Iowa Alumni Magazine | August 2005 | Features

Will You Still Love Me?

By Lin Larson

“Will you still need me…when I’m 64?” the Beatles asked. Plenty of “Gray Panthers” would answer with a resounding yes. Receding hairlines, expanding waistlines, and creaking joints notwithstanding, they do still bring their loved ones wine and send them Valentines.

Television and movie screens, glossy magazine advertisements and billboards may depict men and women with perfect teeth, hair, and bodies romping on secluded beaches or between silk sheets, but many seniors know that loving relationships don’t stop when the gray hairs and wrinkles appear. To quote the Beatles again, “All you need is love.”

So, what accounts for our culture’s generally squeamish attitude toward the thought of older folk sharing emotional and physical intimacy? One-dimensional views of sexuality—that it’s all about intercourse—perpetuate awkwardness and reticence in discussions about sex, particularly when it’s linked to aging. Mickey Eliason, 79BA, 81EDS, 84PhD, a UI associate professor of nursing who teaches undergrads in the UI sexuality studies program, says, “When I bring it up with my students, I distinctly hear, ‘That’s too gross—I don’t want to think about old people having sex.’ We’re such a youth-oriented culture, and everything we see in the media is the young and the beautiful having sex.”

Tom Walz, a UI professor emeritus of social work, has conducted extensive interviews with older people about the influence of aging on their sex lives and seen a complex picture of human relationships emerge. Without family or career pressures, many retirees discover or are reminded of the pleasures of sex. Others find different ways to express and share vital closeness.

Talking to older adults, Walz was struck by how some draw on non-sexual relationships for physical and emotional closeness. It was not uncommon for aging people to report a great joy and pleasure from contact with grandchildren or even pets. Women who had lost partners turned to each other for simple companionship. The intimate came to focus more on communication and connection, less on genital sexuality and orgasms.

“Sex is a form of communication that’s essential to our human well-being,” says Walz. “I think we are still learning to take sexuality for what it is as both a means of reproduction and a means of communication.” Still, even the experts can sometimes feel uncomfortable at the thought of intimacy between people of advanced years. Walz saw a prime example of that in the late 1980s, when he had fallen into aging research almost by accident—winning federal funds for a UI gerontology program and becoming a geriatrics social worker with the Department of Family Medicine. None of that, though, had prepared him for Emma.

Shriveled, unkempt, missing a leg, Emma looked every bit of her 82 years. She lived in a local nursing home and had threatened suicide. Walz set out to determine what was troubling her, but Emma assured him that in her condition, she couldn’t kill herself even if she’d really wanted to. As they talked, Walz realized that she remained a spirited, quick-witted woman despite her worn body. Before long, the two of them were laughing out loud, drawing her doctor’s attention.

All business, the doctor examined the remnant of Emma’s amputated leg, then palpated her good leg, seeking any sign of circulation problems. Walz watched as the doctor moved his hands up her withered thigh and asked how she felt. Finally, Emma mustered a flirtatious look and said, “Doctor, the higher you go, the better it feels.”

Twenty years later, the moment still stands out for Walz, a revelatory glimpse into what was then—and even now largely remains—an uncharted aspect of later life. He saw that a sexual spark still fires in aging minds and bodies, blazing for some, sustaining a comfortable warmth for others.

“Sex is a repository from pain for people who begin to think of their bodies largely in terms of aches and hurts,” Walz says. His first meeting with Emma led to lengthy interviews with her and dozens of older adults, a 1987 book on sexuality and aging, and continued work on a topic that is even more important to him today.

Although Walz is officially retired, he manages Uptown Bill’s Small Mall—a UI-affiliated community center and small business incubator for people with disabilities or low incomes—writes and teaches, and plays basketball when he gets a chance. “I’m 70 years old,” he says, “but come watch me play full-court ball with the kids. You’d be very surprised.”

If Walz was struck by the sex lives of seniors he met during his research, so were most of them. They’d expected to lose their interest with their youth, settling into a quiet, gray, sexless existence. Their experiences varied widely, but many retained a deep attachment to physical and emotional intimacy.

“There were elderly people who had shelved their sexuality, but a lot who were either very active or wishing they were,” Walz says.

For both women and men, sexual activity commonly slows with age. Hormonal shifts affect sexual functioning and desire, and diseases from hypertension to cancer can exacerbate the changes. Also, many aging adults eventually lose their partners to illness or death and find them difficult to replace.

Walz remembers how an elderly woman approached him after he presented a talk about his work to an audience of seniors. “She told me, ‘My husband and I have a wonderful relationship, and I help out my neighbor as well because his wife died,’” Walz says, still marveling at the disclosure. “She wasn’t being coy or cute, just matter-of-fact.”

Alongside the physical or psychological effects that accompany aging, there’s the cultural belief that sex fades away, that it’s pointless, pathetic, or ridiculous for adults past a certain age. Walz insists this isn’t true, describing individuals who report that age brought startling and welcome sexual discoveries. “It makes for a much softer entry into old age,” he says. “Your sexuality is not a loss but a gain—and there aren’t too many things you gain with old age.”

