Sex, Sexuality, and Aging

Laura Rademacher

Sex and sexuality shift over the course of a person’s life. says Laura Rademacher, LMFT and certified sex therapist. “One thing I wish more people knew was that sex changes for all of us. There is an idea that you become sexually active and that is who you are and that is the sex you will have and want. That is not true. The change is normal.”  

Sally Nankivell says that her libido increased before menopause and tanked during and after. She had a full life and didn’t feel like she needed a partner, but about once a year she would decide to try dating again.  

According to Nankivell, dating in the time of COVID-19 has required a long lead-time to physical contact.  Socially distanced walks and phone calls give her time to develop intimacy without sex. This reflects her changing idea of what the “spark” is when dating.  

She feels that her relationships have gotten easier as she has aged. She doesn’t have to worry about if someone will make a good life partner, or a good parent. She knows who she is, what she wants, and that she doesn’t need a partner to enjoy life. This stage of dating is “wonderfully freeing.”

Lori Berg echoes Nankivell’s sentiment when she talks about her current relationship. She says that things are comfortable and she wouldn’t want to return to the uncertainty of dating in her younger years. She and her partner set expectations, including no marriage.  Moments of intimacy include holding hands or performing tasks for each other. Those moments, and cuddling, are as important to them as sex.

Difficult Conversations About Biology

The dating pool in elder care facilities is alive and well, as is revealed by the doubling between 2012 and 2016 of the sexually transmitted infection (STI) rate in people over the age of 65.  People also are struggling with what consent means to someone whose mind is fading with dementia.

Anyone struggling with these issues should talk to care providers or a sex therapist. There are resources for determining if a loved one is capable of consent and to help navigate the conversation. 

As we age, our skin and tissues become more fragile. As women approach menopause, estrogen levels decrease, which can cause vaginal dryness. The shape of the vagina changes, often narrowing and shortening. All of these can lead to pain during penetrative sex.  

In Nankivell’s case, she was put on hormone replacement therapy for other issues, including hot flashes. A side effect was an increased libido. A friend who had medical complications with her vagina was using vaginal dilators to re-stretch the tissues. Nankivell decided to try those in combination with a hormonal cream. It helped. She switched to hormonal suppositories and penetrative sex with partners and now says she will continue to have penetrative sex with herself or others so that she can keep enjoying sex in all forms.

Rademacher points out that sexuality and arousal are as much mental as physical. “Make a date with yourself to focus on your sexuality and what you like two or three times a week so that using the dilators or a sex toy feels good.”

Erectile dysfunction can be confusing and embarrassing for partners. “Men are often told that the extent of their sexuality is an erection,” says Rademacher. “A flaccid penis has nerve endings and can still feel good.”

Nankivell and Berg believe that the confidence and self-knowledge they have now has enriched their dating lives, partnered sex lives, and unpartnered sex lives.  

Resources

Smitten Kitten:  Ask questions of the staff 

JoanPrice.com: Author on aging and sexuality

National Institute on Aging 

The Sexual Information and Education Council

badvibes.org/whats-in-your-lube: Lubricant is important

The Benjamin Rose Institute on Aging

Many people in the LGBTQ+ community had their sexuality demeaned or shamed early in life and so they struggle to seek out information about sexual pleasure. Many report having difficulty finding a provider who won’t continue those harms.  Sex therapist Laura Rademacher recommends exploring websites for providers who brand themselves as friendly to members of the LGBTQ+ community.  That’s also true of aging clients.

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