Introduction

0:00

Welcome to the 27th episode of the psychology of aging podcast. Today we're going to talk about one of my favorite topics, which is aging and sexuality, more specifically aging and sex, to be exact. So today I'm going to talk about older adults and sex, and also a little bit about the benefits of sexuality and expressing our sexuality as we age.

I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness, changes in the brain like with dementia, relationships, and sex, caregiving, and even end of life. Like I say in my therapy groups, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place. Let's get started.

Reflections on Sexuality and Aging

1:17

I'm gonna start with asking you to reflect on your own thoughts about older adults and sex. So what comes to mind when I say older adults and sex? Do your thoughts come with taboos, physical reactions like "ich", prejudices and negative attitudes? What about if I say older men and sex? What about if I say older women and sex? Do your thoughts change? What about if I say same sex couples or opposite sex couples? When you originally thought about older adults and sex, did you think about opposite sex couples or same sex couples? Now, I want to ask you where do you think or what influenced or has an influence on your thoughts about older adults and sex? Is it media? Is it what your family members have shared with you? Is it what people in your community talk about? People in your church? What is it? Who influences your thoughts about older adults and sex? And then if you have the thought, "Well, I don't even think about older adults and sex," then I'll ask you, well, why not? Is it because you're not exposed to older adults who are talking about their sexuality? Is it because in all the media that you watch you aren't exposed? Why don't you even think about older adults and sex?

How Often Are Older Adults Having Sex?

3:03

I want to share with you a little bit about older adults and sex. I mean, of course, you know that, but I'm going to answer the question. How often are older adults even having sex? I mean, are older adults even having sex? A recent study found that 73% of adults, 57 to 64 years old, have sex and sex for the purposes of this study included intercourse, oral sex and masturbation. Okay, well, you might be thinking, "well, that's not really older adults yet Regina, older adults, start at 65." Okay, well, the same study also found that 53% of adults 65 to 74 are having sex. And remember, sex includes intercourse, oral sex, and masturbation. So you could have a sex partner or you could be alone. Okay, but now what about 75 to 85 year olds? So the same study found that 26% of adults ages 75 to 85 are still having sex. Now, I can imagine you saying, "Okay, well, they might be having sex, but maybe not very often. Right?" Well, let me answer that. So the study found that the frequency that an older adult is having sex is basically the same frequency as other adults, ages 18 to 59.

What are the Benefits of Having Sex in Older Adulthood?

4:30

Well, now that we know that older adults are having sex, let's talk about what some of the benefits of sexual intimacy are in older adulthood. And to do that, I want to share with you a great article that I found, and I'm going to link to this article in my show notes, but it was written for Psychology Today by a psychologist Dr. Roni Beth Tower. I don't know her but I really loved her article. And so I'm gonna share some of what she wrote in that article with you. So I'll start by sharing that there are benefits at the physiological level. So, when older adults have sex, dopamine, which is released during orgasm, brings pleasure, and that creates a physiological pleasure response in our body. It also increases oxytocin, which is the cuddle hormone, and promotes bonding and positive feelings of attachment and trust. Sex, also, on a physiological level increases testosterone in both men and women. And there has been evidence to show that the more sex we have, especially the more sex a younger man has, it appears that protects them from prostate cancer later in life, and also helps women later in life as well like reduces risk for incontinence. Also, the other piece, and I think this might be at the chemical level as well, because it's probably related to our heart conditions, and this is not in her article, this is from another article that I read in the past couple of years, is that the more sex a person has as an older adult, so the more frequently a person is engaging in sexual activity, the better they score on cognitive screeners and cognitive tests. Now that might be related to the better a person is scoring on cognitive tests the better their heart function might be, if a person is having sex more often, heart might be functioning better than others, might have less heart disease, etc. So it might be correlational, not causal, of course.

6:52

Back to Dr. Roni Beth Tower. So she also identifies benefits at the behavioral level. So she describes sex being movement, and when we move our bodies that's related to happier moods. So, of course, when we exercise that stimulates the serotonin chemical in our brain, and serotonin is directly related to depression. So sex can also be seen as exercise. And it's fun. And so it's the number one activity with self reported happiness. Why would we want to deny older adults joy and fun?

7:35

Moving right along from an emotional perspective, of course, sex is pleasurable. And so it increases positive feelings. It also is correlated with less symptoms of depression in both men and women, and to greater life satisfaction. It also enhances self esteem. And it allows people to believe that they have something of value to give and benefits us in terms of there is something that happens physiologically to us when we give, when we're generous. Actually, there are studies that show that when we provide care, or we give a gift, that positively impacts our hearts functioning. And so there are benefits of generosity. And when we're engaging in a sexual relationship, and there's a mutual exchange happening, there's generosity happening, and that generosity leads to happiness and increased quality of life.

