If you’re sexy, fit and nimble, if you can part your thighs and bend your knees, if you can see your private parts without a mirror, ignore this. Move on. This is not for you.

This is for those with flailing sex-drive and failing abilities whose sex life is a challenge, but they’d like to make their partners happy and have some fun. Maybe your parents or grandparents. This must be an awful thought, but I’m pretty sure they did it before, or you wouldn’t be here.

Sex in the elderly is not a need. It’s a privilege.

Most days you just hope for a good bowel movement.  You walked out of bed, you peed without a tube in your urethra, you pooped without an enema! Wow!

Towards the end of your life, the day you even think about sex is a good day. You have a spring in your step and tickle in your nether parts, reminding you of the good old days. You feel naughty. But your partner … They may or may not be into it.

You’re not quite sure how to ask. There used to be signals: that special smile; that slow touch; the tongue maybe? You didn’t use to have dentures, then.

It’s hard, whether you’ve been together forever or just since your granddaughter hooked you up on Tinder. You spoon while you sleep. You switch plates at dinner. Sometimes you take his meds. Your intimacy is not sexual.

Today, you feel the stir. You’re not sure how to go there. Wouldn’t that be fun?

Maybe.

There are challenges.

Artificial hips and fused backs hinder your mobility and limit position choices. Avoid low chairs. They make hips come out. Nothing spoils the mood like an ambulance trip.

Atrophic vaginas lack flexibility, so lubrication is essential. Lubricants come flavored in endless choices. Naked strawberry. Pina Colada. Cinnamon roll. I’m looking for one in bacon. They say bacon makes everything better. You need lube, love, and lots of patience.

The penis needs blood to engorge — lots of it. Your heart needs to stand up to the challenge, besides just keeping you alive. Sex may be the only demanding physical activity you’ve engaged on since fighting for that TV on Black Friday. Sex is risky for your heart, your brain, your aorta. Your body works just as hard as if you were shoveling snow, but you’re having too much fun to notice the warnings.

I’m an ER doc, so I’ve seen plenty of heart attacks and strokes caused by sex. A few deaths. They were all men. Their lovers were distraught.

So were their wives, when they all met at the bedside. I saw that twice. Neither man made it.

Be careful. Speak to your doctor. Ask them if your heart is strong enough for sex.

Viagra works. It made a difference in my patients’ sex lives. It gave them hope and joy. It also gave them HIV, and Hep C. Viagra doesn’t work well with alcohol. You may want to forgo the wine and stick with roses and candles. Viagra interferes with nitroglycerin, our go-to drug for the heart. Tell your doctor if you took it.

Regardless, sex is fun, sex is joy, sex is love. If you’re not doing it, you’re missing out.

If you’re lucky, you have an interested partner. Still, coordinating is a challenge. Maybe it’s not their day.

In comes oral sex. The blow job is the refuge of the intercourse destitute. Whether you had surgery, you hate being touched down there or it’s just not your day. Oral sex can be your friend.

How bad can it be? It won’t make you fat. Like celery and grapefruit, it’s negative calories. It will help soothe a relationship that needs more than you can deliver. Look at it as a gift. Share sex like you’d share a special dinner: You can choose your entree, but you have to agree on a time and place.

A few technicalities:

• Soap is cheap. Skin folds are tricky. Wash them twice.
• Dentures: Remove them if they don’t fit well.
• Breathing is a challenge. If you’re oxygen dependent, secure your oxygen first!
• Sex is exercise. Getting in shape will improve your health, your endurance, and your fun.
• Use condoms if it’s just a random night. HIV, HSV, HCV, and gonorrhea don’t care about age.
• It’s not kosher. I checked.

Still, oral sex may not be your thing. You’re not that adventurous. You have a gag reflex. Your morals don’t agree.

Modern technology is there for you. You can cater to each other’s needs without the physical demands. Vibrators conquer challenges that hypertension, diabetes, and strokes make unmanageable. Electricity is cheap.

Caveats:

1. Be careful with batteries. If they catch fire, they spoil the mood.
2. Avoid vacuum cleaners. Too much suction.
3. Avoid vegetables, even healthy ones. If they break inside, they go bad.
4. Same with glass. Stick with plastic.

Bottom line:  Sex in the elderly is not for the faint of heart, but its a way to stay together even as everything else falls apart: joints, friendships, retirement accounts.

Sex is just another way to love each other and meet each others’ needs. Getting them what they need, whether you need it or not is like you’d get them their cereal even if you live gluten-free.

Sex in the elderly is both a challenge and an opportunity. Like walking with a walker, it’s clumsy, but it gets you there.

Until the stairs.

Rada Jones is an emergency physician and can be reached at her self-titled site, RadaJonesMD, and on Twitter @jonesrada. She is the author of Overdose.

Image credit: Shutterstock.com