Embracing Sexuality in Aging: Shatter the Myths

Introduction to Dr. Pepper Schwartz 0:00

This is Doctor Talks, real talk from real doctors on the issues that matter to you most. All right, everybody. Welcome back to another amazing session of the Solving Sexual Dysfunction Summit. I'm so excited because you guys are in for an amazing treat because we have with us Dr. Pepper Schwartz. And this is going to be just I can't even go through all the accolades that she has between like research and TV and articles and books. I mean, she's probably, you know, done everything you could possibly think.

in the world, so thank you so much. Do you mind me call you Pepper or you prefer Dr. Schwartz? Oh, please call me Pepper. Thank you so much, Pepper, for being with us today. So how did you end up in the field of sexual health? Well, there's a long story and a short story. The shorter story, I'll refer to a long story in a moment, is I was in graduate school and they were at Yale. And it was the first year of doing an undergraduate course in human sexuality since Kinsey and Philip and Lorna Sorrell were leading it.

And I was doing a book about the first year of women at Yale. It had been an all male school up until 71. And we thought, well, part of what's going to be interesting about the dynamics of women in what has been for hundreds of years of male school is to look at this human sexuality course. and I read the material and so much was sexist and opinionated and not research-based. And I kept saying, that can't be true, that can't be true. And then the researcher in me was, well, how do I prove it?

How Pepper Entered Sexual Health Research 1:51

So I had to go into sex research because I intuitively felt that things like, that said, there was a book out at the time that said if you didn't have your first child by 25, you had terrible things happen to you, right? And I mean, come on. So there were other things that I felt we needed to know about better. But the long story is that when I was 11, my mother gave me a sex education book, which at that point was, you know, stick figures and sperm and egg chases and things like that. Put it in the linen closet, told me I could go visit it if I wanted to read that.

And one day my friend Franny came crying over that her mother had caught her touching herself down there. and told her she was evil and going to hell. And she was very distraught. And I said, no, no, Franny, don't, don't be so upset. You're not going to hell. You're going to the linen closet. And she, uh, she read there that masturbation was normal and, you know, we were very naive. So with anything printed was real, of course. And so I went to my mother after, Franny felt better and I said, mom, we've saved Franny.

We could save others. And I started little discussion group in our Naughty Pine Basement. So in some ways you could see it was destined. I absolutely love this. And you know what? It's funny. That's actually how I got my sex education growing up. My mom handed me a book when I was in sixth grade. It was like everything you wanted to know about sex and why or something along that. And she was like, here, read this. If you have any questions, let me know. And for me at the time, I remember reading, especially how, you know, how conception happened.

And I'm like, the mail puts the what where I'm like, oh, no, I remember. I was like, I don't want to know about this. And now fast forward, look at what I'm talking about. So, yeah. And then, you know, I think the topic of aging and sexuality is so incredibly important. I mean, first of all, I mean, you've been in this field for a while. Do you feel like we've gotten any further along with talking about sex than we have in the past? In general, yes. I mean, there's many, there's a huge number of books.

You could have counted them when I was a kid. You know, I mean, on one hand, maybe there is at least in fairly liberal districts, there's a lot more sex education that goes on. You know, are there some terrible areas of regression? Yes. But I'm not going to go there right now, but no, I do think we do. Now the more specific question to me right now, are we talking more about sex among older people? Yes, there's a little bit of advancement, but there still seems to be an ooh factor. You know, maybe it's because, you know, it's your parents and you can't imagine them doing anything but cooking together if they do that.

Sexuality and Aging: Cultural Attitudes 4:46

Or issues about body image or issues about, you know, all of the visions we have of sexuality are of young, fit people, et cetera. So I don't think we've had the yardage in talking about sex and aging that we have on other sexual topics. Yeah. And I think, you know, and we're living longer and longer. I mean, we're living now into our 80s and 90s. And so this is something that we need to be talking about. I mean, in fact, I'm going to throw a family member under the bus. And if any of my family are listening to this, they're probably going to cringe.

But when my husband's grandmother died in her 90s. We were going through her stuff. And I'm happy that I, as the doctor, found in her bedroom a whole bunch of condoms. And they weren't condoms from the 1960s. They were pretty new condoms. And I was like, go, Graham, good for you. Because she was in her 90s when she died. But I think if other family members had found that, they would have been a little bit uncomfortable with it. Well, I feel that If we gave people more permission to continue having their sexuality as a prize part of their family, their pleasure, but their life force, we wouldn't be so surprised or we wouldn't, or we'd be trying to help our older people.

