Nobody likes to think about their parents having sex. Maybe that's one reason behind the common belief that when people get old, they lose interest in sex. Now, the most comprehensive scientific survey yet shows what older people themselves have long known: That for most of them, sex remains an important part of their lives. And that it's not the number of years they've lived that best predicts whether they are sexually active.
Several years ago, Dr. Stacy Tessler Lindau was treating a dying older woman who had been brought to the hospital by her children.
"And I said to her with her family at the bedside, should anything happen to you tonight that would require somebody to make a decision for you, who should we call," Lindau explains. "And her son stepped to the front and said, 'Oh call me and I will help make decisions.' And the family left and a couple hours later, I got a call from the nurse who said, 'Dr. Lindau, the patient would like to see you again.' And I went to her room and she said to me, 'Should anything happen to me this is the person to call.'"
That person to call was not her son.
"The person she wanted us to call was her longtime companion — her lover," Lindau said. "It was a relationship she had started since her husband had passed away many years before. And because of the shame and embarrassment, because she perceived it was unseemly for her to start a new relationship as a widow, her family knew nothing of this person."
Important Questions
Lindau started thinking more about just how little doctors really know about the importance of sex and intimacy as people get older, and why that matters for health. It led her to do the study she has now published in the New England Journal of Medicine.
Lindau and her team interviewed and examined more than 3,000 older men and women. The youngest were in their late 50s; the oldest was 85. What they found is that most people — at least into their early 70s — are sexually active.
"Among adults 57 to 85 years old, even if they didn't have a partner, most people said sexuality is an important part of life," says Lindau.
Seventy-seven percent of older men said sex was important; 65 percent of women agreed.
Most of those who reported being sexually active said they were having sex at least two or three times a month. Lindau says that's about the same as what national surveys have found for younger people, ages 18 to 59.
And she says that how often older people have sex doesn't change much from their 50s to their mid-70s.
"For women, especially around age 75 and older, many lose their partner," she says.
Predictors of Sexual Activity
One of the best predictors of whether women or men stay sexually active is whether they have a spouse or partner. Hardly anybody in the survey said they'd had more than one partner in the previous year — just 2 percent of men and 1 percent of women.
But women are more likely to lose a partner.
"Women live on average longer than men," Lindau says. "And there's a sizable cohort of older women who may not be sexually active simply because they don't have the opportunity to do so."
In addition to this "partner gap," people were less likely to be sexually active if they said they were in poor health. And those health problems were more common for people in their 70s and 80s.
Dr. Robert Butler has been a leading researcher in what makes for healthy and successful aging. He's 80 and he welcomes the new research.
"It helps lay to rest the prejudice that somehow older people are not interested in lovemaking and not capable of it and get no satisfaction and all of the usual stereotypes," Butler says.
He says that even many doctors hold those stereotypes, and as a result, they don't talk to older patients about the treatable health problems that can interfere with sex and intimacy.
"If there is no discussion, then there's not going to be a diagnosis, there's not going to be a look to see if there's a problem with diabetes, whether there's some neurological problem that's interfering," Butler explains. "Medications often have adverse affects on sexuality. Anti-hypertensive medications do, for example, and anti-depressants do, too."
A doctor can often switch medications--or change the dosage--to help improve someone's sex life.
Dr. Butler hopes the new study will result in doctors and their older patients talking more frankly about sex.
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