LIVING GREATER

Sex and the single senior

Stephanie Dickrell
sdickrell@stcloudtimes.com
About 73 percent of older adults aged 57–64 engage in sexual activity, comparable to the rates for adults aged 18–59. And of those sexually active, 65 percent reported frequent activity, more than two to three times a month.

As people are living longer, more people are hitting their senior years in better health, expecting to continue their sex lives.

Data confirms that. About 73 percent of older adults aged 57–64 engage in sexual activity, comparable to the rates for adults aged 18–59. And of those sexually active, 65 percent reported frequent activity, more than two to three times a month.

Desire doesn't stop at retirement age either. About 71 percent of women aged 80 to 102 reported fantasizing or daydreaming about the opposite sex.

That's good news. We know sex and intimacy are associated with emotional benefits, such as decreased levels of depression, increased psychological well-being, overall quality of life, and self-esteem, according to research.

But life, circumstances and illness can interfere with ability or enjoyment of sex. In some cases, the loss of a long-term partner may mean entering into a dating (and sex) scene that is very different from 40 years ago.

In a study of Wisconsin seniors, about one in 10 older adults reported problems with having a satisfying sexual experience. Half of the respondents reported difficulty maintaining sexual activity.

There was also a gender split: a significantly higher portion of older adult women reported a lack of sexual satisfaction, while a significantly higher portion of older adult men reported being unable to maintain their sexual relationship.

So, as Salt 'n Pepa advise us: Let's talk about sex, baby.

Some things to consider:

Yes, STDs are still an issue. Many people assume since pregnancy isn't a possibility, there's no need for a condom. In fact, STDs like chlamydia and gonorrhea are making their way around senior communities. Left untreated, some can lead to more serious illness.

"They don't think to ask, 'OK, you show me your test and I'll show you mine,' " said Phyllis Greenberg, associate professor in the gerontology department at St. Cloud State University. "If somebody refuses to use a condom, that should be a big red flag."

Yes, HIV is a problem. One in 10 people diagnosed today with HIV are over the age of 50. The size of the population of older people with HIV is growing, Greenberg said. Part of that is due to better medications helping people with HIV and AIDS live longer. But it's also likely the virus is being passed among sexually active seniors.

Physiological changes mean it's more likely for the virus to be transmitted. For instance, with women, vaginal walls become thinner and more frail, and their body produces less lubrication. That means tearing is more likely, making transmission easier.

Older Americans are also more likely to be diagnosed with HIV infection later in the course of their disease, according to the Centers for Disease Control and Prevention.

Yes, health providers are uncomfortable, too. Just as some health providers are uncomfortable bringing up the topic of death and dying, many are uncomfortable addressing sex issues with older patients.

"I will tell you that too many physicians do not bring up this conversation," Greenberg said, especially when women pass menopause.

Jennifer Aulwes, spokesperson for Planned Parenthood, said their health staff is well equipped to answer questions from seniors.

"That's what our clinicians are really good at, making people feel comfortable. They may slip under the radar at your regular provider's office," she said.

Yes, mental health is involved. Depression and other mental illness can affect desire. It might appear after the loss of a spouse. Intimacy can be incredibly important for people after a loss.

"Being able to have appropriate touch and comfort with somebody else ... that's a big change for them," Greenberg said.

Yes, physiology changes. Osteoporosis, stroke, heart disease, diabetes, and just simply getting older can change the way the body works and how it reacts to stimuli.

Yes, women have more trouble finding partners. Heterosexual women draw the short straw when it comes to intimacy and aging. They tend to outlive their husbands. And the ratio of older women to men can sometimes be 5-to-1, Greenberg says.

As women get older, their pond becomes a puddle, she says. For men, their river becomes an ocean.

"Men are a hot commodity," she said. "Sometimes, they get really nervous about it, women coming at them."

Yes, adult children may be uncomfortable. But they probably want you to be happy. If your family has a pretty open relationship to discussions of sexuality, ask away.

Planned Parenthood works a lot with parents who want help talking to their young children about sexuality, Aulwes says. It's a similar dynamic for adult children and older parents.

"We really find that the anticipation of that conversation is always the worst part," Aulwes said. "Once the conversation has begun, it can be a very positive experience for people."

Yes, looks may be a concern. In our culture, on the superficial level, aging and beauty don't mix. (Living Greater calls foul on this.) That means older women may not even try to find a partner. Greenberg gives advice she's heard from a documentary on aging and sexuality: I'd rather take a chance and be rejected than not take a chance to be accepted.

No, it's not just about intercourse. There are other ways to be intimate. If a man's erection is the problem, people can find another way. And there are ways to be sexually active without starting another long-term relationship.

No, you don't have to do anything you don't want to do. Peer pressure is real, folks. Consent can also be an issue, especially when it comes to Alzheimer's disease and dementia. It can be especially painful when one spouse is suffering while the other watches. On the other hand, people with dementia sometimes lose inhibitions, which can lead to other problems. If you wouldn't let someone sign a legal document, you shouldn't let them consent.

Yes, loss of desire can signal other problems. People should consider changes in desire for intimacy and physiology as possible symptoms for something else, and cause for concern.

Yes, there are solutions. People don't have to give up that aspect of their lives. Consulting with a physician about a loss of desire could mean a medication change. Lubricants like KY Jelly can make intercourse more comfortable. Addressing underlying mental health issues like depression or anxiety may solve some problems.

Yes, there's plenty of information if you look for it. We repeat: Plenty. See resource list below.

Follow Stephanie Dickrell on Twitter @SctimesSteph, on Facebook www.facebook.com/sctimessteph, call her at 255-8749 or find more stories at www.sctimes.com/sdickrell

By the numbers

In 2013, people age 50 and over accounted for about one in five HIV diagnoses in the U.S. 

Among ages 50-54, blacks had the highest rate of diagnoses, followed Hispanics and whites. 

Of the nearly 7,000 deaths related to AIDS in 2013, about ⅓ were among people aged 55 and older. 

Sources: Centers for Disease Control and Prevention. 

Resources 

AARP: www.aarp.org/home-family/sex-intimacy, How to have better sex after 50www.aarp.org/home-family/sex-intimacy/info-2015/sex-questions-libido-stds-schwartz.html, Better Sex: AARP's Guide to Sex After 50.

WebMD: www.webmd.com/healthy-aging/sexuality-aging

American Psychological Association: www.apa.org/pi/aging/resources/guides/sexuality.aspx.

Centers for Disease Control and Prevention: HIV among people aged 50 and over. Sexual health main page