“Okay, so we know you can’t get pregnant.”
Sex educator Dr. Jane Fleishman often starts with this statement when she goes into senior communities to talk about safe sex. This was her way of trying to break the tension and clear up misunderstandings. Whether you’re 15 or over 50, the topic of sex can be awkward at any age.
Then she took out the puppet. But these aren’t the kind you see in children’s puppet shows. They are made in the form of male and female sexual organs – vulva and penis. This usually breaks the ice and causes laughter.
“But then I said, ‘This is a real thing. You don’t want to get it from other people,'” said Fleishman, who earned a degree in human sexuality in her 60s.
Seniors really need this type of education, she said. First, sexual intimacy does not end when a person receives an AARP card.
A 2018 University of Michigan survey found that regardless of age, about three-quarters of adults ages 65 to 80 believe sex is an important part of a romantic relationship. More than half of people in relationships reported having sex. Men in this group are about four times more likely than women to be “extremely interested” or “very interested” in sex.
Another recent study found that 43% of women ages 50 to 80 were active in the past year. 62% are satisfied with their sexual activity. Only about 28% said menopause-related symptoms interfered with their ability to be sexually active.
Fleishman wanted to make sure these adults, many of whom might be widowed or divorced and dating new people, could have sex safely, so she started with the basics. “I talk about mouth to anus, mouth to vulva, mouth to penis, penis to vulva, penis to anus,” she said. “I really try to be as forthright as possible.”
Equally important, she discusses the need for consent and communication in sexual relationships. “Teenagers and college students are learning about consent now,” she said. “But no one is teaching older people about this.”
Older adults are much less likely to contract sexually transmitted infections (STIs) than other adult age groups. Experts say infection rates are still rising at an alarming rate. According to the CDC, sexually transmitted infections (including hepatitis C, syphilis, chlamydia and gonorrhea) increased four to five times among people 55 and older between 2009 and 2019.
Part of the problem is a lack of knowledge. When researchers used questionnaires to survey adults aged 65 and older about their knowledge of sexually transmitted infections, they found many gaps. “On average, older adults answered only about 12 of the 27 items correctly, meaning they did not know the facts about STI risks, manifestations, transmission or treatment,” said the Texas A&M school leader who led the study. Dr Matthew Lee Smith of the study said Public Health.
Healthcare professionals can provide helpful education and guidance, but only to people who are open and honest about their sex lives. This happens more now than in the past, says Nicole Williams, MD, of the Chicago Gynecological Institute. But often, it’s too late to talk to older patients. They just don’t feel comfortable talking about sex.
“They’re not worried about getting pregnant. They just have unprotected sex and then come to me and ask for a test,” she said. “I find this problematic because they are exposed to HPV, trichomoniasis, bacterial vaginosis and other sexually related infections.”
Cornelius Jamison, MD, makes a point of talking about sex with his patients in his family medicine practice in Michigan. Jamison, an assistant professor in the Department of Family Medicine at the University of Michigan, said he tries to make the conversation comfortable and easy, but even then, older patients often have difficulty talking openly about it.
“It’s like the last thing at the end of the visit, they’ll say, ‘Oh, by the way, doctor, I was wondering, are Viagra, Cialis available? I’ve seen them work, But I’m running into some problems.
Jamison said he wants more doctors to ask about sexual behavior during standard physical exams, regardless of a patient’s age. “The desire for sex never really goes away,” he said. “Sometimes providers don’t take that into account.”
Gynecologist Barb DePree, MD, has noticed a significant increase in the number of appointments for women 50 and older. Despree, director of women’s health at Holland Hospital in Michigan, said dating apps’ zero focus on certain age groups may be one reason. The numbers prove it. Nearly 20% of adults ages 50 to 64 report using a dating app or website, according to Pew Research. While this number is not as high as the drop in the next age group (38% for 30-49 year olds), there is still a lot of online activity.
Whatever the reason, the surge in dating could largely explain the rise in STI cases among this older group. In addition, many older people don’t seem to accept condoms as well as younger people, Depre said.
But protection is still important at every age at risk of contracting an STI. If a penis is involved, a condom is usually required. Particularly in women, DePree said, vulvar and vaginal tissue can thin with age and become more susceptible to human papillomavirus (HPV), herpes simplex virus (HSV), hepatitis B and hepatitis C waiting for infection.
Vaginal dryness is common as women age, and DePree says most benefit from lubricants. But when it comes to condoms, Depre has a tip: While silicone lubricant is a popular choice for postmenopausal women, it doesn’t work well with condoms.
“Most condoms degrade when silicone lubricants are used,” she said. Please switch to water-based lubricant.
But condoms don’t always help. Sexually transmitted infections such as herpes and HPV, as well as other types of sexual intercourse, can also be transmitted from the mouth to the genitals. When condoms are not available, talk to your doctor about preventing sexually transmitted diseases.
The fun starts with being comfortable with your partner. And making yourself comfortable often starts with talking.
“Talk about previous STIs, talk about sexual partners, talk about whether you want to use condoms, talk about whether you feel comfortable doing certain positions,” says the University of Michigan’s Jamison.
“If someone has had a hip replacement, maybe that’s not the right position for it.”
Williams says it’s important to get tested for sexually transmitted infections. “I offer this service to every one of my patients, no matter how old they are.”
Safe sex education for all stages of life often includes only warnings. Sex educator Fleishman says it’s also important to talk about pleasure and pleasure.
Many adults in their 50s, 60s, 70s, and beyond find opportunities for renewal, excitement, and liberation in their sex lives. After all, Fleishman said, “Happiness has no expiration date.”
