Sex talks with 60 year olds

As a gynecologist, I not only witness new love but have to regularly ask about it because it can impact my patient’s health. They may need birth control, STI screening and counseling, or pre-conceptual counseling. Then there is one of my favorite group of patients: those that are “older” and entering into new relationships either for the first time or following a divorce or loss of a spouse. The balance of being seasoned in life and the naivete and excitement of starting over, I find refreshing and sweet. It reminds me that we are never too old to embrace something new.

K was a school teacher, an avid swimmer and at age 60, had never had sex. She had been my patient for many years, and one year, when I saw her for her annual exam, I found her beaming, “I met a man!” Her words were flowing out of her mouth so fast, I could barely register what she was saying, but the excitement was palpable. I just sat there smiling as she continued on about how they met, what he was like and how she never thought this would happen. The first thing that popped into my head was, “Oh boy, someone needs to have a sex talk with her.” After I was done examining her, I asked her to get dressed; I left the room but planned to circle back. I knew what I had to do and although I didn’t really have the time, I had to make time. I had to give the sex talk. Who else would?

After she dressed, I came back in her exam room, sat down and said “we need to talk,” as if I was her mother. She looked surprised. I wasn’t sure what to say; I hadn’t even had a sex talk with my own kids let alone a woman in her 60s. But once I got started, it all flowed out as she eagerly listened. I addressed her emotional needs, physical needs, possible issues related to sexual activity past menopause and, lastly, told her that it was OK if she was nervous along with her excitement. Cognizant of other patients waiting, I rushed through it all a bit, so ended with, “Feel free to call me anytime or come back in if you have any questions.” She was very appreciative that I took the time with her and left with more confidence in her walk. She eventually married this man and embraced her new, unexpected life with him. And I found, helping her navigate unchartered waters, gave our relationship more depth and sincerity.

Mrs. L was a legal secretary, very prim and proper, and a widow in her 60s. Under her petite physique hid a lioness that was not afraid to speak up and was in command of her world. There was never a hair out of place, clothing that didn’t fit perfectly and there was an expectation she be addressed as Mrs. L, rather than by her first name. At her exams, she always had questions ready along with a pen to write down the answers. When I asked personal questions about her life, she never shared much; it was all business at her appointments. Because of that, I didn’t really know much about her late husband, her children or whether she was interested in meeting another man.

After years went by, I think I stopped asking. I was so used to her seriousness, I nearly fell off my stool when one day she smiled and said, “I met a man, what do I need to know to have sex again?” I repeated, “You met a man?” as my brain registered what she said. For the first time, as we talked, she didn’t have pen and paper but looked straight at me with a twinkle in her eye. Over time, I realized I looked forward to seeing her as she shared more about her life and her visits weren’t all “business.” And at her last appointment, as I was walking out of the room, she blurted out. “I have one more thing to tell you, my boyfriend wanted to me to pass on a thank you from him for helping me … well, us.” And then she giggled. A seriously, teenage, hands-hiding-your-face giggle. I couldn’t stop smiling the rest of the day.

N was a traditional housewife, usually in a state of disarray and had been approaching menopause. As her children started leaving home, her marriage began to dissolve. It had become apparent that she and her husband had little in common. Discovering that he was having an affair cinched her decision to leave the marriage. At her yearly exam, she started with “I’m getting a divorce, don’t ever get divorced. It is horrible.” The next year, again “Don’t ever get divorced, it is horrible being alone, and at my age, I will never find anyone to spend the rest of my life with.” This actually was a time I was having difficulty in my marriage and was considering a divorce, and her words alarmed me. I questioned her more about her difficulties, and we discussed ways of meeting new people.

The following year, she came in wearing cycling clothes, a helmet under her arm, and a fit body. After we had talked the previous year, she realized she always loved bicycling and found a biking group. She met some great people including a man she was now dating. She had questions about how to protect herself from STIs and whatever else she needed to know in this “new-fangled time.” Another year went by, and she happily announced she was getting married, and then talked nonstop about their various biking trips. It was night and day, the transformation of her attitude towards life and towards herself. Although she hated the time she was alone, she also found strength in herself she probably would not have found any other way. At that appointment when she announced her wedding, I reminded her of how she seemed just a few years before and how much she had changed. She nodded in agreement and added, “Thank you for noticing.”

Any new relationship deserves that moment of reflection, that moment to take care of your needs, that moment to make conscious decisions about how you want it to be. I see my role as one that starts this discussion with patients, so they recognize the importance of self-care. And for those starting over, especially after a long hiatus, to help them overcome some of the fear and trepidation of stepping into the dating world again. At any age, love is in the air.

Andrea Eisenberg is a obstetrician-gynecologist who blogs at Secret Life of an OB/GYN.

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