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Excerpted from Sexuality at Midlife and Beyond

Excerpted from Sexuality at Midlife and Beyond, SHR June 2003

Attitudes about sexuality and aging

Fantasies can help rev up your sex life. Myths, on the other hand, can stop desire dead in its tracks. Such myths aren’t the legends from classical history. They’re the stories we tell ourselves and each other to support the notion that older people shouldn’t, can’t, and wouldn’t want to have sex. This type of myth, however, bears as little relationship to reality as do the fanciful sagas of ancient gods and goddesses. Here are some examples of the most popular sexual myths and the myth-busting truths.

1. The myth: Only the young are sexually attractive.

The culture we live in exalts youth. Turn on the TV or open a magazine and you’ll be barraged with images of supple skin, firm flesh, and lustrous locks. But if your mirror is reflecting a different picture these days, you may feel like the party is going on without you.

The reality: Older can be quite sexy.

Sure, thinning hair, laugh lines, and a paunchy midriff are no picnic. But think back on what it was that made you attractive in your younger years. Was it your soulful brown eyes, your crooked smile, or maybe your infectious laugh? Chances are, those attributes are still as appealing as ever. In fact, a 1999 survey conducted by the AARP and Modern Maturity magazine revealed that the percentage of people age 45 and older who consider their partners physically attractive increases with age.

2. The myth: Sexuality in later life is undignified.

Whether it’s the white-haired grandmother fussing with her knitting or the loveable old codger puffing on a pipe, society is inclined to desexualize older adults. When older adults do express their sexuality, it’s often viewed with derision — for example, the stereotype of the “dirty old man.”

The reality: It’s healthy for older adults to express their sexuality.

People are living longer and remaining healthier. And they are more vigorous than ever before. Former president George H.W. Bush went skydiving to celebrate his 75th birthday, John Glenn returned to space at age 77, and Carol Sing forged a new world record at 57 by becoming the oldest woman to swim the English Channel. With this trend toward later-life vitality, why shouldn’t seniors be allowed to cast off outdated and ill-fitting stereotypes in order to express their normal, healthy sexual appetites?

3. The myth: Men and women lose their ability to perform sexually after a certain age.

Vaginal dryness and erectile difficulties loom large as you hurtle past 50. You may be feeling that you should just listen to what your body is trying to tell you: Sex is a thing of the past.

The reality: You can still have a satisfying sex life.

While a certain degree of physical change is unavoidable, this fact of life doesn’t necessarily translate into insurmountable sexual problems. For men, the Viagra revolution means most erection problems can be corrected with little medical intervention. For women, high-tech vaginal lubricants and hormone creams and rings are viable substitutes for what nature no longer supplies. What’s important for both sexes to remember, though, is that a softer erection, reduced natural lubrication, or a less intense orgasm doesn’t mean you’re no longer interested in your partner or in sex itself. For many couples, these kinds of changes provide an impetus for developing a new, rich, and satisfying style of lovemaking — one that’s based more on extended foreplay and less on intercourse and orgasm.

4. The myth: Sex is boring when you get older.

Drooping libido, slower rates of arousal, and the predictability of having the same partner for 20 or more years all add up to a ho-hum sex life.

The reality: Sex is as good as you make it.

While it’s true that a 19-year-old will have a faster, harder erection and a more forceful ejaculation than his 55-year-old counterpart, it doesn’t mean the quality of the experience is necessarily better. On the contrary, the older man has better control of his ejaculations. Less penile sensitivity means he may be able to enjoy a wider range of erotic sensations and maintain his erection longer. And his experience may pay off in improved sexual technique and a better understanding of what will please his partner.

Many women begin to find sexual confidence in their 30s, and this blossoms with maturity. As a woman moves through her 40s, her orgasms actually become more intense, and she can still have multiple orgasms. After menopause, when she’s free of any worry about pregnancy, she can give herself over to the pure enjoyment of sex.

Although longtime partners do have to contend with issues of familiarity in their relationship, these problems can be offset by greater emotional intimacy and trust. Because inhibitions often lessen with age, sex at 50 or 60 may include a level of experimentation and playfulness you wouldn’t have dreamed of in your younger years.

By the numbers: Statistics on sexuality and sexual satisfaction

In 1999, Modern Maturity magazine and the AARP foundation polled 1,384 adults age 45 and older about the role sex played in their lives. The findings paint a detailed picture of sexuality at midlife and later.

