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Sex education and sexual interest don’t end at a certain age. Melanie Ramey is here not only to debunk myths about sexuality, sexual involvement, and connection later in life but to shed light on sexual information for all ages. This podcast will answer the questions that were never properly answered in health class and address the sex information we need but are too reluctant to discuss. Join Melanie for frank discussions about bodies, sexual health, desire, and age, with honesty and humor.
Narrator: [00:00:03] Is there an age limit for good sex? Is it unusual for seniors to still want to have sexual relationships? Welcome to the Sexually Speaking podcast with sex educator and therapist Melanie Ramey. Melanie assures us that we do not stop being sexual simply because we've reached a certain age. As long as we are still above ground, we are all sexual beings.
Melanie Ramey: [00:00:30] Hello and welcome again. As we have expressed on this program, time after time, our sexuality is the core of who we are as human beings, and sex is what we do. We are sex beings from the time we are born until we die, regardless of how old you live to be. We are going to focus in this podcast about sex as we grow older. So listen up wherever you are on the journey. If you're young, you have parents and grandparents and others you know who are getting older. You may work in a facility where older people live, and if you keep breathing long enough, you will get old. A friend of mine, who is an orthopedic surgeon, told me that the oldest person he had ever done surgery on was a 90 year old man who lived in a nursing home. And it seems that his patient got into an altercation with another resident over a woman they were both interested in. The 90 year old patient leaned out of his wheelchair to hit the other man, leaned too far, fell out and broke his hip, necessitating surgery by my friend. Now, this is just one of many examples I could cite that shows us that as long as we live, we can desire emotional relationships and caring by another human being, including sexual relationships.
Melanie Ramey: [00:02:07] In 2019, Doctor Louise Aronson, a geriatrician at the University of California in San Francisco, wrote the New York Times bestseller Elderhood. I highly recommend this book and will list it on the Facebook page. In her book, she tells us that we need to look at the third part of life with the same concern, curiosity, sensitivity and vigor that we view the other two thirds. She suggests that we should really view life as childhood, adulthood and elderhood as there are changes that occur when we reach 65 and older. An important discussion in her book, I think, is how she talks about the little education that physicians receive about geriatrics. In her case, about 30 minutes during her medical education. I recently talked with a young student who will be receiving a bachelor's degree in nursing in a couple of months, and she has also received zero information about geriatrics. This is relevant because advice columnists, article writers, book editors, so forth and the like are always suggesting that you speak with your health care professional, formerly known as doctors and nurses, for virtually everything, including questions about sexuality. Well, I'm sorry to tell you, you're not likely to get very much help. As a matter of fact, the health care professionals should actually be doing a sexual health assessment for you. I have done an informal survey of probably several hundred people as to those who have had a sexual health assessment. None had had it. If you're having pain during intercourse or if you're having erectile dysfunction, obviously you need to speak with a health care professional and perhaps you need some sort of medication. And sometimes women fare a little bit better, as they may get referred to a gynecologist who can be helpful. But I have heard from several men who have tried to speak with their physician about erectile dysfunction, and they report a variation on the theme of the same experience that the physician seems to be very embarrassed, he hastily writes a prescription, and leaves the room. You will actually be better served by consulting with a sex educator, a psychologist, or social worker, clinical social worker who has special training in this area.
Melanie Ramey: [00:05:15] I recently saw an article that posed the question, can you have good sex after 70? Well, the answer would be the same if the question had been can you have good sex after 40? There is no reason why people cannot continue to have good sex as long as they live. If it's 70, 80 or 90 years old. Obviously sex may not be the same as it was when you were 40, but at 40 it's not the same as it was when you were 20. No big deal. The issue is not trying to compare to some previous experience or idea. What is important is that you feel safe, satisfied, and content with whatever your sexual experience is.
