11/29/2016 06:50 EST | Updated 11/29/2016 06:50 EST

What Do We Really Want From Sex As We Age?

Recently over coffee, a friend complained that none of her friends seemed to want to talk about their sex lives any more. Bear in mind, we are both hovering around 70. You might be thinking, "Of course your peers don't want to talk about their non-existent sex lives." And you would be wrong.

Two hands of an old couple, lying upon each other, with golden wedding rings

Recently over coffee, a friend complained that none of her friends seemed to want to talk about their sex lives any more. Bear in mind, we are both hovering around 70.

You might be thinking, "Of course your peers don't want to talk about their non-existent sex lives."

And you would be wrong.

Several of my aging women friends have healthy libidos and a strong sense of themselves as sexual people. But they are sad that health issues get in the way.

Despite my friend's regret that her friends did not want to open up, as a sexual health educator, other women have been more chatty with me.

"I miss it", said one. "It's not like we aren't loving with each other, but I miss sex, the way we used to enjoy it."

"I feel a sense of loss", said another. Because of my partner's medication, his libido is completely gone. He is happy to please me when I initiate, but it feels so one-sided."

"We've worked something out," said a woman whose husband is disabled due to a stroke. In other words, they have figured out how to be sexual by getting around the impediments.

"My partner is like a teenager. In his early '70s, he is ready -- and able -- at any time."

"When my husband was in his early '80s, he found that he was unable to have an orgasm after his prostate surgery, so intercourse went on too long and too painfully. We finally just gave it up."

When I told one of my friends that I wanted to quote her in this article, she wrote:

"I would add that it isn't just 'health' issues per se that gets in the way, but our naturally aging bodies. I don't consider my thinning vaginal wall that makes sex painful a health issue as much as one of the unfortunate consequences of my body -- at this age, biologically speaking -- not needing so much estrogen anymore."

Quite the range of responses. And I haven't even asked my lesbian friends.

I have written before about sexuality and aging as well as the "joys" of online dating and the sexual pleasures of aging. I have given workshops on the issue and spoken at conferences, but I can't seem to let this topic go. And the personal stories are so compelling.

The studies tell their own stories.

"One such study noted that, "61% of all women in this cohort were satisfied with their overall sex life. Although older age has been described as a significant predictor of low sexual satisfaction, the percentage of...sexually satisfied women actually increased with age, with approximately half of the women over 80 years old reporting sexual satisfaction almost always or always." This confirmed an earlier study by the National Council on Aging which concluded, "Seventy-four percent of the sexually active men and 70% of the sexually active women reported being as satisfied or even more satisfied with their sexual lives than they were in their 40s."

And lest we forget, no matter how we define "sex", intimacy generally trumps sensation. Alex McKay of SIECCAN said in a talk on mid-life sex and STIs, that there was, in his opinion, a "six-minute rule."

Quoting a study on heterosexual use of condoms, he said 71% of women who had 6 - 10 minutes of post sex affectionate behaviour rated their last penis in vagina (PIV) intercourse as "very pleasurable" as opposed to 44% of women who experienced 0 - 5 minutes.

Health Canada is encouraging us to carry on, as is the Canadian Public Health Association.

"Along with better health and active aging comes sex! A nationally representative sample of 3,005 Americans between 57 and 85 years of age revealed that nearly three quarters of seniors aged 57 to 64 were sexually active; while more than half of seniors aged 65 to 74 and more than a quarter aged 75 to 85 reported being sexually active."

However, medication can interfere with one's sex life at any age. For example, "currently available antidepressants may aggravate sexual dysfunction and make depression worse, a new survey of US adults with major depressive disorder (MDD) suggests."

There are other meds that can get in the way of sexual functioning. And people get scared to become "active" after an illness like a heart attack.

"Although most younger patients are sexually active 1 year after an acute MI [AMI], one in 15 women and one in 20 men never resume one of life's greatest pleasures, a new report finds."

Another factor in maintaining a sexual relationship into our '70s and '80s may be loss of interest, especially for those in a long-term relationships. Like lesbian bed death, for heterosexuals it is just a bit less "drastic".

Then there are those older people having great sex, by which I mean there is at least connection and intimacy.

Others may be having more PIV sex because of Viagra, for example, which may bring its own problems, like oppressive demands. Back in 2003, according to a study "few studies have focused on the possible detrimental effects for women of Viagra use within a heterosexual relationship".

"We argue that while previous medically-oriented research in this area has generally assumed an unproblematic link between Viagra use and the resumption of penetrative sex within heterosexual relationships, more attention needs to be paid to partners' perspectives and desires, and to the specific dynamics of any given relationship."

One wonders which people would choose: great sex without intimacy or intimacy without full sexual functioning.

I guess we want it all. Love. Intimacy. Good sex, however we define "sex".

Surely when there is open communication and a willingness to please, there is pleasure to be had. If we see ourselves as desirable, some of that can translate into -- if not desire and the mechanics to go with it -- at least the desire to please. And while some of us are wistful, others may be envious of some people's good fortune, however much of it "all" they have.

I look forward to your stories. Please comment.

Here are some disability resources that may be useful to people who are aging.

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