In part one of our session with Joan Price, we covered the reasons older people don’t seek sex therapy and the different challenges associated with sexuality at an older age. 

In this session, we will cover the major sexual concerns for seniors. These concerns can start as early as some people’s 40s, but they are primarily sexual concerns for those over 60 years old. The older we get, the more prevalent and problematic these concerns can be. 

Physical and Medical Implications of Aging

Some sexual changes require medical attention such as erectile dysfunction (ED) and undependable erections. True ED means erection is no longer possible — no matter what. This means something medical is interfering with erections. 

Suppose the penis owner doesn't know what the cause is. In that case, he needs to see a doctor because true ED could be a sign of heart disease or Parkinson’s, neurological disease, diabetes, or another serious condition.

Medications also have sexual side effects. Often when the doctors prescribe them to an older person, they don't adequately inform them about the side effects or encourage people to reach out if they experience those side effects. 

There are also normal sexual changes with aging. Erections can be less firm, less frequent, and less reliable. A penis owner may have erections that come and go and they may find that they feel they are hard enough to have penetrative sex and feel poorly if they can’t maintain it. 

Normal vaginal changes also happen with age. The vaginal tissue becomes more delicate and can be more susceptible to tearing. There's a greater need for a good lubricant for vaginal penetration, and even any vulvar touching because the skin is thinner and more delicate and we want vaginal penetration to be pleasurable and not painful.

None of this is a reason to give up on sex. This is a normal part of aging. Instead of giving up sex, a person has to expand their view of what good sex is and communicate with their partner. 

Arousal Difficulties

A key part of normal sexual aging is the libido and arousal change. In Joan’s first senior sex book, "Better Than I Ever Expected: Straight Talk About Sex After Sixty," which she wrote at the age of 61, she described arousal and orgasm as something that used to happen as if there were waves crashing, and that at age 61, the arousal, and even reaching orgasm, was like watching waves crashing through a smudged window. 

It was harder, it took longer and often was subtle instead of crashing waves. 

Since aging people don't have that biological imperative to have sex for reproduction, the hormones are no longer screaming, "have sex, have sex, have sex now." This leads to some people not feeling the urge to have sex very much, or at all. You may want to give up, but you should emphasize the journey and not the destination. The question is not, "are you cumming yet,” but instead “does this feel good when I do this?" 

How people feel arousal, where they feel it, and what they like changes over time. People need to be open about sexual changes, and instead of trying to force sexual expressions on one another, explore what works better now.

Relationship Difficulties and Grief

Another important major concern is relationship difficulties, and this is where most people do seek help to settle sexual disparities. 

After losing a beloved one, urges and sexual desires become taboo. People feel ashamed if they feel those feelings or want to date. Joan wrote her book, “Sex After Grief: Navigating Your Sexuality After Losing Your Beloved" after losing a loved one to cancer. It goes into greater detail about those feelings of grief and shame.

One thing that's the most important thing to remember is that there is no timeline that works for everyone. The stages of grief are cyclical; they're not linear. The timeline for when a person starts feeling sexual urges looks different for everyone because often people go numb with grief. Some people take longer than others, while other people may feel extremely sexual right away.

Something to keep in mind is that you can be sexual on your own, which can help with grief because it's a tension reliever. Sex is not all or nothing. Orgasms will relieve tension, but it’s also key to learning the skills of communicating what you need from a partner and what you're not ready for. 

Exploring New Ways of Sex

There are ebbs and flows in sexual interest, sexual responsiveness, and openness to sexual arousal for everyone. One thing people can do when they think they don't feel desire anymore is to track what Joan calls “the tingle.” She explains that “tingle time” is a time during the day when you are more open to sexual arousal than other times during the day. Keeping track of arousal times can open the door for sex.

If two sexual partners find they are most aroused at two different times of day, it’s important to be flexible and meet the other partner where they’re at. By taking turns having sex during your partner’s peak arousal time without the expectation of arousal for yourself, the more likely it is that you will become aroused by your partner’s arousal. 

Being sexually active after exercise is another way to stimulate sex because exercise sends blood flow, not only to the muscles but, to the brain and the sex organs. She doesn’t recommend being sexually active after a meal because the blood flow is going to the digestive system — not to the sex organs. So, her motto is to exercise first, then have sex, and then eat.

Many seniors would not have orgasms at all without vibrators because their sensation is dulled. What once provided adequate stimulation, doesn’t cut it most of the time.

Utilizing sex toys is another way to open up more opportunities for arousal and pleasure. Vibrators don't mean that your partner doesn’t love or arouse you, it just means the sensation has decreased and more intensity is needed to experience pleasure together. 

Joan Price reviews sex toys on her blog from a senior’s perspective. There are specific sex toy manufacturers and retailers that she has vetted and recommended because they care about senior sexual health, senior sexual pleasure, and senior sexual education.

Teaching older people to ask for what they want is really hard. Years of stigma and culture shape their perception of aging and sexuality.

Teaching and learning sexual scripts help open the door for those conversations that make all types of sex acceptable for each person. If you need help taking the first step to those conversations, let us know.