Sex and the Elderly Woman

" I thank you for joining us today. They we're gonna focus on people who are considered the elderly however we think about elderly people we often think about people we're not very active. Well today not only are we gonna talk about activity but we're gonna talk about sexual activity. And starting with us today are few of my guest analyst. To my left is doctor David Kaplan who's an assistant professor of clinical urology at Columbia University welcome. Sitting next to David is doctor Patricia blooms she's the chief of geriatric medicine at St. Luke's Roosevelt hospital here in New York City. Welcome Patricia. And sitting next to -- doctor Derek -- O'Connor who's a psychologist -- sex therapist and really the first woman sex therapist to be trained by masters and Johnson New York City. Thank you all for joining us today it. Well let's start off with sex and the elderly woman and we talked about elderly woman what are we talking about what what is considered to be elderly now."

" I think that really has changed dramatically. Within the last for the last few decades. As the baby boomers are getting older it's really hard to consider somebody over the age of 55 which might have been considered senior in the past as elderly to there are just. Really exhibiting behavior patterns and they've been exhibiting for a long time. -- I think that probably for the purpose of this discussion we're really shall we should really be speaking about the eighth decade of life. My panelists agree with."

" There I don't I don't think that that woman feels old -- and enters menopause. That's the first real sign them all so. On reproductive. And the purpose of life. And that's when most of the cobblestones. And and her sexual -- so you wouldn't say any time between 45 and fifty I would. Although technically speaking Jerry -- it tech. It's over the age of sixty but I will agree with David that are I mean I guess it must approach you know I don't know if I'd like to order side -- and ultimately you're. But and especially talking about sexual activity I think what is interesting is that people usually don't see those people over eighty sexually active but I think you would agree him in surveys show that. Actually the majority of people over the age 65 are still sexually active and even when you get into it. Eighty. Still about a quarter to a hazard -- elderly even women and how sexual activity and that's and that people generally don't think about her you know wouldn't believe -- true."

" Right it's actually certainly not a topic that you hear much about it's not a focus in the medical schools -- in curriculum. And it's something that seems to be appropriate given the fact that their punish people who were sexually active were considered elderly. Couples who aren't in there. And Canada and it's a surprise and they would never dared to tell her grandchildren or there's some good things -- Sneak a glance is there. Well let's start with the physical changes obviously is someone gets older there are physical changes that occur in their body. David what is occurring in a woman from and medical perspective that might make sexual activity different."

" What comes to mind first is is. As along with -- applause from the changes that that accompany menopause there's a decrease in the ability of women to lubricate. As they get older and that's certainly impacts on their ability to enjoy sex. And and perhaps. Participate in that because of their lack of enjoyment. -- there also medical conditions that occur. Such as a trophy that tonight a switch occurs as women get older where. Where where the tissue itself becomes less elastic. On the and the vaginal opening becomes smaller. And and now also interferes with -- person's ability to participate in sex certainly enjoy. All these problems have medical solutions to them. Com and I'm sure doctor -- Takes care of that the conditions on a regular basis and."

" What do do you actually address these problems with the patient that they actually tell you about them. Well that's great question in fact. Part of what I do training positions and we really streamline that ask about sexual activity because it said people assumptions that if you're overs -- not exactly active. So and I think it's very helpful for elderly people is the doctor does that and because they sent and it might be. Come on in there rescuers think it's not a problem it okay to Athens in office. I think to position shouldn't risk than. In addition I mean that it did actual changes in that the giant and surrounding tissues are critical part of what attracts older women but. In addition to that are there medical conditions. Which can influence there and risk their ability and and there's a whole range and that's kind of women with heart disease. Has -- winners vigorously sexually active. People with lung disease who might get restless people with arthritis who house. Typical -- positioning themselves and then there's the whole aspect of conditions which influence women's self esteem and which might just be changes in the body earlier in untouched -- think you have to be you know scouts polite young thing to be sexually active until there. Might be embarrassment about. Shifts in and body composition -- you know and the stomach. Four. I think on the line would be thinks like a mastectomy. And -- To meet our other conditions like that where women with really. You know. Have a lot of self esteem and feel embarrassed especially with the new partner then you know. The situation -- new partner late in life as a whole new thing that are probably."

" It's very difficult I think even younger and her body image problems and then it gets Drupal when you get into old age. But but the nice thing about. Him to cardinals lose his -- Yeah. Honest about it. But many of the women prefer to have a direct and and Manning and their partners and actually -- limited Leo and find that you can. Convince women to move. Somehow shed that embarrassment. And the feels somehow more. Accepting of their body how do you get him to write I write on -- sexual self esteem -- when an alarming. And and -- well. And part of it is learning Latin way it right. Remnant -- woman -- sent to me. And to learn to love my body into -- house."

" That that's very interesting I think sort of in a crisis oriented society could see that happening in all the medical care seems to be related. So when something's a problem people addresses."

