By Loren Stein, M.A.
Horny old broads, dirty old men. These commonly used terms speak volumes about how society views older people who are interested in sex.
Experts say such derogatory labels reflect a deep level of discomfort in our youth-oriented culture with the idea that seniors are sexually active. Sex is identified with reproduction, youthful attractiveness, and power -- and most young and even middle-aged people do not want to confront the inevitability of growing old.
So sexual intimacy among older Americans is a subject that people don't talk about much. The silence, say experts, allows misconceptions to flourish -- including the widespread assumption that seniors lose interest in sex and are, or should be, asexual.
But armed with a spate of studies that help dispel the myth that older people don't have sex or enjoy it, experts say the negative stereotypes couldn't be farther from the truth.
"There is no age limit on sexuality and sexual activity," reports Stephanie A. Sanders, PhD, associate director of the sexual research group The Kinsey Institute. While the frequency or ability to perform sexually will generally decline modestly as seniors experience the normal physiological changes that accompany aging, reports show that the majority of men and women between the ages of 50 and 80 are still enthusiastic about sex and intimacy.
"Use it or lose it," says geriatrics expert Walter M. Bortz, 70, author of three books on healthy aging as well as several studies on seniors' sexuality. Dr. Bortz, a professor at Stanford Medical School, is past president of the American Geriatrics Society and former co-chair of the American Medical Association's Task Force on Aging.
"If you stay interested, stay healthy, stay off medications, and have a good mate, then you can have good sex all the way to the end of life," he says. A Duke University study shows that some 20 percent of people over 65 have sex lives that are better than ever before, he adds.
And although not everyone wants or needs an active sex life, many people continue to be sexual all their lives. "There's strong data all over: It's a matter of survival," says Dr. Bortz. "People that have sex live longer. Married people live longer. People need people. The more intimate the connection, the more powerful the effects."
But older people may encounter an obstacle they hadn't expected: their adult children, who may be less than pleased to see their aging parents as sexual beings. Such judgmental attitudes prevent many older people from moving in with each other or even having their partner over, according to Dr. Jack Parlow, a retired clinical psychologist in Toronto. "This attitude creates a block to many seniors who want to be sexually active," he says.
The topic may well lose some of its taboo status, however, as the baby boom generation enters its later years. With their increased numbers and a marked increase in life expectancy, older adults are now the fastest-growing segment of the US population. In 2000, one out of ten Americans was 65 years or older, according to the US Census Bureau. By the year 2030, it is estimated that one in every five Americans will be 65 or over.
'I expect to make love as long as I can'
Louise Wellborn of Atlanta, Georgia, 73, believes deeply in the benefits of good sex -- at any age. "Sex keeps you active and alive," says the former businesswoman. "I think it's as healthy as can be, in fact I know it. That's what kept my husband alive for so long when he was sick. We had excellent sex, and any kind, at any time of day we wanted."
After grieving for several years over her husband's death from Alzheimer's in 1997, Wellborn began a new relationship with a man in his 80s. They occasionally have sex, but mostly they enjoy each other's company, she says. "He wants so badly to have an erection, but it's hard for him," she says. "It might be the heart medication he's taking that causes the problem, because he's a very virile man. So we just have sex in a different way -- I don't mind at all -- and we're also very affectionate. He says it's so nice to wake up next to me."
Her mastectomy two years ago after contracting breast cancer hasn't changed her self-image as a sexual being, primarily because Wellborn has had a lifelong positive attitude towards sexuality.
Her experience bolsters experts' contention that patterns of sexuality are set earlier in life. They also note that the biological changes associated with aging are less pronounced and sexuality is less affected if sexual activity is constant throughout life.
Wellborn and her husband were deeply in love, she says. After the children left home and her husband retired, the couple had more freedom to express their sexuality. She says that she and her husband had sex three to four times a week when the children lived at home; once they were alone they made love almost every day.
"I expect to make love as long as I can," she says. "I see no reason not to, and I see all kinds of reason why I should. If you've had a good loving man and a good sexual life, you'll miss it terribly if you stop. I've had everything from a cancer operation to shingles, and I'm still sexually active."
Sex is different but not diminished
Wellborn's openness about sex -- and the frequency with which she has enjoyed it -- may be somewhat unusual, but her perspective is not. One advantage of growing older is that personal relationships can take on increased importance as children and careers take a backseat. Seniors can devote more time and energy to improving their love lives. And while some seniors may be forced to give up strenuous sports, sex is a physical pleasure many older people readily enjoy.
A clear majority of men and women age 45 and up say a satisfying sexual relationship is important to the quality of life, according to a survey by the AARP (the organization formerly known as the American Association of Retired Persons). Among 45- to 59-year-olds with sexual partners, some 56 percent said they had sexual intercourse once a week or more. Among 60- to 70-year-olds with partners, 46 percent of men and 38 percent of women have sex at least once a week, as did 34 percent of those 70 or older.
Similar findings emerged in a survey conducted by the National Council on the Aging (NCOA). The study found that nearly half of all Americans age 60 or over have sex at least once a month and that nearly half also wanted to have sex more frequently. Another finding: people find their mates more physically attractive over time.
As for making love, it just gets better with age, according to Cornelia Spindel, 75, who married her husband Gerald when she was 72. They met when Gerry Spindel took his wife, who was dying of Alzheimer's, to a kosher nutrition program where Cornelia, a widow, worked as a volunteer. The two gradually became close friends, and after his wife's death, became intimate. When Gerald proposed, she accepted with pleasure. Now, Cornelia says, "We feel like young lovers or newlyweds. I felt like I was able to make love better when I was 30 than when I was 20, and now I have a whole lifetime of experience."