If they're in rest home or, you know, assisted living or whatever, we'd be trying to help them have privacy and, and support for being sexual beings, but we're still kind of like, neutering them at some age. And that age seems moving back a little bit because as you say, we are living older, but we're not, we're not expecting people. I mean, it was interesting. I have a friend who is now in her early nineties, but at this time of my story, she was in her early eighties and gave a big dinner party with a lot of people at different tables.

And friend of mine leaned over to her and she, this friend of mine was there with her boyfriend who was in his eighties too. And my friend said, do you still have sex to her? And the woman turned to her and said, of course. Now, I don't know if she was or she wasn't, but when do we feel entitled to ask any person who just met at a dinner party, if they're still having sex, if they're 50 or 60, the older they get, the more we're embarrassed by it, the less we think that they're having it. And there's some statistical proof that not as many people are having it, But it's putting it in that special, like, could this possibly be happening category that makes people embarrassed at the idea that there's still being a section.

I know even from my standpoint, when I talk to patients, sometimes the reaction I get from some, not everybody, but some of the older population is, Oh, that part of my life is over, or I'm too old for that stuff. And I'm like, you're never too old for this. And so part of the problem is, you know, they've picked up the cultural message or, or it was never a really great thing for them. You know, and so it's not a cherished thing to continue, but between the cultural methods that you outgrow it, and the cultural methods that you're not sexy after a certain age, and the cultural experience maybe that it was never done the right way in the first place, and the prohibition particularly against masturbation, that all works against you.

Yeah, I was gonna say, what do you find to be the biggest issues when it comes to sexuality and aging? Well, part of it is the prohibition against masturbation because you lose partners. And so if you think your sexuality is only enabled by somebody else, you know, it's over for you. If you think it's over for you, if you don't have a partner.

Keeping Sexual Function Active With Age 8:43

So the numbers fall drastically among singles, let's say over 65, 70. Whereas if they're long-term relationships or for them in short-term ones, it's not like people are having, you know, wild sex all the night, but they have a continuing, much more likely to have a continuing sex life. Part of it's having a partner. Part of it's not keeping your body in shape for sex. I mean, you know, I tell people if they decided not to use their left arm and then 10 years later they said, you know, I want to throw a ball with it.

Their arm's not going to work very well. I've never touched it since then. And the same thing, it's with, you know, erections and vaginas. It's sort of like, you know, you need to keep it And it's in shape. You need to use it. You need to keep the tissues vital. You need to make sure that you know what to do in terms of whether it's taking Viagra for a man or getting good lubrications for a woman or maybe topical estrogen, whatever it takes. People, they have tennis elbows. They don't just say, okay, I'm never picking up a racket enough.

they try to fix the tennis elbow. So you have to feel like, okay, there's upkeep required from the sexual parts of my body. And if you don't do that, then it's not as available to you. Yeah, that is such an incredibly good point. I'm always telling people if you don't use it, you lose it. And I agree with the masturbation. Because I guess as a gynecologist, I talk about it like it's no big deal. I forget that some people are very, touchy about the subject because I just found out that May is International Masturbation Month and I did some posts online and I was surprised at the people that, you know, there were the people that were like, yay, thanks for talking about this.

But then there were the people like, oh, this is terrible. I can't believe you're talking about in person or I don't need to do that. I have a man. So, you know, that brings up what you're talking about with those cultural perceptions of it. So, oh, honestly, you know, I've done a lot of TV work for many reasons. But one of them would just be talking about, you know, a recent book I had done. And I could talk about almost any sexual subject if they if they let me talk at all, but never masturbation, either because it's religiously prohibited as people see it.

I mean, one little sentence in the Bible, boy, talk about a big impact. But the idea being that pleasure for pleasure sake, I mean, not talking about pleasure because you're making love or having a baby, you're manipulating your body to have an orgasm for pure pleasure and no other reason. And I think we are like scandalized at the idea of pleasure, of just having the right to do pleasure for yourself without anyone else involved. Yeah, that is a really good point because, you know, and gone the other age, the end of aging, I wanted to do some education because unfortunately, our town just the Board of Education decided to remove the sex ed from our curriculum, unfortunately.

So I was trying to talk to some of the moms about, well, like, I'll get some of the girls together and I'll talk and I'm Mentioned the word masturbation. Yeah, I was met with, there were a couple moms who were like, yeah, you only have sex to procreate. Like we don't want to teach our girls to, you know, unfortunately, you know, use masturbation as self-expression or, you know, as an alternative to sex. So yeah, I wish that conversation would become more of a norm and hopefully, you know, talking about it enough, it will.

