Monday, Jan. 19, 2004
Still Sexy After 60
By Frederic Golden
They are not yet eligible for Social Security or Medicare, but you can tell from their sagging chins, receding hairlines and growing paunches that they are on the verge of major changes in mind and body. Yes, America's 77 million baby boomers are coming of age--old age. In two years the first offspring of the post--World War II generation (born from 1946 to 1964) will turn 60. What will that mean for the sons and daughters of the Age of Aquarius? Will passion diminish? Will performance decline or (gasp!) wither away?
Well, kids, take it from someone who has collected his first Social Security check: the sexual impulse doesn't vanish with age, even if--how to say this delicately?--execution sometimes falters. There's plenty of evidence--scientific and otherwise--that healthy seniors, even residents of nursing homes, continue to have active sex lives. Consider the decision of a Riverdale, N.Y., senior home to permit trysts among clients as long as they are consensual. Or the buzz about the film Something's Gotta Give, in which Jack Nicholson plays a 62-year-old roue who boasts of never having had sex with a woman over 30, only to free-fall for Diane Keaton, his latest girlfriend's mom, still steamy in her 50s.
And why not? Without fear of an unwanted pregnancy--or worries about kids barging into the bedroom--older couples have much less reason to be uptight about sex. They are also much more likely to be adept at pleasing each other, knowing where and how to arouse. Some sex counselors report that they see quite a bit of what anthropologist Margaret Mead called PMZ (post-menopausal zest). "Indeed, some women begin to have orgasms for the first time as they grow older," write Dr. Robert Butler and his wife, psychotherapist Myrna Lewis, in The New Love and Sex After 60 (Ballantine Books; 400 pages), the latest edition of their classic advice book.
So what's to fret about if you're only edging 60? Well, there are a few impediments. For all the cheerleading of sex-advice books and the fervor of magazines like Modern Maturity, the AARP's house organ (GREAT SEX: WHAT'S AGE GOT TO DO WITH IT? blared a cover a few years ago that featured a voluptuous Susan Sarandon), age does bring sexual changes for both genders. My father, who flirted outrageously even after he turned 90, liked to tell the story of the old guy who wants his doctor to "lower" his sex urge. At your age, says the astonished physician, you ought to be happy to have any sex urge. "You don't understand, Doc," the old guy persists. "I want you to lower it from here [pointing to his head] to there [his groin]." Erectile dysfunction is, in fact, no joke; it afflicts about 1 of every 4 men over age 45 and half of all men over 75.
Nowadays doctors can help many of them. Since Viagra's ballyhooed debut in 1998, the little blue pills and their progeny (Levitra and Cialis) have been doled out--thanks in part to former Senator Bob Dole's TV huckstering--by the millions. They have been a boon for countless men (and, one hopes, their partners) while reducing demand for penile implants and other awkward mechanical aids. "We took Mr. V on our cruise," an elderly couple recently wrote Tampa, Fla., sex therapist Bonnie Saks from their post-counseling trip. "Had a great time. Thank you very much." Still, these wonder drugs won't do any good if there is no sexual urge in the first place or if other health conditions impair erectile function. As Saks points out, "The medications won't initiate libido. The desire has to be there already in order for them to work."
Yet sexual dysfunction isn't just about male impotence. Both sexes experience failures as they age. And any number of health factors may be at fault, including poor circulation, diabetes, high blood pressure, heart disease, stress and alcoholism--to say nothing of the medications often prescribed for them. For women, the problem is often a decline in estrogen at menopause, usually around age 50. That may cause disconcerting hot flashes as well as dryness and a thinning of the vaginal wall that can make intercourse unpleasurable, if not painful. Production of the male sex hormone testosterone--which occurs in both sexes--also drops, and with that may come a diminished interest in sex. Finally, as wrinkles and cellulite accumulate, they can affect a woman's self-image. She may not only feel less desire, she may feel she's less desirable to her partner, who by this time is probably having self-image and performance problems of his own.
For women, there are no magical routes to arousal. So far, Viagra-type drugs haven't worked for them. On the contrary, an indifferent partner who suddenly becomes amorous can ruin a relationship. Divorce lawyers talk these days about Viagra affairs and split-ups. Some doctors are prescribing testosterone as a libido booster for so-called low-T women, helping push up testosterone sales some 17 times in the past decade to about $400 million annually. Variously given as a pill combined with estrogen or as a patch, cream or injection, testosterone remains unproven as a sex aid. Meanwhile, it can cause oily skin, unwanted facial hair, a lowered voice and an upsetting onslaught of sexual fantasies.
But these risks haven't slowed the run on sex-enhancing nostrums, from herbal supplements like horny goat weed to topical Viacreme, many of them sold on the Web. How good are they? Probably not much better than the monkey testicles worried men had sutured onto their own testicles in the 1920s. ConsumerLab, a White Plains, N.Y., testing firm, found when it sampled Web-peddled human growth hormone (HGH) supplements that they contained no more HGH than a hamburger.
Most gerontologists recommend exercise and a healthy lifestyle as a far better route to prolonged sexual happiness. Says Dr. Jeffrey M. Drazen, editor in chief of the New England Journal of Medicine: "You're better off spending your money at a gym." Heeding his own advice, Butler, 76, the former director of the National Institute on Aging and founder of the International Longevity Center in New York City, and his wife, 64, exercise daily, stressing aerobic fitness, strength, flexibility, balance and posture. On weekends they go off with a walking group. And their sex life? "Just great," says Butler.
