Tuesday, September 18, 2007
Consider the older man who slips into the bathroom before bedtime and surreptitiously swallows a Viagra pill. He decides against telling his wife, afraid she might think he's having a problem because he's no longer attracted to her.
Now picture an older woman admitting to her girlfriend that sex with her husband isn't what it used to be. She'd like to suggest he try Viagra but hasn't, afraid that he'll feel more inadequate than she suspects he already does.
A widely reported survey showed recently that older Americans live active sex lives. They are supported in this endeavor by an active pharmaceutical industry that reaps increasing profits from sales of sex-enhancing drugs. Viagra, used to treat erectile dysfunction, brought in $1.7 billion in 2006, for example; its rival Cialis, $971 million.
But no matter how many pills, shots and creams drug companies dispense, therapists say, they are far from finding the potion that will truly enhance the sex lives of an aging population: the ability to talk freely about sex, or the lack thereof. Mortgage payments, Iraq, even a sick child are easier to discuss than sex, especially for boomers who grew up thinking they could have all the sex they wanted, at any time, only to find that they no longer can.
When people are younger -- in their 20s and 30s -- the parts hum. But as bodies age, hormonal levels in both men and women change, sometimes not at the same time. One partner may be up for sex, the other not. A woman in her 40s, therapists say, frequently experiences an increase in desire while a man's performance in those years is taking a dive. At about 50, the average age for menopause, her desire may begin to decline and reach a level lower than his.
Add to this the routine of a marriage or long relationship, as opposed to the fireworks of new attraction, and you've got the setup for a long night's snooze every night.
"Most of us really care about our partners and want to be in those relationships," says Gina Ogden, a Cambridge, Mass., sex therapist. "But sexual pleasure after 20-plus years of being together? The blush is off the rose. And we don't have a language for talking about it. The experience is larger than you can count or measure."
Sexual satisfaction contributes to overall health, experts say. It may not be on par with, say, eating lots of fresh fruits and vegetables, but it's right up there. Couples who enjoy sex together fight less often and relax more easily. If they have children, family life runs more smoothly.
A good sex life "helps build the bond of family and makes up for things that wear and tear on the family," says David Scharff, a Washington psychiatrist and former president of the American Association of Sexuality Educators, Counselors and Therapists. Carolyn Shaffer, a Bethesda psychologist, has seen this pattern among her clients as well, particularly men. "A man can have all these problems with his wife, but when we fix the sex life, the other things go away," she says.
That said, older Americans are enjoying sex in large numbers. The recent survey of Americans ages 57 to 85, which was headed by researchers at the University of Chicago and published in the New England Journal of Medicine, revealed that more than half were sexually active at least two or three times a month.
But almost half of the sexually active also said they had problems with sex.
Number one for men, according to the Chicago study, was erectile dysfunction, or ED. Most sexual problems have multiple possible causes, which is why they're difficult to talk about with any clarity, and ED is no exception. It can occur because of disease, excessive drinking, concerns about work or family.