Does sex get better with age?

Plus, hospital care goes remote

View this email online April 30, 2023 by Andrea Muraskin With the lusty month of May around the corner, we talked to a sex therapist about how to have a satisfying sex life, when you're no spring chicken. Also, hospital acute care is going remote, a mom-to-be must come up with $15,000 overnight to save her twins, and scientists discover a sneaky cause of UTIs.  Optimists do it better and other advice for great sex after 60 iStockphoto It’s generally believed that people should be able to enjoy their golden years, but what does that look like? Time for hobbies, travel, spoiling your grandkids? What about great sex? A study published last month in The Gerontologist looks at how well our sexual expectations match up with reality over time. As part of the MIDUS (Midlife in the US) study, hundreds of partnered adults ages 45+ were asked to rate how satisfying they expected their sex lives to be 10 years in the future. Researchers then checked in with the participants a decade later. Their findings seem to demonstrate the power of positive thinking.  Participants who were optimistic about their sex lives reported having significantly more frequent and more satisfying sex than those who had lower expectations. Also, “sexually optimistic” individuals who acquired limitations they didn’t have ten years before – such as pain that made it harder to lift groceries or exercise – reported having more frequent sex compared to individuals who had lower expectations, and did not have those physical limitations.  Natalie Wilton, a therapist who specializes in senior sexuality, says it's no surprise that many people feel pessimistic about sex as they age. “As a society, we buy into a lot of those really dangerous tropes and stereotypes, which make it very difficult for older adults to, I think, feel open about talking about sex. Like that dirty old man's stereotype, or the woman as a cougar, or even kind of infantilizing. We see two older adults and we'll be like, oh, cute, they're holding hands, right? Or when they do do anything related to sex, we're like, oh, that's weird.” She says these kinds of norms discourage discussion of healthy sexuality for older folks, but it doesn't have to be that way. In her practice, Wilton helps clients navigate the changes in their bodies when it comes to sexuality. “I'm always amazed at how people are surprised about talking about sex and older adults, like it's always this great revelation,” she says. “If something was really good right now, why would you want it to stop?”  With some adjustments, she says, there’s no reason to leave sexual satisfaction in the past. Here's some of her advice.  Slow your roll Good sex takes time, Wilton says, even more so later in life. As we age, our sexual response cycle – the time it takes to become aroused before and between sexual activity – becomes slower. Women especially may require more time and more touch beforehand, a feeling of “my mind is there but my body’s not quite there yet,” Wilton says. For older adults with medical conditions whose symptoms worsen at night, she suggests planning sexual activity for the morning or afternoon.  Avoid ouch moments “Mobility is a huge issue,” Wilton says, when it comes to having comfortable sex, but today’s seniors have options. “There's tons that exists on the market, benches and wedges and different kinds of things, but you can also just use the things [like pillows] that you have in your own home.” Even simply changing position can help. A tip: assistive equipment like foam wedges marketed for sexual activity can often be found for much cheaper at medical supply retailers or on Amazon marketed as “back support” and the like.  Check out the toy store “Something like lube is great,” Wilton says, “for women as they get older.” She also encourages her clients to experiment with different toys. “It is actually a really great experience to go into a sex shop, but it's pretty cool that we can go online and look for things, if we don't feel comfortable or even live in a small town that doesn't have great access to that kind of stuff,” she notes. Drug store chains generally carry lubricant, and many now stock a few toys as well. Open up to new ideas Wilton encourages clients to redefine what sex and intimacy looks like, and develop flexibility around that. “Say your partner can't get an erection or your partner doesn't seem to be in the mood. It’s not getting like, ‘oh my goodness, they don't wanna be with me. This is awful. We need to stop.’ If things aren't going the way you want it to, just snuggle instead, give each other a back massage or touch each other differently,” she suggests. “Just kind of give that time and space for things to move and flow a little bit more organically.”  Watch for side effects When it comes to sex, Wilton recommends asking questions and advocating for yourself at the doctor’s office. “Things like diabetes, heart disease, Parkinson's, the whole host of issues that we tend to see more commonly as people get older, often have either a sexual side effect based on the illness itself, or many of the medications may have some kind of side effect,” she says.  To learn more, Wilton recommends the books and website of senior sexuality advocate Joan Price.  Despite challenges, Wilton says the sex you have when you’re older can be the best of your life. “Sometimes we develop a bit more of a confidence for ourselves when we get older, right? We're like, ‘yeah, you know what? I am who I am and I like me.’ Most people, as they get a little bit older, they stop caring about some of those less important things, and I think that promotes a better sex life too.” Check out these interviews and stories for more advice and reflection about keeping the heat turned up as you age: Lubrication and lots of communication: Navigating a new sexual life after menopause Sex, friendship and aging: 'It's Not All Downhill From Here' Can a person with dementia consent to sex? Participate in Public Media Giving Days Next week, we are celebrating Public Media Giving Days. Our work is only possible through the help of listeners, readers and supporters like you. We don’t have investors, owners, or shareholders. We hold ourselves accountable to you. If public media has ever made a positive impact in your life, we hope you’ll consider donating and supporting our mission. Every single gift makes a difference. Donate today. Newsletter continues after sponsor message Unraveling a hidden cause of UTIs -- plus how to prevent them Getty Images/Westend61 When one of my girlfriends complains about a urinary tract infection, I assume she’s been having lots of sex. But according to new research, I shouldn’t jump to conclusions. Learn how to lower your risk of getting this yucky condition that makes it hurt to pee, and sends over 1 million Americans to the ER each year.  Post-pandemic, even hospital care goes remote FG Trade/Getty Images With an IV drip, an oxygen monitor and a tablet for virtual check-ins, David Elder is recuperating from a bone marrow transplant in his living room. Since rules for around-the-clock care relaxed during the pandemic, “hospital-at-home” programs have sprung up around the country. While the comforts of home can be more conducive to healing than a hospital room, critics say the practice can place unfair burdens on family members and endanger patients.  Bill of the Month: She was pregnant and had to find $15,000 overnight to save her twins Zack Wittman/ KFF Health News Once in a while, health insurance plans make exceptions for doctors who are normally out-of-network; if the patient provides documents proving their problem is urgent and they can't access an in-network provider. But for a mother facing imminent risk of pregnancy loss, there was no time for paperwork. For the latest in our “Bill of the Month” series, NPR and KFF Health News investigate a Florida woman’s insurance quagmire, and her quest to get reimbursed.  We hope you enjoyed these stories. Find more of NPR's health journalism on Shots and follow us on Twitter at @NPRHealth. All best, Andrea Muraskin and your Shots editors Listen to your local NPR station. 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