Melanie Ramey: [00:06:16] A common experience is that sometimes one divorces or a partner dies after a long relationship. As with the story I told at the beginning of this podcast, nursing home residents having an altercation about a woman, it is not unusual to see older couples marrying. A few years ago, I read a very interesting article in the New York Times about a man who was a widower, and he celebrated his 100th birthday by getting married to a widow he had known for several years. And recently there was a clip on the news about a couple who are both 99, getting married. Presently, about 17% of Americans who are over 65, with an additional 6000 joining the ranks every day, there is no question that we were in the midst of a huge demographic change, which challenges our ideas and attitudes about aging in general, and certainly our society's view about sexuality later in life has not caught up even with the character of aging in general. Not only the young and middle aged, but older people themselves are quite negative sometimes about the aspects of sexuality and as they age. Even people who have had satisfying sexual life may find that they need different information, they may need support and sometimes treatment to continue enjoying sexual activity as they age. The fact is that we all carry baggage related to sexuality, and the baggage consists of our genes, our parents, our families, our teachers, our religion and society at large.
Melanie Ramey: [00:08:29] It's very helpful to understand what underlies these attitudes and problems about sex that we encounter. Now, some of them are actually internal, and they require a look inward to yourself to ferret them out. For example, you may have wondered, is it normal for older people to have sex lives? Is it appropriate? Or is sexual interest a sign of senility? Or maybe brain disease. Is it poor judgment, or is it an inability just to accept getting older? And what would other people think if they knew I'm still interested in having sexual relations. These are questions that you need to ask yourselves and to think through, because they may be underlying what is keeping you from actually feeling free enough to engage in new relationships. A contributing factor to all of these doubts and questions is the language and what it conjures up when we think about older people. For example, when you hear the word grandmother, what do you think about? Well, a lot of times we think about a cute little old lady making cookies in the kitchen. And if we hear the word grandfather, that may make us think of a kindly looking man sitting in a rocking chair, maybe reading a book. Our language is full of phrases to describe older men that we think might be interested in sex. And some of those phrases are dirty old men and old fool and old goat. Older women are viewed really as uniformly sexless or sexually unattractive, and when there's humor about sexuality and age, it usually portrays the older man as impotent and the woman as ugly. So language that you may have always heard in the society or seen on television or whatever, and you have sort of incorporated into your own thinking, may be one of the barriers that's being a problem for you.
Melanie Ramey: [00:10:58] Men, of course, I think, have unfortunately been subject to life long emphasis on physical performance. Masculinity is often equated with physical prowess. Older men tend to judge themselves as they get older by the frequency and potency of their sexual performance as compared to younger men. However, these comparisons tend to place little value on experience and the emotional side of a relationship. So at the first signs of any change, they often begin to have self-doubts and anxiety about their ability to perform sexually. When women are under less pressure to perform, they too experience changes. Sometimes the muscle strength in the vagina weakens. The size of the vagina may also change, and dryness may occur as the natural vaginal lubrication diminishes. Both men and women without partners may worry that they may lose their capacity to totally enjoy sex due to lack of use. So as people age and the hair turns gray or disappears, the skin loses its elasticity and the body often thickens around the middle for both men and women, and they feel unattractive. Clearly, the idea of beauty desperately needs to change to include character, expressionists, achievement, disposition, voice and speech, personal warmth, personal style, social skills. These are all traits that make each of us as individuals unique and can be found at any age, and should be valued at all ages.
Melanie Ramey: [00:13:01] I want to comment a minute about lesbian, gay, bisexual, transgender, queer plus people. Together, they constitute somewhere between 5 and 10% of the population. Older LGBTQ couples and individuals have many of the same concerns and issues as older people generally, but they also sometimes have to deal with issues specifically to them. I have dealt with some of the positive and negative issues about sexuality and older people here. However, I do know that there are many older people who are not interested in sexual relationships, and I want to be clear that sexual disinterest is only a problem if the individual feels that it's troubling, or that it causes a problem to them in relating to others. Some people were never very interested in sex, even when they were younger, and it could be because of their biological makeup, or more likely, because of the particular social conditioning they've had. However, older people who do enjoy sex deserve encouragement and support as well as necessary information, accurate diagnosis.
