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By Root 575 0

’s bow is undeterred by age. In fact, it may fly truer and land deeper. How many times in the last decade have I said that I was through with lovers, wasn’t even thinking about relationships anymore? “That part’s over for me,” I would announce. My women friends would invariably smile and say, “Yeah, okay, Jane, but ‘never’ is a big word.” I was so certain—and then along would come love, and let me tell you (though you can probably imagine), love and good sex are the best rejuvenators, better than any face-lift. And don’t think for a minute that older folks aren’t getting it on. According to the most comprehensive national survey ever done of sexual behavior among older adults, a lot of us are still doing it. As reported in the New England Journal of Medicine in 2007, 84 percent of men from ages fifty-seven to sixty-four reported having had some sexual contact with another person in the last year, compared with 62 percent of women in the same age group. The numbers dropped to 38 percent and 17 percent, respectively, in people seventy-five years and older. But among those seniors who were sexually active, about two-thirds had sex at least twice a month into their seventies, and more than half continued at that pace into their eighties.

There are, however, definite age-related changes. Nearly half of those in the study who were sexually active reported at least one sexual problem, with 43 percent of women reporting diminished desire and 39 percent vaginal dryness; 37 percent of men reported erectile difficulties.

In this chapter I hope to address these changes and perhaps help you manage them. Knowing what to expect of your own body and what to expect of your partner’s can make all the difference. Some of the changes are positive, and almost all can be dealt with by giving yourself more time to have sex. Other things that can help include patience, communication between partners, appropriate use of sexuality-enhancing drugs, and some basic knowledge.

Men and Health

There is nothing about aging in and of itself that gets in the way of our having sex. Health problems and medications are the key impediments—more so in men than in women. Only 10 percent of women report that their cessation of sex was due to their own illness or lack of interest. Mainly it is due to scarcity of appropriate partners (for every fifty-one men aged seventy-five and older, there are one hundred women!), illness of the spouse, or inability of the spouse to have intercourse. Dr. Michael Perelman, a clinical associate professor of psychiatry, reproductive medicine, and urology at Weill Cornell Medical College and codirector of the Human Sexuality Program at New York Presbyterian Hospital, told me that the health of the male partner is probably the strongest determinant in whether or not a couple continues to have sex. His failure to perform as he has in the past can become so bothersome to him emotionally that he will develop a pattern of avoidance that is as damaging as the lack of erectile function itself. Avoidance can become a habit and cause the man to pull back from giving or receiving any form of affection, for fear that he will be expected to follow up by performing sexually.

In New Passages, Gail Sheehy cites the Massachusetts Male Aging Study: “51% of normal, healthy males aged 40 to 70 experience some degree of impotence,” caused by medications, heart problems, diabetes, or anything that impedes blood flow to the penis. The effects of these health issues on sexual performance vary greatly from man to man, but generally they result in:

Taking longer to get erections and requiring more direct manual stimulation.

Erections are less firm and harder to maintain because of changes in blood flow.

The penis starts to get smaller with age.

Taking longer to reach orgasm (just what women have always wished for!).

If there is orgasm, the force of ejaculation is reduced.

There are fewer contractions.

More time is needed between erections.

Peyronie’s disease is a condition that affects approximately 10 percent of older men, causing their penis