8:42

Then, Dr. Tower goes on to describe benefits at the interpersonal level. So, in the relationship, there are feelings of attachment, which can lessen feelings of loneliness and isolation. And when we're in long term relationships, like long term marriage or long term partnerships, sexual contact actually helps sustain the marriage, even while we're experiencing other stressors that could challenge the marriage like sexual barriers, and we'll talk about what some of those sexual barriers are in a minute.

9:19

What I really like about this article is that Dr. Tower also describes benefits of sexuality at the cultural level and at the spiritual level. At the spiritual level, she describes being able to take care of someone else sexually evoking feelings of gratitude, and back to that sense of generosity, this generosity of spirit, and also that physical touch is a powerful way to communicate love, and affection. Above all, she writes that sexual behavior in people 50 and older has an important role to play in the quality of life, both physical and psychological, for our sense of self and self fulfillment. I wanted to share this with you because, one, we have so many misconceptions about older adults and sexuality, and, two, we minimize how important it is in aging. Since this is the psychology of aging podcast and one of my primary goals with this podcast is to destigmatize mental health needs and wellness, and also dismantle ageism, I have to include sexuality in this conversation.

Barriers to Sexual Expression in Older Adulthood

10:47

Let's talk a little bit about what gets in the way of older adults engaging in sexual self expression. So, one of the things that does get in the way of self expression for older adults is, indeed, health conditions. So as men get older, for example, they might have more difficulty generating or sustaining an erection. Thankfully, there are some medications to help with that. And, as women age, they might have more difficulty generating and maintaining our body's natural lubrication. And thankfully, there are some resources for that as well. In order to help with these challenges that we will likely all experience as we age, we need to be able to talk about this with our health providers. And so that's one reason I'm sharing this podcast with you today is that I want to start some conversations around older adults and sexuality so that older adults will have, you know, conversation starters with their primary care providers and mental health providers.

11:55

The other thing that interferes with older adults and sexual expression are stereotypes that we have about older adults and sex. We are so uninformed. Actually, when it comes to older adults and sex we have all of these ageist ideas like older adults are no longer sexual, or if older adults are sexual, somehow they're perverted. Or that sexuality at some point becomes unimportant, or that it's abnormal for an older adult to be interested in sex, when, of course, we engage in sexuality and sexual expression all throughout our lives, not just when Hollywood tells us we do.

12:40

Some other hindrances might be, you know, other chronic health conditions like heart disease, certain cancers, that can change our body, right, like a prostate cancer or breast cancer, and might change our sense of self and our self concept. Sometimes when our bodies physically change, like if we have to have a mastectomy or are going through radiation or chemotherapy and our bodies are changing, we might not feel the same sense of sexuality or the same type of sexuality that we felt before. We might have a different intimacy need at that stage. And then we also have to adjust to our new state and our new body. And that can take some time, of course.

At every stage of life, we require companionship, intimacy, and love.

13:28

But I do want to say that sexual expression and intimacy are fundamental and intrinsic to our sense of self and to our well being. As I mentioned earlier, it reduces risk for depression, increases the sense of connection and contribution. And at every stage of life, we require companionship, intimacy, and love. I wanted to share this episode with you today because I do want to challenge us. Listeners (hey!) I'm going to challenge you and I'm going to challenge myself to be reminded that at every stage of life, older adults benefit from sexual expression, and need sexual expression. I have worked with people throughout my career where, you know, some of the challenges that arise when older adults move in with their adult children that we have so many moral judgments as well about older adults and sexuality. And I think that also this can be linked to ageism. It's also linked to family relationships and generational differences and sometimes linked to different faith structures and moral structures. In future episodes, I do want to talk about dementia and sexuality and dementia caregiving and sexuality because those are two topics that are near and dear to my heart.

15:01

I hope actually, as I age, that I will still maintain a desire and a need for intimacy. And I hope... now, I'll say different stages in our lives intimacy and desire and our libido ebbs and flows, having kids and now being like, peri-menopausal mine is ebbing and flowing... ebbing more than flowing. And so I would love to have the belief that down the road that my sense of desire and my libido will be back. I would hate to think that it's only downhill from here. And I would hate to think that for my older clients, and for you as well. I want people to be living full and fulfilled lives, in their relationships, and in their bodies.

Subscribe and Leave a Review

16:03

If you like this episode, be sure to subscribe, so you'll be the first to know when new episodes are released, and then leave a review. Subscriptions and reviews help people to find this show. In wrapping up, it's important to share that the ideas expressed in this episode are mine alone. And that information shared does not take the place of licensed medical or mental health care. We'll see you next week. Same time, same place. Lots of love to you and your family. Bye for now.