The new revolution of sex and aging: talkin' 'bout my generation

The baby boom generation that started the sexual revolution is about to enter elderhood: By 2030, 80 million people will be 60 plus. While many have traded flee love for a committed relationship, kids and an SUV, most likely this generation will reinvent the definition of sex and aging.

Although their parents may still not want to talk about it, research shows that parents of boomers enjoy sex well into later years. "Many people who have entered the golden years say they are having the best sex yet," says Ellen Kamhi, PhD, author of The Natural Guide to Great Sex. "Gone are the days of concern over unwanted pregnancy, and people have more time for relaxation," she says. A study of married and single men and women, ages ranging from 80 to 102, found that touching and caressing were more common than intercourse, but no less enjoyable (Archives of Sexual Behavior, 1988).

What's Normal

Physical changes can make elderly sexual experiences different from those of youth (see "Sex Ed for Adults," p. 35). For women, the first sign of change is linked to menopause, which can lower desire and make intercourse uncomfortable, but frequency and lubricating products help. "The old adage 'use it or lose if applies to human sexuality," Kamhi says. "Women who continue to experience sexual stimulation later in life have fewer problems with vaginal dryness and thinning." As an alternative to prescription estrogen products--which can help with dryness but may have negative side effects--look for apricot and almond oils or naturally derived progesterone creams, all of which can be found in natural products stores.

Although men don't go through abrupt hormonal changes, their hormone levels do decline. Some call this stage andropause, Kamhi says, which can slow sexual response time. Just as for women, it may take longer, but the experience can be just as pleasurable.

Some medications, such as antihistamines, acid-blocking drugs and especially medicines for high blood pressure and depression, can lower sexual desire. Therefore, don't hesitate to ask your doctor whether a prescription could affect sexual function.

Mind-Body Connection

If there was ever a motivator to start eating well and exercising in midlife, studies linking weight loss to sexual performance should be enough to get millions off the couch and into the gym and perhaps into the bedroom. In one study, after a 2-year period of healthful eating, exercise and weight loss, about 33 percent of the subjects (overweight, middle-aged men) recovered from earlier problems with erectile dysfunction, as compared to less than 1 percent of the placebo group (The Journal of the American Medical Association, vol. 291, 2004).

Other studies show that men and women who exercise in midlife have lower chances of erectile dysfunction and sexual problems, respectively, later in life.

For women, the relationship between mind, body and sexual health are intertwined. Women correlate their general satisfaction in life with sexual satisfaction; stress and menopausal symptoms are the major factors that disrupt sexual pleasure, according to the November 1984 edition of the journal Maturitas.

"Women of any age may experience a lessening of libido. This is often due to health conditions that lead to fatigue, stress, unhappy emotional relationships, poor nutrition and many other factors," Kamhi says. "There are also times when a woman may choose to purposely lessen her sexual focus and activity, such as while pursuing a time of internal self-reflection and growth."

Herbal Remedies

Among the plant-based remedies for sexual impotence, such as kava, ginseng, yohimbe and querbracho, most work by helping with relaxation (kava) or improving circulation to the genitalia. There is widespread historical use of these products in Asia and South America. However, because they shouldn't be taken with commonly used prescription drugs for seniors--and they can affect blood pressure, heart rhythms, and liver and kidney function--they should only be used with the advice of a licensed physician, instead of self-medicating.

Hormone Replacement

The obvious solution for both men and women's decline in hormone levels is hormone replacement therapy (HRT). But it's not that easy. Medical science hasn't delved deeply enough into the intricacies of HRT for men or women to know what combinations are necessary and safe.

A relatively new practice called bioidentical hormone replacement is proving helpful for many women. Based on the patient's blood tests, a physician and pharmacist compound a blend of plant sources that mimic naturally occurring hormones. (See "Bioidentical Hormone Replacement," p. 42). For instance, soybeans are used to derive estrogens and testosterone; wild Mexican yams are the basis for progesterone and testosterone.

The practice should not be confused with herbs or other dietary supplements that are sold in stores, which are a one-size fits-all approach. Instead, these compounds are made specifically for each person based on individual hormone profiles. For a thorough explanation of this practice, look for The Midlife Bible: A Woman's Survival Guide by Michael Goodman, MD.