But for every person who experiences a sexual rebirth in aging, there are other adults who retire from sex out of choice or circumstance. “I’ve heard several stories of great pain, mainly from women, who said sex was never a pleasure for them,” Walz says, noting that some attributed their feelings to a history of sexual abuse, others to ingrained fears of pregnancy or distaste for the “messiness” of sexual contact. Others lost partners or just slowed down.

“Most of the stories were fairly predictable,” Walz says. “Perhaps these people drifted a little bit from sexual intercourse, but they continued to enjoy the warmth and touch and tenderness of another person.”

Lately, Walz has turned his attention on media portrayals that promote stereotypical views of sex and old age—from sexless crones to bored retirees and dirty old men. He suggests that the notion of inevitably sad, chaste, or sexually dysfunctional older adults stems from the “Dorian factor” (named for the Oscar Wilde book The Picture of Dorian Gray, which mused on the value of youth). In this view, youth equals beauty equals sexuality.

Among the misconceptions surrounding aging is the idea that older people—especially men—are drawn only to younger partners. “If you look at congregate meals or clubs, if there’s any interest shown in wanting a relationship, there will be plenty of takers,” Walz says. Granted, a 15- or 20-year age difference means less the older the partners are, but the flirtation that erupts in groups of seniors attests to the fact that many remain interested in each other.

Health and helping professionals may be nearly as ignorant about the realities of sex and aging as the average man or woman on the street. Professor Eliason says that education programs often clump sexual topics into a single course instead of integrating them into lessons on human development, aging, and diagnosis. Physicians, nurses, therapists, and others may avoid talking about sex because they’re unprepared, embarrassed, or afraid the conversation may take too much time.

Patients often skirt the topic, too. “A large number of people who come into clinics have some sexual problem they would like to discuss with a healthcare provider, but they wait for the provider to open the door,” Eliason says.

This chronic avoidance extends to long-term care facilities, which may do everything possible to discourage sexual activity among residents. “There are still places where a married couple going into a nursing home are assigned separate rooms and not allowed to visit at night,” Eliason says. Walz points out that many other aspects of life—like eating when hungry instead of during scheduled meals—also are complicated by regimentation at care facilities.

The Baby Boomers, the children of the so-called sexual revolution, may help counter these myths about sex and aging. “A lot of women in past generations thought that when you hit menopause, your sex life was over,” says Dr. William Davis, 73R, 82F, UI assistant professor of obstetrics and gynecology and a reproductive endocrinologist. “This generation wants it all forever, so it’s a real attitude change from when I started practice.”

Walz agrees: “I think Baby Boomers will be less likely to retire sexually, just as they are going to be less likely to retire from work. They’re going to be much more demanding and much more likely to continue sexual activity into old age, and many will have a longer run with their partners due to longevity.”

Indeed, Walz says his own aging has further dispelled his old misconceptions about age, sex, and more. He now appreciates beauty in a way he couldn’t as a younger man, but at the same time he recognizes the emotional and spiritual constants that run throughout his life. “I probably have the same struggles at 70 as I did at 18,” he says. “It’s like playing basketball: I can’t run as fast, but that’s the only difference. Everything else is exactly the same—except the enjoyment is greater.”

The Downside of Aging

In the age of Viagra, male erectile dysfunction (ED) may be the most talked about sexual problem connected to aging. Even Senator Bob Dole appeared in soft-focus, understated TV commercials touting the benefits of the little blue pill.

Dr. Bernard Fallon, 93MBA, UI professor of urology, says the problem is subjective, pointing out that some men who complain about erectile problems report being able to have sex multiple times a day. Nonetheless, older men have a higher than normal risk of experiencing ED. Often, erectile problems are linked to diseases and conditions that can particularly affect older men, such as high blood pressure, diabetes, and prostate cancer, as well as a normal gradual decline in the hormone testosterone.

Men with ED are more likely to report general unhappiness than their fully potent peers. “People accept the fact, though they may not like it, that physical performance deteriorates with each decade,” Fallon says, explaining that men aren’t surprised when they can’t run as fast as they used to. “The only area they really object to is erections.”

Women’s hormonal changes and the symptoms that accompany menopause, such as vaginal dryness and reduced sexual desire, may seem more dramatic, but they’re also gradual. “I think a lot of people have the notion that the ovary fails overnight,” says Dr. William Davis, 73R, 82F, an endocrinologist and UI professor of obstetrics and gynecology. “In fact, it probably occurs over a ten- to 15-year period, and the three hormones produced by the ovary fail at different times.”

For both men and women, shifts in libido are highly individual, their precise causes difficult to pinpoint. Davis notes that, during their reproductive years, women experience a rise of testosterone at the time of ovulation, when they are most likely to conceive. “It’s a sneaky hormonal fact that nature cues sexual assertiveness to promote pregnancy,” he says.

Low doses of male hormones can help some women with libido problems, but they’re not a panacea.

Depression—which may itself stem from hormonal changes—is notorious for altering sex drive, and the drugs used to treat it may make matters worse. “It’s such a complicated issue,” Davis says. “There are hormonal reasons, emotional reasons, childhood reasons, marital reasons. On top of physical changes, there are Freudian arrows flying everywhere.”