" Com what is important that. Some of these problems and -- problems. They are things you can do NAFTA and by this time are they -- Whitney and the sex there. I'm some of the standing around the -- and a painful intercourse. Can be taking Caro died. Some friction and what I on traffic. It's the inside it's that tissue is the same as any tension about similar movie -- it. We don't do it obnoxious the more its traditions and -- and I worked a lot of him. To make them more on Google I just practical. And of -- and you know getting them on joint appearance -- attention."

" The women come to a sexual therapists and other words to -- come on their own is that a physician that refers some as an urologist or Jerry attrition. Because as we had earlier this is really a subject that doesn't get much attention. And make."

" I mean I get referrals from all of you end. I also get referrals from my book video pictures and do it yourself that you -- sex therapy and couples start using -- and and they kept them and -- com. And the so called transparent so sorry taking place they know -- irony. I'm also by France. You know he feels safe when you have a friend who's. Right right it makes it so that's --"

" it was interesting to me because that's obviously an issue that's not an age related that begins way back. -- that seems to become more of an issue as someone gets older. Com or maybe it just becomes more of a focus but do you address that what do you do not someone who really doesn't have the self seem to move ahead."

" It's not -- asking them. Who. Trunks the problem right through and even learned that you have to look like a model. In order to be sexual. You have to start looking at -- gotten I have a women's and noodles for under there and look at their bodies and draw pictures as an artist. And a one -- comparisons. And you've got to come away from -- that. Loving kind things about him. They may start the thirteen government fingernails. But they slowly have to grass to grow to love. And you'll need to that is not --"

" Now that has that your attrition yeah. You see someone that's safe for problem with chronic lung disease or problem chronic heart disease you can in the appropriate social setting. When this the issue of sex and sexual function come up that's something that you bring up with every patient you see -- it's something that you wait to be addressed with you."

" Well I try is part of the initial. Harassment to ascertain whether people are actually. If they -- is at a time earnings aren't having any problems with it. Judy which -- And that that's it is. Give them permission to talk about they might not want to explore it during -- visit but at least it opens the door to communication. And then you know hopefully tonight and every visit will ask him if there's anything else they're concerned about it and in hurting me. Bring it up on subsequent visits is that something is bothering him at an initial -- but I think handing. You know an open door it kind of dialogue is helpful. Similarly I think with. Time off steam. Up a lot of these I think have to do with communication. Then new getting into. What that person want -- mean that is at the basis of policy issues whether it's with a partner in old partner or new partner and interestingly first on the elderly people that's the biggest issue that you don't have a partner. And so there's some interesting relationships that form. As a result of that and in some women who have been heterosexual all their lives. In the form of very nice relationship with another woman. And people who just don't have a partner at all that money -- that. Self. An expression of sexuality is something that really enjoy learning in -- later you're making yourself current. It's an important part of things. It's not what we say is shameful and too quickly that you make love to warplanes. And take your time to Athlon. I think that it's important I think for everyone to remember is when talking about elderly people who people are elderly now whether. Or something that would -- Most of that category of people grew up their whole lives. Not talking about that. You know I think that people's willingness to be open and talk about -- came later you know and I guess we'll leave it there -- sexual it."

" and sexual revolution certainly lately because of the pharmaceutical and older patient I think silently you know and everybody but. You know. Since the advent of some of the new pharmaceuticals -- of course viagra com by Pfizer. Where there are now commercials on television with ex presidential candidates talking about their sexual problems. It really has opened up the door. And and allowed for people to comment and and acknowledge that there near -- the problem and their lives and and I think they are speaking about it more and one viagra hit them the F pharmacy shelves. My office was inundated. With people who are suddenly facing the fact. That they do have a problem and now the thing -- that there was something of fallible that was. Fairly easy to take appeal -- they were really coming out of the woodwork. Looking for answers on and then we're on the topic of women right now there has been some amount of research based in Boston of using. This drug viagra and the treatment of female sexual dysfunction so when the news articles that stands about the results of backed that that research -- I had a tremendous number of women. Questions about its possible role in their -- so there is their role possibly for women mountain that's still under under examination. I don't know how technical you want to get right now but there's there's no question that that drugs such as viagra will increase literal blood flow which is really analogous to -- what viagra doesn't and that it improves the quality erection. And with and that's been proved with doppler altars in the little Muslim does inquiries. Now of course -- sexuality is probably more complicated. So just because they have increased little butler doesn't mean. That -- sex drive and their ability to enjoy sex and and they're ability to reach orgasm for instance is necessarily improved. But the drug doesn't work and and and it does do what it's posted the decree what's left."

" The point being that there -- now drugs being aimed at older people for the sole purpose of engaging in sex is really something that goes along with the fact that we have to start talking about absolutely well I appreciate the three you want -- panel tonight experiencing topic I certainly learned quite a bit I'm sure our audiences aren't quite a bit as well. I'm older people have a life and without -- they should enjoy the same pleasures that they did when they're younger. This is doctor mark which they can thank you for joining us tonight."