Her 75-year-old husband agrees, and dislikes the patronizing attitude many people display toward older people who are intimate. "Whenever people ask us how long we've been married, we say 'two years,' and they say, 'Oh, that's so cute.' We're 'cute?!' What does that mean?"
Cornelia Spindel agrees. "I don't know anything about being cute. Our love life is very warm. And very satisfying."
New treatments for sexual problems
Both men and women can expect normal physiological changes as they age that may affect the way they experience sex. Experts say these changes are not usually a barrier to enjoying a healthy sex life, but couples may have to take more time for arousal.
Postmenopausal women, for example, have lower levels of the hormone estrogen, which in turn decreases vaginal lubrication and elasticity. In many cases, dryness can be relieved by something as simple as using a water-based lubricant like KY Jelly. Doctors can offer other remedies for more difficult cases.
Men may suffer from impotence or have more difficulty achieving and sustaining erections as their blood circulation slows and testosterone levels decrease. Impotence is also more prevalent in men who have a history of heart disease, hypertension, or diabetes. Now, however, sildenafil citrate (Viagra), vardenafil (Levitra), and tadalafil (Cialis) have aided some older men who weren't helped by other treatments. (Some experts, in fact, worry that these drugs may cause an upsurge in AIDS in people over 50, because they are not likely to take precautions; they urge older people who are dating to practice safe sex.)
Some studies also suggest that the supplement ginkgo biloba, which increases circulation, can help treat impotence, but others show no such effect. Men should always check with their doctors before taking it. Among other things, ginkgo can interact with anticoagulants to cause a stroke. Despite these hopeful prognoses, studies show that only a fraction of the seniors who could be treated for sexual problems actually seek medical help. That's too bad, experts say, because even serious medical conditions need not prevent elders from having a satisfying sex life. Seniors should see a physician if they've lost interest in sex or are having sexual difficulties. Some sedatives, most antidepressants, excessive alcohol, and some prescription drugs have side effects that interfere with sex; a doctor can help adjust medication or set guidelines on alcohol intake. Illnesses, disabilities, and surgeries can also affect sexuality, but in general, even disease need not interfere with sexual expression.
The partner gap
The physical changes that occur with age can give older people a chance to revitalize their lovemaking by focusing more on intimacy and closeness instead of sex alone. Often less preoccupied with performance, they can express their affection and closeness in other ways, such as cuddling, kissing, and stroking.
"Sex is being warm and caring; sex isn't just sex," says Christopher Rhoades,* 66, a San Francisco Bay Area college professor who's been married for 18 years. "It feels good to lay next to a naked woman's body."
As he grows older, Rhoades says he doesn't feel the "compulsion" to have sex as much as he did when he was younger. With a grown son still living at home, he says he makes love less often than he'd like but still enjoys it very much. "There's a great beauty in the freedom from necessity. Sex becomes more a matter of choice and is more interesting and intriguing for each partner," he says.
But among older women who are widowed, divorced, or single, finding a partner can be difficult. According to several reports, women make up the majority of the elderly without partners. The reasons: women live longer than men, and healthy older men tend to pair up with younger women. Older women are also judged by society as less attractive than their male counterparts, a double standard that women's groups have long decried.
This "partner gap" greatly inhibits women's social and sexual activity as they reach their senior years. In the AARP study, only 32 percent of women 70 or older have partners, compared with 59 percent of men in the same age group. In the NCOA study, older men are more likely than older women to be married and have sex partners.
For men, "biology or hydraulics" is the biggest impediment to sex later in life, says Dr. Bortz. "For women, it's opportunity and availability."
Mia Pickering,* a 74-year-old San Diego author, knows this all too well. Widowed after two 20-year marriages, she finds herself single again. "A lively man with something to offer can find a woman 10 or 20 years below his own age, which leaves women in my age bracket generally out of the running," she says.
Missing male companionship, she has gone out on blind dates and actively sought out partners through dating services and personal ads -- an exercise, she says, in "futility and frustration."
Despite these challenges, Pickering, like many seniors, wants to have sex and intimacy in her life. "At this point I don't have a lot of loose lust flying around," she says. "My sex drive has diminished, but if I met a man that really attracted and interested me, it could be restarted."
* Names have been changed.
AARP. Sexuality at Midlife and Beyond: 2004 Update of Attitudes and Behaviors. May 2005. http://www.aarp.org/research/family/lifestyles/2004_sexuality.html
U. S. Census Bureau. 65+ in the United States: 2005. December 2005. http://www.census.gov/prod/2006pubs/p23-209.pdf
AARP. "Modern Maturity Sexuality Survey, http://research.aarp.org/health/mmsexsurvey_1.html
Feifer, Eric. "Determinants of Sexual Behavior: Middle and Old Age." Journal of the American Geriatrics Society: Vol. 20. 1972, pp. 151-158.
Jacoby, Susan. "Great Sex: What's Age Got to do With It?" Modern Maturity. Sept. 1999, pp. 43-48.
Mayo Clinic. Erectile Dysfunction. January 2008. http://www.mayoclinic.com/health/erectile-dysfunction/ds00162
Last Updated: March 11, 2013
Dec 12: Benefits of Mammography
Review of 4 large studies on mammography concludes screening leads to substantial reduction in breast cancer deaths.