The importance of sex

Over all, the majority of men (66.8%) and women (56.7%) responding felt that a satisfying sex life was important to their quality of life. But an even higher percentage (91.9% of men and 87.1% of women) thought that a good relationship with their spouse or partner played a key role in their happiness.

Frequency of sexual activity

Of individuals with partners, just over 60% in the youngest age bracket surveyed (45–59) had intercourse at least once a week. At age 75, the proportion dropped to one in four. Still, nearly three-quarters of respondents of all ages had intercourse once a month or more, provided they had partners. However, when the group was examined as a whole, one out of five men and two out of five women had not participated in any form of sexual touching or caressing over the last six months.

Men tended to think about sex and feel sexual desire more frequently than women. While rates of intercourse were similar for both sexes, more men than women reported engaging in sexual touching. Self-s timulation on a regular basis was also about eight times higher among men.

Factors affecting sexual satisfaction

Not surprisingly, one of the major factors associated with respondents’ satisfaction was the availability of a partner. In the 45–59 age group, roughly four out of five individuals had partners; by comparison, only one in five women over 75 had partners. Declining health also appeared to have an effect on sexual activity and satisfaction. On a list of features that might improve their sexual satisfaction, the men ranked better health for themselves or their partners at the top. Although impotence emerged as a significant issue for nearly a quarter of the men, less than half of those men had ever sought medical treatment for the problem.

Table 3. Survey facts and figures

What participants said, in a nutshell Men Women

A good relationship with a spouse or partner is important to quality of life

91.9%

87.1%

My partner is physically attractive

59%

52.9%

A satisfying sexual relationship is important to my overall quality of life

66.8%

56.7%

Sexual activity is a pleasurable but not a necessary part of a good relationship

50.4%

52.9%

Had sexual intercourse at least once a week during the last six months

43%

35%

Engaged in kissing or hugging at least once a week during the last six months

74%

48%

Am satisfied with my sex life

54.9%

54%

Better health for myself would improve my sex life

30.3%

15.9%

Better health for my partner would improve my sex life

22.1%

19.4%

Have taken medication to improve sexual functioning

10%

7%

Sex becomes less important to people as they age

38.7%

36.5%

Emotional and social issues

“The brain is the body’s most important sex organ.” This oft-repeated phrase bears more than a little truth. While the initial prerequisites for sexual activity are physiological — functional sex organs, adequate hormone levels, and freedom from healt h conditions that interfere with the body’s ability to respond to erotic cues — these elements don’t guarantee sexual satisfaction. Stress, anxiety, self-esteem issues, negative past experiences, lifestyle demands, loss of loved ones, and relationship conflicts can weigh heavily. During midlife and beyond, these factors, combined with naturally occurring physical changes, can make you vulnerable to sexual problems.

Lack of a partner

It may seem obvious that not having a partner is an impediment to an active sex life, but it’s an especially important issue for older people. By age 65, many people find themselves alone, through either divorce or widowhood. This affects sexuality in a variety of ways.

According to the AARP/Modern Maturity Sexuality Survey, 64% of men with partners and 68% of women with partners are primarily satisfied with their sex lives. This is in sharp contrast to the small proportion of those without partners (18% of men and 28% of women) who are pleased with their sex lives.

The partner gap is a particular problem for American women because their average life span (79 years) is more than five years longer than that of men. Because American women marry men who are on average three years older, that can mean even more time alone. Should a woman want to remarry, her chance of finding a new mate in her age bracket dwindles yearly; there is an average of only 7 men for every 10 women age 65 and above. All this boils down to the fact that, compared with men, women are likely to live a greater portion of their lives without a mate.

Finally, starting a new sexual relationship after divorce or the death of a spouse can present its own dilemmas. People often fear that they will not become aroused or be able to have an orgasm with a different partner. They also may be self-conscious about baring their body in front of someone new. Because a new relationship may come along months or years after their last sexual relationship, some individuals feel anxious that they have “forgotten how to have sex” or that “the equipment doesn’t work anymore.” For those who have lost a much-loved spouse, feelings of guilt or disloyalty at starting a new relationship can be overwhelming.

Relationship issues

Tension in a relationship can be deadly to a couple’s sex life. In many cases, conflict is at the root of a sexual problem. Other times, a sexual issue strains a couple’s ability to get along. The following issues are often connected to sexual problems.

