Tuesday, November 19, 2013

Sexual Schizophrenia—Sex and Senior Citizens

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Perhaps it began two decades ago, perhaps somewhat less, when almost overnight art began to reflect life. Print and visual media seemed to realize that senior citizens still wanted to, and when possible, be sexual. As recently as 1990 my nursing students who were learning to do intake interviews admitted that neither they nor the doctors they were working with asked anyone over fifty about their sexual behavior. That seemed to them to be the cutoff age for sex; the penis shrivels, the vagina atrophies, breasts sag, sexual appetite and appeal wane. A great many seniors knew that wasn't true and despite this myth, continued to enjoy coitus until poor health or the death of a partner effected closure.

Producers of movies and TV programs as well as novelists seemed to suddenly realize and accept late adult sexuality and began to portray seniors in intimate situations. In the British sitcom, Waiting for God, Tom and Dianna, both over seventy, are intimate. The same is true for anther BBC offering, As Time Goes By, where the principals, both over sixty enjoy an active sex life. The new Canadian mini-series, Last Tango in Halifax, centers on a relationship of two seniors in love as teenagers, who discover each other fifty years later after the deaths of their spouses, rekindle this love and decide to marry. Grumpy Old Men (1993) and Grumpier Old Men 1995) portray sexual desire as being a source of their conflict. In my novel, The Footpath, Dr. Avrial Woodsen believed that sex had died with his murdered wife only to discover years later that he still had both the urge and the ability for intimacy. One doesn't have to watch many hours of TV before seeing an add for Viagra, Cialis, vaginal lubricants, and OTC nostrums to reawaken sexual desire or enhance sexual pleasure featuring actors portraying senior citizen. In 1999 the most prevalent STI among Florida's seniors was pubic lice, discomforting but indicative.

When a woman enters menopause, several physical and emotional changes occur as her estrogen level begins to decline. For many the change is accompanied by annoying hot flashes, a darkening of facial hair, changes in breast shape, a decrease in vaginal lubrication, a lessening of interest in sex, changes in mood, and dissatisfaction with overall body image. Women are more interested in how they appear to other women, less so to men, and some spend considerable sums to disguise the changes in face and form that result from getting older. Men, not so much.

There is a troubling cliché that haunts many middle-aged women—that their husband will trade in his fifty-year-old wife for two twenty-five-year-olds. (I'm probably more aware of this because of the number of women who came to me for help adjusting to the loss of their spouse to a younger woman.) There are too many reasons for this loss of consortium to be noted here, however a primary cause is the loss of affection in the relationship, affection that may note the changes in appearance and attitude but is not troubled by them—husbands and wives who like and love each other still find each other attractive and desirable even into their advanced years. During one of my classes with Masters and Johnson, Bill Masters said that the key elements in a sexual relationship that continues into old age are an interested and interesting partner. It is incumbent on both partners to keep these attributes firmly in mind. Romance need not die as the couple ages; experienced differently as time goes by, yes, but still be alive and well.

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