Sex and seniors: You'd be surprised, Lawrence nurse says
- on April 5, 2012
Karen Roberts isn’t bashful when talking about sex with seniors. That’s because she does it a lot as a nurse practitioner at Lawrence’s Internal Medical Group where she’s worked for 13 years.
“You’d be surprised,” she said. “I have patients who are still quite sexually active in their 70s, 80s and beyond.” She had a hospice patient who was older than 100 and missed having sex with his 90-something girlfriend. “It was a big deal for him.”
Roberts gave a presentation this week that was hosted by the Kaw Valley Older Women’s League and was attended by about 25 people. It was the first time that sex was the topic at one of their monthly programs in at least 30 years.
“I think we shied away from it — not sure how comfortable people would be. We thought it might be a little too controversial,” Pattie Johnston, OWL member, said and then laughed. “We’ve talked about physician-assisted death and depression, but not sex.”
At first, everyone was tense as they sat at tables that formed a big square in the Doud Room of the United Way Building and listened to Roberts talk about the physical and mental health benefits of sexual activity. But soon, there were jokes and laughter.
Roberts said there tends to be two perceptions about seniors when it comes to sex. The first is that they are old, dried up and done with it. The second is that they are dirty, old men or cougars. Many nodded in agreement.
“The truth is — it is somewhere in between,” she said.
She said some people have sex once every 10 years and some have it five times a week.
“You’re normal,” she said. “What’s important is that you are happy and your partner.”
She said it’s important to talk open and honestly with doctors about sex. Don’t be afraid to ask questions. She suggested scheduling extra time when making an appointment.
“You shouldn’t be embarrassed, and if your provider seems really uncomfortable then you can move on to a specialist such as a urologist or gynecologist, but most providers are going to be open and able to help you,” she said.
Roberts said the most common problem is that one person wants sex more often than the other. “It’s a lifespan issue,” she said with a grin. “Most of the time it’s the man, but not always.”
Roberts said everyone has a right to his or her own comfort levels and shouldn’t feel pressured into sex. She suggests that partners discuss the issue and try to reach a compromise. There’s also masturbation.
“It’s a pretty good thing,” she said, adding there are plenty of products that can help.
“Just be sure you have a good friend to come get them, the second you die,” she said, and the room burst into laughter.
The second most common issue is men having erectile dysfunction and women having discomfort with intercourse because of decreased lubrication and elasticity.
“Those are the natural causes of aging and on top of that there are health issues and medications, which can cause a lot of problems for people who still want to be sexual,” she said. Common medications that can cause problems include ones for: seizures, depression, sleep disorders, high blood pressure and heart issues. Alcohol always affects function, but its effects are magnified as people age.
She said there are medications that can be safe and effective in helping improve sexual function, including hormone replacement.
Roberts warned that sexually transmitted diseases are a growing problem among older adults. She said syphilis, chlamydia and human papillomavirus, commonly called HPV, are prevalent. HPV is being linked to cancers including cervix, anal and throat. She’s also seen cases of HIV.
“I think the primary reason we are seeing it is because relationships are much more fluid than they used to be: divorce, remarriage, widowing. Older people are deciding to have intercourse outside of marriage who maybe 30 years wouldn’t have,” she said. “Also, people are staying younger longer and there are medications to help them stay sexually active.”
Roberts said older patients who are diagnosed with a sexually transmitted disease often will say, “But, he went to church and seemed like the clean-cut type.” She said it’s never good to make assumptions. “Don’t stereotype. It doesn’t matter if he’s a tattoo artist or a deacon in a church.”
Additionally, she said, older men often don’t want to use condoms because they already are having erectile dysfunction and so that leads to exposure of bodily fluids that can transmit infection.
“Ladies, always have condoms on hand,” she advised.
Bottom-line is sexual activity — whether it’s holding hands, kissing or having intercourse — is an important part of life, Roberts said.
“We should try to experience this as a positive aspect of our life and if we need help with medication or talking or whatever to try and make it an important and significant part of life again, then that’s what we are here for,” she said.
One elderly gentleman asked when it was appropriate to move beyond the dating phase and how to bring up the topic of sex. He mistakenly referred to spending a year of dating and then getting no sex as a “year wasted.”
The women booed him. Then, they offered advice: Be honest and ask about moving the relationship beyond a friendship by the third or fourth date.
“If I don’t get a kiss by the third date, you’re out,” one woman said.
He replied: “So, it’s like high school rules. Nothing has changed.”
You bet, the nurse said. “It’s an age-old problem You are always feeling your way along.”
Twenty-eight-year-old Duncan Gilles, who was visiting from Boston, took his grandmother Helen Gilles to the event. He said she was a longtime Lawrence pediatrician and probably knew more about the subject than he does. He found the presentation interesting and liked the open dialogue.
“It’s a little sad to know that I might still have the same issues in 40 or 50 years,” he said, laughing.