That's depressing news you just gave me. What are you going to do? Yeah. Yeah. So what kind of advice do you end up giving to people or would you recommend like as we're aging, what, what things should we be thinking about or, you know, how do we kind of keep our sexuality going? Well, if you're single, I think your choice is masturbation or dating, which means you have to make sure that if you're a woman that lubricate that you're, you know, that you feel comfortable having you making sure you have a condom because there's no other boy telling this preaching to the choir here.

But people often think, well, I'm not going to get pregnant. No, still get a nasty STD. You know, so you don't, pregnancy is not the only thing you have to worry about, but sometimes they think that he's a lovely guy and he doesn't, you know, he couldn't possibly have an STD. So we didn't use a condom. you know, and then he's the hub of the wheel. If he has one for all these ladies he's seeing, particularly in, there was some years where they had real increases in sexually transmitted diseases in nursing homes because there was, you know, fewer men than women because of the women tend to live longer than men.

And so these men were on active duty and they caught something, they gave it to everyone. So I mean, this isn't the conventional way of thinking of older sex, but, I'm saying that you have to realize that you still have to do health behaviors as well as sexual upkeep if you want to see it that way. I think the important thing is internally to feel you are lovable. You can be beautiful. You can be sexy.

Masturbation, Pleasure, and Social Stigma 14:05

You can be wanted. You can want. You don't have to look like your 30 year old self. You can look your 80 year old self and still turn your partner on or yourself on in your imagination. If you have a partner, I think, you know, this is gonna sound very unromantic, but no, you're not as driven sexually as you would have been. I mean, the endocrine system is part of the machinery, but if you don't, as you said earlier, if you never stop, the arousal mechanisms are still there. And what I say is you sort of have to have appointment sex.

In fact, I think this is true for all marriage, pretty much. If you just say, you know, we're only doing it when I feel it, you know, beforehand with children, with work, you know, taxes, whatever's making you nuts, you can go a long time. But if you say Sunday morning or Saturday night or every Thursday, we're having sex and we'll figure it out, but that's what we're reserving it for, you will have it. And people say, oh, that's so mechanical. And I'd say, well, when you were thinking of a date as a kid, and you had to wait till Saturday night, was it worse?

No, it was better. You were so anticipating. You were excited about, you know, waiting for this date, right? So, you know, if you, plan it and then seduce each other, you know, and make it fun and make it sexy and make it intimate or whatever it is. But you have to schedule it and make it, you know, you could also like, I'm with my husband, I'll go like, you know, it's been a while. We are having sex tomorrow. You know, it's sort of like, okay. And with older people, they have to, probably the men over 70, huge number of them will probably need vibra or Cialis or some of them.

And some people don't, and then the men get all like, okay, I don't want to do it anymore because I can't have it done. But they can, there's lots of ways to do that now. Not to mention the tissue is pleasurable even if they're not fully hard. There's lots of ways to get all those nerve endings recharged. It's having the self-image that you deserve it, the self-image that you want it, and the self-image that you want of both, you know? And you are. You are. So, I mean, it's, I look at Helen Murin who is, you know, not getting plastic surgery.

She, she says, you know, she's an elegant older woman and just from the look in her eye, you know, she's about sexy broad. And that's what she portrays on the films. And yes, she's unusually attractive as a, as a star, but, but a lot of it animates from within her. And, and so that we're the person that can make ourselves sexy. just by animating desire and reacting with pleasure in an unabashed way. And you don't ever have to lose that. And it's, it's health producing. I could go, you know, you, I'm just, I'm going into, into your quiver with some of your arrows in it, but you know, you'll sleep better.

Um, you get the right hormones that are good for your skin and for your, you know, you know, oxytocin and all the androgens get going and and you're with men, you're cleaning those tubes. So you're less likely to get, you actually will have lower prostate cancer rate. I mean, there's a lot of reasons and not to mention just that sense of animation that it's a health procedure as well as a pleasure one.

Practical Advice for Older Adults 17:28

I love actually everything that you're saying and I even think I mean that whole setting time aside like you said not even just if you're older like if you're in a long-term relationship and definitely because I've been married for 20 years and you're right you get busy and it's like okay if you wait around it's gonna be tired or like right or there's something else to do and then you know take a step back to with the STDs that is actually so important with the older population you're right because i see that especially with women they're like well i don't i can't get pregnant anymore once i've hit menopause they're like oh i don't get pregnant so they kind of forget about protection about STDs and i remember it was about a year or so ago there was some jokes about that There was the retirement community down in Florida, which had one of the highest rate of STDs in the area.

