals, make you see yourself as “less than”.
Yes! Things still work amazingly well… down there.
Amen.
Knowledge is power, and sometimes, a heck of a lot of fun and, brain boosting, too.
Dr. B.
References:
No Expiration Date for Sex - Medscape - May 18, 2023.
SEXY BRAIN Berkson DL Awakened Medicine Press 2017
Love this!!! YES! I’m quickly approaching the 70 mark and my better half is 88. I think we have more sex than people half our age. We are both on BHRT. It makes a difference! The medical community needs more education and there are too few providers who are open minded enough to treat. They ruminate in the fears placed in
Medical schools that are inaccurate. You bring so much light to this topic.. THANK YOU
What the ......!! I hope your reply was akin to 'all works perfectly thank you, but just how perfect YOU certainly, will never know'. Dr DLB, I am 64 and the privilege of your company would be a dream, then alone being on a date date ... #sexybrainisassexyas