When Louise Hay celebrated her 90th birthday this year, I was inclined to consider this question as it pertains to life, love and sexual intimacy, “How old is too old?”

Louise Hay epitomizes the manifestation of an intentional life of love and admits that she didn’t get started until well beyond 50 doing most of the things she is known for today. This reminds us that it is never too late and there is no such thing as, “too old.”

I spend large amounts of time talking with women who struggle with libido and feel empty in their relationship so I’m always intrigued when a, “much older” woman enters my office beaming ear to ear because she is having the best sex of her life! It happens a lot and it always inspires me. Studies reveal that 50% of men and 40% of women over 60 are having sex. With the advent of the pink and blue prescription medications, couples are able to respond sexually at older and older ages. 

Sometimes the renewed interest and closeness stems from deep relationship work we have done or treatment of a physical issue such as sexual pain that had been holding the couple back from sexual expression. However, on occasion, the invigoration stems from finding a new lover and exploring love-making in entirely new and exciting ways. While both situations fulfill my deepest yearning to educate and guide women to live their best lives, within and outside their relationship, there are very different topics to cover in these distinct office visits.

In the case of a renewed long-term connection, we discuss the value of continued honesty, authenticity and vulnerability. The importance of realizing that marital contracts, once developed, are never static and need to be constantly re-negotiated, molded and transformed to keep up with the growth of the individuals involved. The primary bond that holds a relationship together is the inner work that a person is willing and able to do on him/herself. It seems counterintuitive, but we cannot expect to HAVE a contended, loving, engaging and secure partner unless we EMBODY those qualities for our spouse. Our visit ensures that sex is comfortable for both parties but, also, that other forms of sexual intimacy are expressed so that when/if dysfunction arises, it doesn’t destroy the foundational love.

When a woman has entered a new and exciting relationship, we talk about health and safety including emotional protection until commitment is ensured. We will also breach the essential topic of sexually transmitted infections. Men on Viagra are six times less likely to use condoms that 20 year olds. While college men use condoms with 40% of encounters, men over 60 glove up only 5% of the time, leaving an open door for infections. The Centers for Disease Control (CDC) reveal that, in the over 65 year crowd, the rise in syphilis (52% rise) and chlamydia (32% rise) rates are similar to increases observed in 20-24 year olds. Geographically, Arizona and Florida, with the greatest populations of seniors, have syphilis increases exceeding all age groups, (Arizona 87%, Central Florida 71% and South Florida 60%). We can attribute these staggering statistics to people living longer, healthier and more fit lives than ever before. Medicine and preventative health measures are making sexual function possible well beyond reproductive years, but, sadly, providers are not readily offering education and testing to older folks. Despite multiple public health campaigns, seniors remain undereducated about sexually transmitted infections, and sexuality in general, having been raised at a time when open dialogue was discouraged. Risk is compounded by the fact that, with age, immune responses lag and infections become more prevalent and severe.

Love and belonging are irreducible needs on Maslow’s hierarchy of needs and sexual intimacy remains an essential and beautiful communication of humanity’s deepest desires. 

I am hopeful that, with education, guidance and open discussion, sexual expression of love will not only be safe but a whole lot of fun for men and women at all ages and stages of life.