And then one of my good friends, when she first went into practice as a gynecologist, she had bought a practice. And in her first week that she was there, she had a whole bunch of women that all came in with herpes and they were all 65 plus with herpes. And she was like, what is going on? Like she'd never seen that many cases of herpes in her life. And backtrack, they were all on the same bus trip. So there was definitely some fun going on on that bus trip. So, you know, that stuff is, you know, that stuff doesn't go away just because you're older.

So it's viral. And so you're going to, you know, the president keeps on giving, right? These, and that means somebody has to be aware. We, we, sex education, we often think of it. Okay. You know, they get it when they're a pre pubertal or pubertal and their, their adolescents, we tell them about the diseases and what to do, et cetera. And then we never talk to them again. They, so, you know, so you've either forgotten it or you don't know what's appropriate for your age, but we don't really do that.

So this guy who might've had herpes, maybe it was asymptomatic, maybe it wasn't, or maybe who the woman was. She didn't know why she had this little stinging thing, but she didn't look, she didn't ask. She thought it was, you know, she, she didn't have a language for it. And then everybody gets to share in a very unpleasant, I mean, some people have herpes, they barely know it and other people, it is not pretty. And it's, it's, and it. you know, they can get a temperature and you know, all those things that, that are not something you want to, you want to get, but, but easily avoidable.

If somebody is health conscious for themselves and others uses a condom or doesn't do penetrative sex, but has other kinds of, of sexual touch, oral manual, whatever, there's all kinds of ways to enjoy your body and each other. But, but you know, you need to be responsible too at any age. And I love that you touched upon that beauty kind of from the inside because I think confidence is incredibly sexy. And unfortunately, you know, we're seeing some of these examples, especially amongst our celebrities is as they're getting older, they're starting to mess with their faces and they don't look like they used to.

So, you know, I don't want to throw Madonna under the bus, but I'm a little disappointed in what she's done because I was hoping that she'd be our example of somebody that was going to age gracefully and just kind of go with the flow, but it hasn't happened. No, I mean, there's so much pressure to look, you know, flawless. I'm always wondering though, when I see some people like that, or I think it was Renee's or whatever, I assume that these people are so wealthy that they would get the very best doctors, you know?

We wouldn't be able to tell and then, you know, get these things like OMG. I mean, I'll tell you who was, I mean, it's pretty, it's unnatural, but Jane Bond, Fonda looks beautiful. She wrote about all her surgery. She's dead honest about it. She suffered quite a lot for her beauty, but I must say she looks lovely as opposed, and she looks herself. What worries me out, and I feel bad for people if they come out looking not like themselves, you know? I mean, you want a better version of you. someone else, you know, but purified it wrinkles and things like that.

And my guess is that Jane does so much body work that her, her body is as good as her face. You know, it's she's made, that's a part of who she is. It's a part of who she wants to be. Although she says she's done. She's very, you know, public about this stuff, but, but the, the, the things we will do to ourselves to to look good in our own eyes. So often it has nothing to do with how our partner sees us, but to look good for ourselves. You know, we have to do some work on that. Honestly, if somebody wants to do something surgical or wear makeup, I mean, we all, not all of us wear makeup, but most of us do to make ourselves feel that we look better.

And when I'm on television, oh my God, it's just plastered all over me.

Confidence, Appearance, and Sexual Vitality 22:48

And, you know, it does look good on that, but it's, you know, anyhow, it gets me. But so be it. You know, I'm not going to judge what we need to look good for ourselves. But we also have to know that what sexy is as sexy does. But sexy is a sexy anime. You can be very attractive and not be putting out anything of a sexual being. You can be less attractive. and be flirtatious, and I don't mean in a gross way, but in a kind of like, I get you, whether you're a woman who wants women or a woman who wants men or Lord knows there's a spectrum on all of this, that there's that thing where you see this person sexually alive and it makes them more attractive, but you have to feel that way.

You have to put it out there. And I think, I'll see very beautiful women and very handsome men who have zero sexuality emanating out of them because they haven't cultivated. Excuse me, I've got dogs by the barking. So, I mean, Europeans are much better on this stuff. They've had, I mean, I remember art films from many years ago. There would be women who were past 50 and who were the romantic you know, part of the love story. And we've done a little bit of this with some of the comedies actually, you know, where a few older actresses have been to love interest, but not anything like how many aging male stars are there.

