Doctors Silent on Senior Sexuality

By MCauch
SageHealth Network

Last month, the New England Journal of Medicine caused quite a stir and media buzz with its extensive study on senior sexuality. Everyone was surprised, delighted and shocked by the statistics of seniors’ sexual activity, frequency of activity and types of behaviour:

• 73% reported being sexually active
• 2/3 had sex at least twice a month
• More than half had sex at least twice a month into their 80s
• More than half of those aged 57 to 75 and 1/3 or 75-85 year olds said they gave or received oral sex

However, there was another statistic on doctor-patient communication was not so much titillating as it was cause for concern:

Only 22% of women and 38% of men had discussed sex with a doctor since age 50 (NEJM, 2007).

The high rates of sexual activity compared with low rates of how many seniors talk to their physicians about sex shows a huge disparity. Withholding information may put many individuals at risk. This absence of open communication is a barrier to health education and results in major societal consequences. Older adults are embarrassed to broach the subject with their doctors and doctors are embarrassed to discuss sex with their older patients.

"Sex is an important indicator of health," Georgeanne Patmios of the National Institute on Aging, remarked in the NEJM study. Sexual problems can be a warning sign of diabetes, infections, cancer or other health woes. Untreated sex issues can lead to depression and social withdrawal; emotional stress; extra marital affairs and divorce; low self esteem and poor body image. “This subject has been taboo for so long that many older people haven’t even talked to their spouses about their sexual problems, let alone a physician,” said the lead author, Dr. Stacy Tesser Lindau, a University of Chicago gynecologist(NEJM, 2007).

Another problem stemming from this doctor-patient silence is that older adults may be at increased risk of contracting sexually transmitted infections. Many doctors perhaps are simply ignorant of the fact that their older patients are sexually active or could even be injection drug users.

Dr. Marianne J. Legato of Columbia University College of Physicians & Surgeons in New York stated, “Physicians need to detoxify the sexual subject for themselves and learn more about the physiology of normal sexual experiences. This should be taught in medical schools,” (Sexual Health Network, July, 1999).

It’s simply not enough to acknowledge the fact that many physicians are mum on sex when it comes to their older patients. Action must be taken to educate medical interns and make them aware of and counter their subconscious ageist attitudes. Physicians need sensitivity training and learn to be comfortable in assessing older patients lifestyles and health care issues. This includes being at ease with such topics as sexuality throughout the lifespan, risky sexual behaviours and querying about drug use.

This direct approach is imperative in providing holistic healthcare to seniors regardless of averted eye contact and blushing for both parties. Health care workers and medical professionals should not make the topic taboo, but should approach the discussion very matter-of-factly and as part of a normal health history.