To understand and treat effects of aging on sexuality, it is important to address the three components of sexual desire: drive, beliefs/values, and motivation, as well as the sexual equilibrium within the primary relationship. (Kingsberg, 2000)
From here on out, I am going to cease using the term "the elderly" and substitute the term "the ageful" in its place. Thank you, Ashton Applewhite! (Smith, 2022)
Thinking about sex and the ageful is worse than thinking about your parents having sex. With your parents you’re the obvious result of it happening. With the ageful, you don’t even think about it. Why would you want to? When I think about sex, I think about it from where I am at now. Like it or not, the topic is pretty taboo with anyone. Let alone anyone over 65. Or so I think. Does anyone think about sex over 65? Have the desire or capability at 75 or 80? 85? The fact that 65 is a cutoff number in and of itself is pretty annoying. And then you have movies like Moonstruck (Cosmo’s Moon) and Cocoon (alien pods in swimming pools) that awaken these dormant volcanos of desire. And then it’s “Isn’t that sweet”
Stigma against sexual expression in LGBTQ older adults may cause concealment of sexual orientation from family or care providers due to fears of rejection. Cognitive impairment affects frequency of and satisfaction with sexual activity, as well as capacity to consent. Staff biases about sexuality can negatively impact sexual expression in healthcare settings. Dementia-related inappropriate sexual behaviors (ISBs) are common and distressing. Recent research has focused on early identification and prevention of ISB, in addition to management through non-pharmacologic and pharmacologic approaches. (Srinivasan et al., 2019)
So, the marginalization of ageful sexuality is included in the marginalization of the ageful themselves. Even in the research community where there is a dearth of data on ageful sexuality.
Fortunately, sexuality is an important part of a person's life continuing into older age.
Sexual expression of older adults is influenced by diverse psychosocial and biologic determinants including ageist beliefs. Although the prevalence of sexual dysfunction increases with age, studies of sexual satisfaction reveal that only a minority experience significant distress. (Srinivasan et al., 2019)
Yes, for many women estrogen levels continue to slowly drop in their 50’s increasing vaginal dryness. Yes, erectile dysfunction happens to many men. Tried and true positions become obsolete due to hip and knee replacements, bad backs, injured limbs or paralysis. The loss of a longtime partner and the attendant grief that come with this loss.
As the rules of the body change, the rules of the game change. And whoever is the keeper of the rules of the body is the keeper of the rules of the game.
Sexuality remains integral to quality of life for many older adults and informed consideration of their needs is critical to healthcare delivery and institutional service planning. A comprehensive understanding of older adults' sexuality can enhance education, research, policy, and clinical care for this growing population. (Srinivasan et al., 2019)
And one benefit of being older is that you don’t care what anyone thinks about you.
The goals of many ageism activists is to normalize senior sex. And letting go of the traditional expectations of the gatekeepers of propriety opens up the way for other types of sex.
A key, as on all liberation fronts, is education.
“Whatever hits you, don’t decide ‘This is it. Sex is over for me.’ Instead, get the resources—like my books—and learn what there is to know about your body. Also, consult a doctor in case there is a medical cause. So many people skip this, thinking they’re just getting old, but often there is a medical cause behind it. So consult a doctor to rule out whatever medical cause and deal with it. – Joan Price: Author: Sex Over 65 and Sex After Grief (Lion's Den, 2022)
So these are the “of course” surprises…the surprises that makes sense when thought of in a different context.
· Necessity of open marriages increases
· Majority of anecdotes state use a porn as the main means of arousal
· Not caring about what anyone else thinks open’s sexual exploration
So let’s let go of goals, schedule sex dates, understand responsive vs. spontaneous desire, what times of the day are we most sexually responsive, exercise before sex, have more sex more often, use words, communicate, figure out solutions and workarounds (Yes, this means sex toys, etc)t, talk to your doctor, make sure your doctor is sex-positive, and understand that erections are not required for orgasms.
Communicate your desires with your partner; let go of expectations of what you are supposed to be doing sexually and embrace what actually feels good to you; be open to your own changing body and desires (and that of your partner’s); and take the sexuality of all people, regardless of age, seriously.
And so I think!
References
Interview with senior sex expert: Joan Price. Lion’s Den: Pleasure. Passion. Romance.
(2022, July 30). https://www.lionsden.com/blog/joan-price-interview
Kingsberg, S. A. (2000). The psychological impact of aging on sexuality and
relationships. Journal of Women’s Health & Gender-Based Medicine, 9(supplement 1), 33–38. https://doi.org/10.1089/152460900318849
Smith, Z. (2022, July 27). Ashton Applewhite interview: The solution to ageism. Elder. https://www.elder.org/the-elder/ashton-applewhite-author-of-this-chair-rocks-explores-the-solution-to-ageism/
Srinivasan, S., Glover, J., Tampi, R. R., Tampi, D. J., & Sewell, D. D. (2019). Sexuality
and the older adult. Current Psychiatry Reports, 21(10). https://doi.org/10.1007/s11920-019-1090-4
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