If the barrage of advertisements
for erectile dysfunction meds is anything to go by,
the older generation's interest in sex is far from dead.
A new survey of 3,005 Americans aged 57-85, published
in the August 23 New England Journal of Medicine, goes
a long way towards confirming that anecdotal view.
"The frequency of sexual activity
does not change a whole lot across age groups," says
Stacey Tessler Lindau of the University of Chicago,
lead author of the study, in a telephone conference
call with reporters.
SELF-SATISFIED
"We found that about 50% of men and a quarter of the
women reported that they masturbate, irrespective of
whether or not they had a sexual partner," said Dr Lindau.
"This suggests that, among older adults, there is an
internal drive or need for sexual fulfilment."
Seventy-three percent of respondents
aged 57 to 64 reported having sex at least once in the
past year. Among those aged 65 to 74, the proportion
was 53%, and among those aged 75 to 85, it was 26%.
A tailing-off with age was as much driven by the loss
of partners, or loss of physical ability, as it was
by a loss of interest.
Among those in a relationship,
the most common reason for lack of sex across all age
groups was the male partner's physical health. Fifty-five
percent of men and 64% of women listed this as the primary
obstacle. Only 14% of men reported taking medication
to improve sexual function, suggesting this problem
is still under-treated.
It's often assumed that older patients
- indeed all patients - are shy about coming forward
with sexual problems, but Dr Lindau is not so ready
to let physicians off the hook.
"Discussion of sexuality later
in life has long been a taboo subject, and physicians,
like the rest of the public, have been susceptible to
perpetuating these stereotypes," she argued.
Certainly the survey response rate,
at 75%, suggests that the elderly are not afraid to
talk about sex. That shouldn't come as a total surprise.
A 70-year-old today would have been a teenager when
Alfred Kinsey published his explosive research on human
sexuality, and would have been 31 in the 1967 "Summer
of Love." These aren't Victorians.
NOT
IN THE MOOD
The numbers suggest that for every elderly patient too
shy to discuss sex, there is another who simply finds
the subject boring. Lack of interest was the most common
sexual problem in women overall, reported by 43%, followed
by difficulty with lubrication (39%), inability to climax
(34%), finding sex not pleasurable (23%), and pain (17%).
How much this lack of interest
is voluntary is debatable. Women who'd lost a partner,
and unbalanced sex ratios, mean many women outlive their
partners. At ages 75-85, 22% of men, versus 60% of women,
are single.
These are American findings, but
would probably hold fairly true here, says Jan Boyd,
a senior social worker at Baycrest Geriatric Health
Care System in Toronto.
One caveat is that the population
surveyed was community-dwelling. The findings can't
be reliably applied to a nursing home population, or
to patients with dementia. In these settings, controlling
inappropriate sexual behaviour is often a greater priority
than helping couples keep sexually active.
GET
A ROOM
But even that may change, says Ms Boyd. "We are beginning
to recognize that nursing homes and hospitals should
provide better environments for couples who wish to
remain sexually active," she says. "At one hospital
where I worked, we set up rooms which allow a bit of
privacy. Right now, if you walk down the corridor of
a hospital or nursing home, every door is open. I think
our generation will have very different expectations."
Like Dr Lindau, she's found that
women are less willing to talk about sexuality than
men. She suggests that not all of the reticence in talking
about sex comes from the elderly patients. "In geriatrics,
caregivers are much younger than patients. Many are
just out of college, and they tend to see patients as
you would your parents or grandparents. Of course, people
generally don't want to know about their parents' sexuality."
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