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Things to Know About Sex in the Elderly

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If you’re young and slim and pretty, if you can touch your toes and part your knees, if you don’t need help finding your sex organs under your pannus, ignore this. Move on to “How to lose 10 pounds in a single steamy sex session without messing up your hair.” This piece is not for you.

It’s for the others: those with questionable sex-drive and variable abilities who still want to make their partners happy and have fun. It’s for my sex-challenged elderly patients.

Sex in the elderly is not a need but a privilege. The day you want sex is a good day. You got out of bed, you peed without sticking a tube in your urethra, you pooped without an enema…Wow!

Then there are the artificial hips and the fused backs. They hinder mobility and limit positions choices since artificial hips tend to come out easily and having to call 911 to get your hip back before climax is likely to spoil everybody’s fun.

There are risks: for many, sex is the only demanding physical activity they ever engage on. That’s risky business for the heart, for the brain, and for the aorta. Your body works just as hard as it would if you were shoveling snow, but you’re too excited to notice the warning signs.

I’ve had patients come into the ER with heart attacks or strokes happening during sex. I’ve even had a few deaths. All men. Their lovers were remorseful and distraught. Their wives were too — until they all met at the bedside. I’ve seen that twice. Neither man made it. Just saying. Be careful. Speak to your doctor and ask if your heart is strong enough for sex.

Viagra has made a huge difference in the sex lives of the elderly, giving them hope and joy while leading to an increase in their rates of HIV and Hep C. It mixes poorly with alcohol and hot baths. Stick with roses and candles. It also interferes with nitroglycerin, the first drug used for heart attacks besides aspirin. If you end up in the ED, please tell your doctor you’ve been using it.

If you’re lucky enough to have an interested partner, coordinating gets harder as you get older. The drive may be missing but the longing is there — sex is fun, sex is joy, sex is love. If you’re not doing it, you’re missing out.

In comes oral sex, AKA the blow job. It’s the refuge of the intercourse destitute — when you just can’t go there. Whether it’s recent surgery or if you hate being touched down there or it’s just not your day, oral sex is your friend. It can’t be much worse than doughnuts, for God’s sake — the things you put in your mouth every day would make your mom shudder. It’s not going to make you fat — it’s negative calories, like celery and grapefruit. Nobody ever said that those are unhealthy! It can oil a relationship that needs more than you enjoy delivering. You can exchange it like tokens — you today, me tomorrow. Share sex like you’d share a nice dinner — choose your entree and your cocktail, but you may have to agree on a wine.

A few technicalities. The cleaner the better — don’t skimp on the soap, it’s cheap. Dentures complicate things. Take them out if they don’t fit well. Breathing is a problem, worse for those who are oxygen dependent and tethered to a tank. Secure your oxygen first! Being in poor shape doesn’t help — remember, sex is a form of exercise. If you can, start a walking routine to improve your health, endurance, and enjoyment.

If oral sex is not for you, there is modern technology, available in adult stores and online, for any need and every taste. It can help you cater to each other’s needs without the physical demands. Vibrators can conquer challenges that hypertension, diabetes, and strokes make unsurmountable. Electricity is cheap and easy, (avoid batteries, they tend to overheat and catch fire and that may cause more excitement than planned.) Stick with the plug-in type.

Sex in the elderly is not for the faint of heart. It’s an opportunity to stay together even as everything else falls apart. It’s a way to meet each others’ needs and love each other in an asexual way even when it’s about sex. It’s a meeting point of where you both have been and where you are going. It’s making sure that you each get what you need, just like you’d get them their cereal in the morning even if you live gluten-free.

It’s like walking with a walker — a little clumsy, but it gets you there.

Until the stairs.

Rada Jones, MD, is an Emergency Physician. She practices in Upstate New York where she lives with her husband, Steve, and his deaf black cat named Paxil. She’s about to publish her first novel, an ER Thriller where a lot of people die in exciting ways and the good guys drink like fishes. Find out more at, instagram RadaJonesMD and twitter @JonesRada.

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