Workouts of the imagination can help too. "Take a vacation; make out in the car," sex therapist Cynthia Lief Ruberg, co-author of Pathways to Pleasure (PEC Publishing; 223 pages), tells elderly clients who complain they're in a rut. Or try new ways of doing the same old thing. In Married Lust: 10 Secrets of Long-Lasting Desire (Hearst Books; 224 pages), Pamela Lister and the editors of Redbook prescribe new sex positions, from tender to kinky, as "a perfect antidote to the encroaching dullness of routine." (Their survey shows women favor the missionary position, while men tend to want the woman on top.)
As for balky erections, Viagra alone may not suffice. "Men feel they're expected to perform, which can create a situation called spectatoring," explains Tampa's Dr. Saks. "Rather than being in the game and enjoying the passion, you become a spectator, watching and observing and anxious, worrying about your performance and your partner's acceptance. You can't get an erection even with Viagra." One answer may be more direct stimulation by a sympathetic, caring partner. "You have to start slowly, with touching, and take the pressure off," says Saks. "People make sex too much work."
That's a lesson the aging sometimes forget. Too often they fail to appreciate their own sexual needs or powers, succumbing to old myths about declining sexuality. Freud was sure female sexuality ended at menopause--a time, he huffed, when women become petty, stingy and sadistic and acquire other "anal-erotic" traits. But the evidence suggests quite the opposite. "Many [seniors] still want and seek orgasms when they're in their 70s and 80s," says Dr. Kevan Namazi, former chair of the gerontology department at the University of Texas Southwestern Medical Center at Dallas.
But satisfaction can come in unexpected ways. As Peggy Brick, co-author of New Expectations, a frank handbook for sex counselors for seniors from SIECUS (the Sexual Information and Education Council of the United States), points out, "What's appropriate sexual behavior for a 21-year-old is not appropriate for a 70-year-old." Given the diminished male ability to produce erections, many older couples rely on what sex counselors call "outercourse." Instead of penetration, says Brick, who at 75 remains an active sex educator, outercourse involves other types of pleasuring, such as touching and cuddling. "[Without] the pressure on men to produce an erection," she says, "[sex] can be much more satisfying."
The emphasis, in any event, may be as much on a caring relationship as it is on sex. Both widowed and both 87, Hilde and Joe met through relatives, took to each other and decided to set up joint housekeeping--though, at her insistence, only on weekends. "We had our lovefests at my place," says Hilde, a lively community volunteer in Tamarac, Fla., a suburb of Fort Lauderdale. "But on Mondays I'd send him packing." Recently Joe suffered a mild stroke. Refusing to go into a nursing home, he moved into a little house across from Hilde's. She got it furnished, makes him dinner and continues to enjoy his companionship. "He still likes his sex," she says with a laugh, "though I'm not back yet at my old energy level because of all the work." Ettie and Ben Kranz of Cleveland, Ohio, have had a somewhat different experience. In their 68-year marriage, they had plenty of good sex until his 86 years finally caught up with him. "Our lives aren't the same, but we complement each other," says Ettie, who at 89 still drives around town, shops, cooks, bakes and tends to him. "He's my child now."
Even nursing homes are finding they must adjust to late-blooming love and its attendant complexities. In a forthcoming book, Stella Henry, a Los Angeles geriatric nurse and bioethicist, describes the very different family reactions to a romance between two pseudonymous residents--Jack, 92, and Jill, 86--in a Los Angeles-area long-term-care facility. While the man's family gave its blessings, the woman's relatives were appalled. Henry, reflecting the enlightened view of a new generation of caregivers, is sympathetic to late-December pairings as long as both partners still have their wits and the relationship doesn't disturb other residents.
Because men are often outnumbered in senior homes, they may be subjected to a lot of attention. Nancy, 83, a very proper widow who had just arrived at an upstate New York senior residence, recalls casually accepting a ride one fall afternoon from a fellow resident, a lively gent who wanted to show her the countryside. The next evening at cocktail hour, Nancy was taken aside and told in no uncertain terms by another widow that the man was already taken. "I thought I was back in a high school locker room," recalls Nancy, astonished by the woman's aggressiveness. Sexual games among the senior set can also have a happier outcome, of course. Discovering each other via the Internet, old high school sweethearts Barbara MacLeod and Bill Jessup, both 77 and living in Miami, got married last March and found, in his words, "we can teach something to newlyweds" about sex. He loves chasing Barbara around the house, he says, though happily for him, "she won't run that much."
Innocent fun or not so innocent, senior sexuality still ruffles feathers in a society that prefers not to acknowledge its existence. Many doctors won't even bring the subject up with older patients. "That affection is subject to ridicule seems just wrong, ageist," says Butler.
But attitudes are changing. "To be bodily close again, to enjoy whatever the aging process allows, is one of the greatest blessings I know," a woman, 73, tells sex educator Eric Johnson. "Grow old along with me," the Victorian poet Elizabeth Barrett Browning wrote to her new husband Robert Browning when she was 40, he was 34, and open expression of sexual desire was unheard of in polite society. "The best," she promised, "is yet to be." We're only beginning to learn how right she was. --With reporting by Kathie Klarreich/Miami and Wendy Malloy/Tampa
With reporting by Kathie Klarreich/Miami and Wendy Malloy/Tampa