Anger and frustration. Accumulated anger, hurt, disappointment, and resentment can fester, destroying closeness between partners. These pent-up feelings often extinguish the flames of desire. For men, anger and frustration can interfere with arousal and getting an erection. Likewise, the breakdown of trust can be devastating to a woman’s ability to reach orgasm. Both partners can suffer loss of libido in a conflict-ridden environment. This type of disappointment turns toxic when one or both partners resort to criticism and defensiveness — two of the major harbingers of divorce. In addition, one member of the couple may unconsciously withhold sex as a way of expressing anger or to maintain the upper hand in a situation where he or she feels otherwise powerless.

Poor communication. Communication is essential for partners to build the trust needed for a successful sexual relationship. By talking frankly about your feelings, you can foster acceptance and understanding in your relationship. This makes it easier for you and your partner to collaborate on finding solutions to issues, and it can prevent resentments from piling up. When conversation breaks down, anger and resentment are likely to build.

Dialogue is especially vital as physical changes take place. Vaginal dryness or erection difficulties can be wrongly perceived as waning interest in sex, which can trigger feelings of rejection and resentment. By articulating feelings, couples can sort out the physiological factors from the emotional and relationship issues, and address each appropriately.

Boredom. Once the honeymoon is over, almost every couple has to contend with boredom sooner or later. The person who was once so electrifyingly mysterious to you may become as comfortable — and as alluring — as an old shoe. While the deep trust and intimacy created from years of shared experiences are the building blocks of a truly loving relationship, such familiarity can take the edge off desire. Sex may not even seem worth the trouble when you’re facing the same old lovemaking routines.

When sexual activity wanes, other types of physical affection often fade, too. This lack of physical connection can extend the emotional distance between you and your partner. As a result, it’s all the more difficult to resume sexual intimacy later on. But it’s possible to do so.

Resentment, tension between you and your partner, a breakdown in communication, or even boredom can produce sexual problems.

Affairs. While researchers can’t seem to agree on how many people seek sex outside their marriage — the estimates range from 20% to 60% — one thing is clear: An affair is often an indication of an unmet need in the relationship.

One frequent motivator for a person to have an affair is a quest for newness. This yearning may arise from a need to banish midlife drudgery, a desire to find out what sex is like with someone else, or an urge to recapture the heart-pounding sexual highs of youth. Other times, an individual searches out a new partner to meet unfulfilled emotional or intellectual needs. An affair sometimes occurs because of sexual dysfunction in the marriage. For example, men who have erection difficulties or women who can’t reach orgasm may seek out new lovers to prove that the sexual problem is their spouse’s doing, not their own. Likewise, the partners of those with sexual difficulties may try to seek reassurance that they’re still sexually appealing in the arms of someone else.

The reverberations of an affair can extend throughout a couple’s relationship like ripples on a pond. Sometimes the straying partner isn’t able to respond sexually to his or her spouse because of guilt over the affair, fatigue from juggling two sexual relationships, or a negative comparison of the spouse with the new lover. If the spouse discovers the affair, he or she may withdraw emotionally.

An affair can be a serious, sometimes fatal, blow to a relationship. However, it’s possible for a marriage not only to survive infidelity, but also to grow from this painful expe rience. To do this, though, both partners must face the personal and relationship issues that led to the affair in the first place. Couples therapy is a good place to turn for help in doing this. Sex therapy can also be useful if the affair has caused or resulted from sexual problems.

The Viagra revolution

In the years since the famous “little blue pill” entered the market in March 1999, millions of couples have seen firsthand what this drug can and can’t do. In many cases, Viagra (sildenafil citrate) is the answer to a prayer for men who have been unable to have an erection. But the drug offers no help in untangling the emotional and relationship pressures that frequently accompany erectile dysfunction.

For one thing, Viagra only works if there is desire to have sex. If emotional issues are impinging on libido, the pill won’t help. It’s important that the partner of a man who has begun taking Viagra understands this. During a long bout with erectile dysfunction, many women blame themselves for their partner’s inability to perform. When Viagra comes onto the scene, the woman may find it hard to let go of past feelings of rejection. She may mistakenly assume that her husband’s newfound erections are merely a chemical phenomenon, not an outgrowth of sexual attraction to her.

When intercourse is suddenly a possibility again, relationship issues can sprout up or resurface. For example, dramatic differences in libido sometimes emerge. Also, a woman can develop problems related to vaginal atrophy if she hasn’t had sex in a long time. She may need to undergo a few weeks of therapy using medication or dilators before she can comfortably resume intercourse.

The bottom line is that couples should try to regard Viagra as an opportunity to become erotic again, while realizing that it is neither a mandate to have intercourse nor a panacea for every problem in the bedroom.