Melanie Ramey: [00:14:33] Sexuality goes beyond the sexual urge and the act itself. For many older people, it offers the opportunity to express not only passion, but affection, esteem and loyalty. It provides evidence that one can continue to count on one's body and its functioning. It comes with the possibility of excitement, of romance, and it expresses delight in being alive. It offers an ongoing challenge to grow and change in new directions. I want to go off on a tangent here to mention one of the barriers that many older adults encounter about remaining sexually active, and that is the attitude of their adult children. It's really bizarre that many adult children concern themselves about their parent's sexual lives. I think basically you should just tell them to bug off. I recall a woman in a group I was conducting who told about her experience with her adult children. Both she and her husband were retired and sometimes they decided to have sex in the afternoon. They had two daughters, and both of the daughters had keys to their house to use in case of an emergency. One afternoon, she and her husband were having sex and they heard the door open and someone enter. They thought it was one of the daughters, and the husband called out to say that they would be out in a few minutes. However, before they had finished, the person left. Later in the day, the woman called one of the daughters and asked if she had come by and the daughter said she had, but she didn't understand why the parents were in the bedroom with the door closed. Her mother told her it was simple. They were having sex and it would work out better in the future if she and her sister called before they came over. She said her daughter seemed stunned into silence and simply said in a small voice, okay, and hung up. I think it's worth pointing out that if a parent is divorced or widowed and may be getting involved in a new relationship, that the concern may also have roots in wanting to be sure to protect what they may right or wrongly assume to be their inheritance. Do not let your adult children interfere with your happiness. They should attend to their own business.
Melanie Ramey: [00:17:23] There are some considerations that are more specific to older adults about sexual experiences. And so let's talk about some of them specifically. Well, one thing is that as we age, we often have more time to spend in physical intimacy. We should take the opportunity to explore other sexual experiences, such as massage or other erotic experiences. While people are busy working during their life, they often relegate their sexual experiences to certain times of the evening or early morning, or whenever they can work it in around their schedule. But I think what we need to do when we have more time is to explore other kinds of experiences than we've had before. For example, different times of the day in different places, that maybe that you've never had a sexual experience with your partner. Chances are, if you're retired, your whole routine has changed, and this will enable you to initiate experiences in different times and in different ways. And so you should use time to your advantage. Obviously, as we age, it can take longer to become aroused or to get turned on. But use the time that we now have to focus on other aspects of giving and receiving pleasure. This time can actually deepen your emotional connection with your partner and make the experience even more satisfying. Another idea is to consider sex toys. You would probably be surprised if you haven't had sex toys, how they might add to you and your partner's satisfaction. And you can find them online without any difficulty. Another idea is to use mobility aids; with aging may also come some mobility issues. Perhaps using pillows might make a partner more comfortable. And there are actually some chairs and benches designed to be used for sex by seniors and disabled people. So you can also find them online.
Melanie Ramey: [00:19:46] And a very important thing is to practice safe sex. Sexually transmitted infections are no respecter of age. You can get them at any age. They actually seem to be more common among older adults who are widowed or divorced. The best idea is to use a condom or dental dam. It is also a good idea to bring up the subject of testing if you aren't sure about your partner's sexual history. It's important to remember that the immune system weakens with age, making one more susceptible to infection or to complications from infections. I will put on the Facebook page a sexual history form that can be used by both men and women. If you want to discuss a sexual issue with your health care provider, I will suggest one of two approaches. Fill it out before you go and take it with you so you can address any issues you have. Or leave it blank and take it with you and tell him or her that you would like to discuss it with him. With any luck, they might actually make a copy and use it to discuss the topic with other older adult patients. In the next podcast, I will discuss specific medical conditions and how to deal with them when continuing to have sexual relationships, and also how some medications can affect performance and very importantly, the special issues involved if you live in a long term care facility. Until next time, be well and happy.
Narrator: [00:21:44] You've been listening to Sexually Speaking with sex educator and therapist Melanie Ramey. Join Melanie again for more fascinating topics about sexuality. Please visit Sexually Speaking with Melanie Ramey on Facebook, Instagram, and LinkedIn.