“OK, so we all know you are not going to get pregnant.”
Sexuality educator Jane Fleishman, PhD, sometimes opens with this line when she goes into senior communities to speak about safe sex. It’s her approach of making an attempt to interrupt the strain and clear the air. Sex talk may be awkward at any age, whether or not you’re 15 or 50-plus.
Then she brings out the puppets. However these aren’t the type you see at a youngsters’s puppet present. They’re made within the type of female and male intercourse organs – a vulva and a penis. That normally breaks the ice and will get amusing.
“However then I say, ‘That is actual stuff. You do not wish to get an an infection from someone else,’ ” says Fleishman, who acquired her diploma in human sexuality research whereas in her 60s.
There’s an actual want for this sort of schooling amongst people who find themselves older, she says. To start out with, sexual intimacy doesn’t finish when an individual receives their AARP card.
About three-quarters of adults 65 to 80 agree that intercourse is a vital a part of a romantic relationship, no matter age, based on a 2018 survey from the College of Michigan. And greater than half of these in romantic relationships reported being sexually energetic. Males on this group had been about 4 instances extra seemingly than girls to be “extraordinarily ” or “very ” in intercourse.
One other current research discovered that 43% of ladies ages 50 to 80 had been sexually energetic prior to now yr. And 62% had been glad with their sexual exercise. Solely about 28% mentioned menopause-related signs interfered with their skill to be sexually energetic.
Fleishman desires to make it possible for these adults – lots of whom could also be widowed or divorced and relationship somebody new – are approaching intercourse safely, so she begins with the fundamentals. “I discuss mouth to anus, mouth to vulva, mouth to penis, penis to vulva, penis to anus,” she says. “I actually attempt to be as blunt as I probably may be.”
Simply as importantly, she discusses the necessity for consent and communication in a sexual relationship. “The enterprise of consent is taught to youngsters and to varsity college students now,” she says. “However no person’s educating older adults about it.”
Discovering the Gaps
Older adults are far much less more likely to get sexually transmitted infections (STIs), in comparison with different grownup age teams. Nonetheless, an infection charges are going up at an alarming fee, consultants say. Between 2009 and 2019, in individuals 55 and older, STIs – together with hepatitis C, syphilis, chlamydia, and gonorrhea – elevated by 4 to 5 instances, based on the CDC.
A part of the issue is a lack of expertise. When researchers examined STI consciousness in adults 65 and older with a questionnaire, they discovered loads of gaps. “On common, older adults solely appropriately answered about 12 of the 27 gadgets, which implies they didn’t know info about STI threat, presentation, transmission, or remedy,” says Matthew Lee Smith, PhD, who led the analysis at Texas A&M’s College of Public Well being.
Health care professionals can present useful schooling and steering, however solely to people who find themselves open and sincere about their intercourse lives. That’s taking place extra now than it has prior to now, says Nicole Williams, MD, of the Gynecology Institute of Chicago. However usually, the dialog occurs too late together with her older sufferers. They’re simply not as keen to speak about intercourse.
“They don’t seem to be apprehensive about being pregnant. They’re simply having unprotected intercourse after which coming to me and asking for testing,” she says. “I discover that problematic as a result of they’re getting uncovered to HPV, trichomoniasis, bacterial vaginosis, and different sexually associated infections.”
Cornelius Jamison, MD, makes it some extent to convey up intercourse along with his sufferers in his household drugs follow in Michigan. He does his finest to make the dialog comfy and straightforward, however even nonetheless, older sufferers usually have hassle talking brazenly about it, says Jamison, an assistant professor within the Division of Household Drugs on the College of Michigan.
“Will probably be like the very last thing on the finish of the go to, the place they’re going to say, ‘Oh, and by the way in which, Doc, I used to be questioning, is it potential to get Viagra, Cialis? I’ve seen that they work, and I am having some points.’”
Jamison says he needs extra docs would ask about intercourse throughout normal bodily exams, it doesn’t matter what the age of the individual. “The will to have intercourse by no means actually goes away,” he says. “Typically suppliers aren’t fascinated with that.”
Let’s Discuss About (Protected) Intercourse
Gynecologist Barb DePree, MD, has seen a giant spike in relationship amongst girls 50 and up. Relationship apps that zero in on sure age teams may very well be one cause for that, says DePree, director of women’s health at Holland Hospital in Holland, MI. And the numbers bear that out. Practically 20% of adults ages 50 to 64 report utilizing relationship apps or websites, based on Pew Analysis. Whereas that’s not as excessive as the subsequent age group down (38% for ages 30-49) it’s nonetheless plenty of on-line exercise.
Regardless of the cause, this spike in relationship may do a lot to elucidate the rising variety of STI circumstances on this older set. As well as, DePree says, many older adults don’t appear as accepting of condoms as youthful individuals.
However safety remains to be necessary at all ages when there’s a chance of an STI. The place the penis is concerned, that sometimes means a condom. For girls, particularly, the vulva and vaginal tissues skinny with age and may very well be extra inclined to infections akin to human papillomavirus (HPV), herpes simplex virus (HSV), hepatitis B, and hepatitis C, says DePree.
As girls age, vaginal dryness is frequent, and DePree says most will profit from a lubricant. However the place condoms are concerned, DePree has a tip: Whereas silicone lubricant is a well-liked selection for postmenopausal girls, it doesn’t pair nicely with condoms.
“Most condoms will probably be considerably degraded with a silicone lube,” she says. Use a water-based lubricant as a substitute.
However condoms gained’t at all times assist. Oral-to-genital transmission can also be potential for STIs akin to herpes and HPV, in addition to in different forms of intercourse. Ask your physician about methods to guard towards STIs when a condom isn’t potential.
Conserving It Enjoyable
Enjoyable begins with being comfy together with your accomplice. And getting comfy usually begins with a dialog.
“Discuss earlier STIs, discuss sexual companions, discuss whether or not or not you wish to use condoms, whether or not or not you’re feeling comfy doing sure positions,” says Jamison from the College of Michigan.
“If somebody’s had a hip replacement, then perhaps this isn’t the place to do.”
And, importantly, get examined for STIs, says Williams. “I provide that to each one in every of my sufferers, regardless of how previous they’re.”
Protected intercourse schooling, in any respect phases of life, tends to incorporate solely the cautions. Fleishman, the intercourse educator, says it’s necessary to speak concerning the joys and pleasures as nicely.
Many adults of their 50s, 60s, 70s, and past uncover an opportunity for renewal, pleasure, and liberation of their intercourse lives. In spite of everything, says Fleishman, “There’s no expiration date on pleasure.”