You know, I'm somewhat encouraged. I've been trying to do this with my own show, it's no avail. They just say, We know how you feel pepper, but to get older people in, you know, these reality shows and the, the bachelor for the first time, something called the golden bathroom 71, very handsome man. And I was wondering like, okay, who are they going to pair them with? And sure enough, the women that they've been putting on the commercials are in the sixties and seventies too. And they might, I don't think they go low.

Maybe they go as low as five. high fifties, but they're grown up women for him and some of them the old age. And they look great, you know, and they're lively. They picked well, I think, at least from the trailers that I've seen. I would like to see more of that. I think that encourages us. I think that, you know, you can look at there and say, well, I'm as sexy as that woman or I look as good as her. She's on TV. You know, I mean, I want to sell that inner self part because That's what's really going to let women and men extend their sexual being way longer.

You know, it's funny. You made me think about I started taking pole dancing classes to get fit. So we have fitness pole dancing here in New Jersey. And actually, there's actually there's a couple of places in Washington state. When I was out there, I checked them out. But I remember the first time I walked in, I was so nervous because I'm in my 50s and I'm thinking to myself, I'm going to walk in. It's going to be all these 20-something year olds. And I was so excited to walk in and find out that I wasn't the oldest one in the class.

In fact, there was a woman who's in her 70s who just kind of runs circles around the rest of us and just exudes this confidence that just is absolutely amazing. And then there's a couple in their 60s, and then there's another couple in their 50s. And we do have the 20-something year olds, but we have the whole range. So it's been really nice to see that. You have to be strong to do that, don't you? It's a lot harder than I thought. I don't like the idea of exercise. I was like, I got to do something that's going to be fun and a little bit challenging and different that will get me to exercise.

And I actually have found that it actually motivates me to do other exercise because I need to get the strength to do all the things and I'm still not anywhere close. But it's a fun way to exercise. I'm just thinking all that upper body strength you need to do those things. I think that's very cool. So is there anything that I didn't ask you about aging and sexuality that you really wanted us to know about? What I would want to say is if you have some problems, there are people who, like yourself, who specialize in sexual medicine.

Treating Sexual Problems and Finding Resources 27:28

Unfortunately, not a lot of them. because, but, but they're there. And if, you know, women who have pain during intercourse, there are things that they can do about that. They can fluff up those tissues a lot with hormones or with topicals or, you know, just much better lubricants. That doesn't mean the end of the journey there. They should know that the clitoris is a very generous organ and it doesn't degrade much and it's easily re-encouraged. So there's You know, there's no reason to feel like that has become an inoperable part of your body, far from it.

For men, there's a huge number of things they can do about erections. They can, they can do implants. They can do the Viagra types of, of pills. They can do suction. I mean, there are things that if they really want to make sure they could have an erection, they can do a lot, not everything because there are some you know, prostate cancer operations that really, but even then the tissue is, is, is sensitive and pleasurable. Even if there's not an erection in this, they have to feel like they're, they can get, they can still get orgasms that they have to feel like, okay, I just do it a new way.

I mean, that's tough for people, but you need you, there's a lot you can do in terms of, of your, you know, getting your, your, your body back in shape. I knew I had a friend who, turned out she and her husband hadn't had sex for 10 years. And she was 70 when he left her. And she went and realized she just couldn't get anything in the vagina. The vagina just clenched together. So she went through a series of expanders and eventually was able to, actually she met this man who'd been in love with her for years.

And when he heard she was, Free, he was right on it and they had a beautiful love story. But she had to go out and find a way to be sexual again. And the point is you can't. It's not over. Even if you've neglected all of this caretaking, you can restart your body in many ways that you might not think you could, but you can. That is amazing. I love that. That's a great story too. Well, thank you so much for taking the time to talk with us. Where can people find out more information about you? Well, they can go to drpepperschwarz.com or pepperschwarz.com.

You can go to meridithfirstsite.com. I'm up there and they can see my work that way. I just finished a book this February with Jessica Griffin called Relationship RX, which is a lot of suggestions about how to deal with various level of couple problems. So I'm around if they want to find me. I'm not too hard. Awesome. Wonderful. I'm going to go check out some of your books too. So thank you once again for taking the time to speak with us. I really appreciate it. I want to just remind everybody to stick around because we have more amazing sessions coming right up.

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