Performance anxiety

Defined as an overwhelming concern about sexual performance that obscures pleasure and leads to sexual dysfunction, performance anxiety is a particularly insidious issue affecting aging couples. Performance anxiety becomes a particular problem for men as they move into their 50s. It’s the most common psychological contributor to erectile dysfunction.

Here’s how the problem often develops. The natural effects of aging dictate that a man needs more time and direct penile stimulation for an erection. Medications and cardiovascular disease may also contribute to erection difficulties. If a man continues to expect the instantaneous rock-hard erections of his 20s, he may equate this change in his physical response with the end of his virility. Once he makes this erroneous leap, the problem snowballs. After a few incidences of erection failure, embarrassment and feelings of defeat leave him unwilling to try again. He may withdraw from all forms of intimacy to avoid having to perform. In turn, his partner feels rejected and fears that she’s no longer attractive enough to sexually excite him. She may also suspect him of having an affair.

If this happens, the woman may shy away from touching her partner sexually out of fear that another failure will occur. Paradoxically, her reticence denies the man just the type of direct stimulation that he needs at this stage of life to achieve an erection. The result is that an addressable physical issue becomes a morass of anger, resentment, and frustration.

Women, too, can experience performance anxiety. Frank discussion of sexuality has become commonplace in women’s magazines and on daytime television. This openness has had the unintended consequence of making some women worry that they do not respond quickly or intensely enough to be considered a “good lover.”

After an instance or two of having erection problems, many men are reluctant to initiate sex. This can be the start of a cycle: performance anxiety leads to further erection difficulty, which heightens the performance anxiety.

Body image and self-esteem

At one point or another, you may have come to the realization that gravity is not kind to your body as you age. Nor is childbirth, a fatty diet, lack of exercise, or the hormone declines that lead to muscle loss, loose skin, and thinning hair. But what does this have to do with your sex life? It can have everything to do with it if you let it. Worry about having your partner see your sagging breasts or potbelly can discourage you from even thinking about having sex. If you do decide to be intimate, you may demand that sex take place only under the covers, with the lights out, while you’re wearing a T-shirt. Needless to say, these conditions don’t leave much room for inspired lovemaking. You may also find that your preoccupation with your appearance while making love prevents you from fully enjoying sex.

Relationship conflicts can ensue. When one partner needs constant reassurance about his or her attractiveness and becomes overly sensitive to perceived criticism, it can foster mutual resentment. The paradox in this dynamic is that the majority of middle-aged and older adults responding to the AARP/Modern Maturity Sexuality Survey said they still found their partners physically or romantically attractive. What’s more, the percentage increased with age.

By shifting your focus away from your perceived flaws to your attributes — for example, your eyes or your hair — you can boost your self-esteem and establish your own standards for attractiveness. Also, try directing your attention to the experience of giving and receiving pleasure during sex. This can help you find the confidence to give yourself over to the experience. Great sex is often the outgrowth of a deep emotional connection — something that’s not guaranteed by having a perfect body.

A negative self-image isn’t always rooted in your appearance. Career setbacks or other disappointments can lead to feelings of failure and depression, both of which sap desire. For men, episodes of impotence can undercut confidence in their manhood. No matter what its cause, a poor self-image can take a toll on your sex life. When performance anxiety develops as a result, it can spark a downward spiral of repeated sexual failure and diminishing self-esteem. Correcting this problem demands serious attention to its origin. Because feelings of low self-worth are a symptom of depression, you should talk to a doctor if the problem persists.

A negative body image can impede your sex life.

Expectations and past experiences

Your sexuality is a natural drive that’s with you from birth, but your family and cultural background shape your attitudes toward sex. As you become an adult, your own experiences further influence your sexuality. The result for many is a healthy enjoyment of sex, but others may have more mixed feelings. The changes that take place in midlife and beyond often exacerbate issues about sex. Deeply entrenched negative associations can also emerge during this time.

For example, women (and men) — particularly those who came of age before the so-called sexual revolution in the ’60s — may cling to the notion that it is improper for “nice girls” to enjoy sex. This belief can be damaging for both partners. A woman who has merely acquiesced to sex as a duty to her husband or as a necessary step in childbearing may feel uncomfortable seeking sexual pleasure. Her partner may interpret this lack of enthusiasm as a reflection of her feelings about him.

