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Aging—and Loving—in America

Aging—and Loving—in America

by Dr. Barb DePree

I don’t always catch AARP The Magazine, I suspect because I’m still adjusting to thinking of myself as part of their demographic. But the most recent issue contained an article I’m glad I saw: “You’re Old, I’m Not,” a report on an AARP survey on “Aging in America.”

Among the findings are a few you’ll accept as common wisdom: People in their 40s define “old” as younger (63) than people in their 70s (75). As we grow older, we find that the process is “easier than I thought,” that we’re not held back from doing what we want to do. Older people appreciate old-folks humor more than younger folks do.

One section of the results, though, sparked my interest in a different way. There’s a difference by gender in agreement with this statement: “I know I’ll enjoy sex no matter how old I am.” Seventy-one percent of men agreed; only 51 percent of women did. Gender mattered much more than age: There’s only a 7-point difference between people in their 40s (66 percent) and people in their 70s, 59 percent of whom still expect to enjoy sex.

Given my line of work, I take that difference by gender as something as a battle cry. I certainly don’t want women to be like menvive la différence! But I take it as a personal, professional, and generational challenge to see more women look forward to enjoying sex!

I doubt that AARP was able to delve into the thinking behind people’s responses to that question. My guesses about why women are less optimistic than men are based on my years as a menopause care provider, not on AARP’s data. But here are my theories:

First, we’re young at understanding menopause. The average age for menopause is now 50; until 1900, few women lived past that age. We’re living longer now, and have much more experience with menopause, but we have no deep cultural expectation of conversation about it.

And that leads to the second factor: In the absence of good information, the worst-case scenario tends to take over our imaginations. Have you noticed that talk about child birth and root canals nearly always leads to the sharing of horror stories—the labor that lasted four days, the excruciatingly painful dental experience? Even though those stories are the exception, not the rule? I’ve seen the same thing happen with women talking about menopause, and the women who hear those stories are more willing to accept limitations and less empowered to take control of their own sex lives!

There’s one more factor, too: We as women start to receive messages that sex and older don’t compute. For some reason, “sexy woman” conjures a young woman in our media and culture—and, for some reason, we’re susceptible to that suggestion!

I don’t know when AARP will conduct this survey again. But when they do, my hope is that women agree just as often as men that “I’ll enjoy sex no matter how old I am.” Because we can, when we take the time to understand what’s happening as our bodies change. And we want to, when we recognize what sex means to our health, our well-being, and our relationships—and all the ways those intertwine.

And, okay. Because we women can be a little bit competitive, too.


  • You are right, the most likely solution for your vaginal ‘atrophy’ is a prescription medication to reawaken these tissues. By the way, I saw a women in the office about 1 weeks ago who hadn’t had sex in 8 yrs because of this same reason, they had not been intimate in other ways (no sexual touch/oral sex, etc) but after 12 weeks of treatment she returned having had sex completely pain free and stated ‘it was absolutely great’. But the necessary element to achieve this was a prescription (in this particular case Osphena, but there are other options too), and that costs money. Right now none of the vaginal atrophy prescription options have a generic available to us. It’s so frustrating to have to give this up for things like rent/food/utilities, etc, but that is a reality for many people. It is estimated that women lose 80% of their genitals in the process of vulvovaginal atrophy, that explains where the labia went, they literally melted away in the absence of estrogen. The majority of my sexually active postmenopausal women who continue to have intercourse (there are other options, check out are using a prescription for maintain vulvar/vaginal health or are having sex >3X/week (the ‘use it lose it theory’).

    It is worth trying vaginal moisturizers to see if that provides any improvement. Generally we see those for early or mild atrophy and less effective for advanced or moderate to severe atrophy, but it may be worth checking them out. They are non-hormonal and non-prescription, here is a link to those we carry on MiddlesexMD,

    Dr. Barb on

  • Would love to be able to enjoy sex at age 58. BUT I had a hysterectomy at age 45 and my vagina is as dry as the desert with zero elasticity, so sex is off the table at this house. There’s no lubricant in the world that’s going to make my vaginal tissues come to life. My insurance does not cover Premarin cream nor the Estring. We cannot afford either w/o insurance coverage. Since vaginal intercourse is not an option, then I would need to perform oral sex for my husband at some point. It’s not something I like to do. It’s so embarrassing that most of my labia has flown the coop along with my libido. I would love to know what these “old” people that take these surveys are doing behind closed doors!

    Carolyn on

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