Inexperience and embarrassment over discussing sexual matters may hamper people from fully expressing themselves sexually. For example, intercourse alone does not give many women the kind of stimulation they need for fulfilling sex, and uneasiness about discussing the problem prevents some couples from developing techniques that could offer the woman greater pleasure. Compounding the problem, childhood taboos against masturbation may prevent a woman from ever discovering the means to her sexual pleasure, so she’s unable to direct her partner in this regard. It may be more comfortable for a woman to forgo her own pleasure than to confront these matters. She may ultimately resort to faking orgasms rather than risk asking for a different approach to lovemaking. When this pattern exists for years, revealing the truth would mean admitting to a longstanding deception, which could shake the trust in the relationship and injure her partner’s self-esteem.

Alternately, a man may feel his self-worth depends on his ability to please his partner. His focus during sex, therefore, is on performing rather than succumbing to pleasure. If his partner doesn’t immediately respond to his efforts, feelings of inadequacy can pervade the relationship, eroding the couple’s bond. This dynamic can ultimately lead to performance anxiety and related sexual problems.

During the early years of a couple’s relationship, such missed connections are often masked by priorities outside the bedroom, such as building a marriage, raising a family, and launching a career. However, midlife may prove to be a turning point. Upon reaching menopause, the long-unsatisfied woman might greet the physical changes in her body as a sign that her sexual duties are fulfilled. If her husband is still interested in sex, a conflict is likely to erupt.

A much more hopeful scenario is also possible. Midlife and later may be a time when a woman’s sexuality blossoms. Menopause means that women no longer have to worry about pregnancy. Often, children are grown and family responsibilities have eased, allowing a couple to engage in more relaxed and spontaneous lovemaking. In addition, the changes a man is experiencing during these years, such as slower erections and longer time before ejaculation, lend themselves to the kind of pleasurable play that a woman may have been missing out on before.

For a couple wishing to embark on the more positive course, the key is to begin to unravel negative patterns. To do this, you must open up a dialogue. It’s also important to resist succumbing to unproductive beliefs about aging and sex.

Stress and lifestyle issues

Stress and fatigue are major libido sappers. During midlife, stress can hit from any direction and take any form. Challenging teenagers, financial worries, aging parents, and career woes are common. Concern over your own health or that of a loved one, or general anxiety about aging can also weigh heavily. With so many demands on your time and attention, you and your partner may neglect to nurture your relationship. This inattention can cause your sexual connection to fray as well.

Sheer lack of time is often a major factor. The physical changes in sexual response that occur in both men and women as they age mean that it will take you and your partner more time to become aroused and reach orgasm than it did in your younger years. You may find it hard to squeeze an extended lovemaking session into an already packed day. If a couple typically waits until bedtime to have sex, exhaustion also can become an obstacle.

Stress has a particularly deleterious effect on libido, especially in women. Whereas men can sometimes use sex to relax, women more often need to be relaxed in order to enjoy sex. This mismatch can create conflict for a couple.

Sexual issues brought on solely by stress and fatigue often can be remedied simply by taking a vacation. If you and your partner are able to resume pleasurable lovemaking in a pressure-free environment, you’ll be reassured that the underpinnings of your sexual relationship are sound.

Midlife and after is also a time when profound lifestyle changes take place. Events such as retirement and children leaving home can upset decades-long patterns in a couple’s life. For example, many couples go through a period of adjustment when they retire. If a woman is used to having the house to herself, her feeling of control over her domain can be threatened by her husband’s constant presence. If both partners worked outside the home, they must each adapt to having more time together at home.

One bonus is that retirement may allow you and your partner the opportunity to engage in leisurely lovemaking — something you may have lacked for many years. One danger, however, is that couples who begin spending a lot of time together may stop making an effort to include romance in their relationship.

Chronic illness also affects many couples’ sexual relationships during this stage of life. People who are ill may find that a condition or its treatment causes sexual difficulties, while healthy partners may worry that sexual activity will make their loved one’s condition worse. The fatigue and stress of the caretaker role may also dampen desire. In addition, sexual interest may wane for both partners if their caretaker−patient relationship begins to feel too much like that of a parent and child. During this time, many people also experience the loss of someone close — parents, friends, or siblings. Grieving may make it difficult to enjoy anything pleasurable, including sex.

For sexual issues linked to stress and fatigue, sometimes taking a vacation can help.


Sexuality in Midlife and Beyond

Sexuality in Midlife and Beyond

The physical transformations your body undergoes as you age can have a major influence on your sexuality. By understanding the crucial physical and emotional elements that underlie satisfying sex, you can better navigate problems if they arise. The Sexuality in Midlife and Beyond Report is an essential tool that can help you remain active, vibrant and vital as you age. Read more »