Embracing Sexuality In Aging: Shatter The Myths

Pepper Schwartz, PhD

Oh, please call me Pepper.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Thank you so much, Pepper for being with us today. So how did you end up in the field of sexual health?

Pepper Schwartz, PhD

Well, there’s a long story and a short story. The shorter story, I’ll refer to the 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 Phil, and Lorna Sarell 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 to 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 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 research for me was, well, how to improve it. 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 children, or first job 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, tell me I could go visit 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 be so upset, you’re not going to hell, you’re going to the linen closet. We did that. It’s a true story. And 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 a little discussion group in our basement. So in some ways, you could see it was destined.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I absolutely loved 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 like 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 male puts the what? Where? I’m like, Oh no. I remember in sixth grade, I was like, I don’t want to know about this. Right now fast forward look what I’m talking about.

Pepper Schwartz, PhD

Yes. So.

Betsy Greenleaf, DO, FACOOG (Distinguished)

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?3

Pepper Schwartz, PhD

In general, yes. I mean, 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. 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 or issues about body image or issues about all of the visions we have of sexuality of young fit people, etc. So I don’t think we’ve had the yardage in talking about sex and aging that we have on other sexual topics now.

Betsy Greenleaf, DO, FACOOG (Distinguished)

And I think, you know, and we’re living longer and longer. I mean, we’re living now into our eighties and nineties. 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, if any of my family are listening to this, they’re probably going to cringe. But when my husband’s grandmother died in her nineties, we were going through her stuff. And I’m happy that I, as the doctor found like 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 Gram, good for you. Because she was in her nineties when she died. But I think, you know, I think if the other family members had found that they would have been a little bit uncomfortable with it. So.

Pepper Schwartz, PhD

Well, I feel that if we gave people more permission to continue having their sexuality as a prized part of their family, their pleasure, but their life force, we wouldn’t be so surprised or we wouldn’t, or we trying to help our older people if they’re in a rest home or assisted living or whatever? We’ll be trying to help them have privacy 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 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 to a lot of people at different tables. A friend of mine leaned over to her and she’s, this friend of mine was there with her boyfriend, who was in the eighties too. And my friend said, do you still have sex to her? And the woman turned over and said, of course. Now, I don’t know if she was or she wasn’t. But, you know, when do we feel entitled to ask any person you just met at a dinner party, you know, if they’re still having sex, if they’re 50 or 60. What’s the older they get, the less we, 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 the idea that they’re still being sexual.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I know even from my standpoint when I talk to patients, sometimes a 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.

Pepper Schwartz, PhD

And so part of the problem is, you know, they’ve picked up the cultural message 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 may be that it was never done the right way in the first place. And the prohibition particularly against masturbation that only works against you.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Yeah. I was going to say, what do you find to be the biggest issues when it comes to sexuality and aging?

Pepper Schwartz, PhD

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. So the numbers fall drastically among singles, let say over 65, 70. Whereas if they’re long term relationships or if they are having short-term ones. It’s not like people are having, you know, wild sex overnight but they have to continue, much more likely they have a continuum sex life. So 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 ten years later they said, you know, I want to throw a ball with it., Their arms not going to work very well. They have never touched it since that. And the same thing. It’s with, you know, erections and vaginas. It’s sort of like, you know, you need to keep it 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 man or getting good lubrication for a woman or maybe topical estrogen, whatever it takes. I mean, if I had, you know, people, they have tennis elbow, they don’t just say, okay, I’m never picking up a racket and they try to fix a 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.

Betsy Greenleaf, DO, FACOOG (Distinguished)

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 to 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, yehey, 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. what those cultural perceptions of it.

Pepper Schwartz, PhD

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 ever 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’s sake. I mean, that’s 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.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Yeah, that is a really good point. Because, you know, and going on the other age, 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 mentioned the word masturbation. Yeah, I was met with there were a couple of 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.

Pepper Schwartz, PhD

That’s depressing news you just give me. What are you going to do?

Betsy Greenleaf, DO, FACOOG (Distinguished)

Yeah. Yeah. So what kind of advice do you end up giving to people or would you recommend like as we’re aging what things should we be thinking about or how do we kind of keep our sexuality going?

Pepper Schwartz, PhD

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 you lubricates, that you’re you know, that you feel comfortable, haven’t you, making sure you have a condom because there’s no other way of telling this preaching that require here. But people often think, well, I’m not going to get pregnant. No,  you’ll 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, they think 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 gonna pop his wheel I know if he has one for all these ladies he’s seeing particularly. And there were some years where they had real increases in sexually transmitted diseases in nursing homes, because there were, you know, fewer men than women because 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, you can be wanted, you could want.

You don’t have to look like your 30-year-old self, you can look like your 80-year-old self and still turn your partner or yourself on in your imagination. If you have a partner, I think, you know, it’s this is going to sound very unromantic, but know 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, you know, 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 marriages, pretty much. If you just say, you know, we’re only doing it when I feel it, you know, beforehand, with children, with work, with, you know, taxes, with 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, 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. I 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’s better, you were so anticipating or excited about, you know, waiting for this date. Right? So, you know, if you play in 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, oh, it’s my husband. I’ll go like, you know, it’s been a while, we are having sex tomorrow. Yeah, it’s sort of like, okay. And with older people, if they have to probably the men over 70, a huge number of them will probably need vibrators 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 a hard-on. 

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 are 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 to have both, you know. And you are, you are. So I mean, it’s, I look at Helen Mirren who is, you know, not getting plastic surgery. She’s an elegant older woman and just from the look in her eye, you know, she’s one sexy bride. And that’s what she portrays in the films. And yes, she’s unusually attractive as a star. But a lot of it animates from within her. 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 even have to lose that. And it’s health producing. I could go, you know, you just go into your quiver with some of your arrows in it, but, you know, you’ll sleep better. You get the right hormones that are good for your skin and for your, you know, oxytocin and all the androgens get going. And with men, you’re cleaning those tubes so you’re less likely to get, you know, you actually will have lower prostate cancer rate. I mean, there’s a lot of reasons. Not to mention just that sense of animation that it’s a health procedure as well as a pleasure one.

Betsy Greenleaf, DO, FACOOG (Distinguished)

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

Pepper Schwartz, PhD

It’s viral and so you know the person keeps on giving right of these. And that means somebody has to be aware. Sex education we often think of it, okay, you know they get it when they’re pre-pubertal or pubertal and they’re adolescents. we tell them about the diseases, what to do, etc. And then we never talk to them again. So you either have 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 have had herpes, maybe was asymptomatic or 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 didn’t have a language for it. And then everybody gets to share in a very unpleasant, I mean, some people have herpes, and they barely know it, in other people, it is not pretty. And, you know, they get a temperature and, you know, all those things that are not something you want to get. But easily avoidable if somebody is health conscious for themself and others, uses a condom, or doesn’t do penetrative sex but has other kinds of sexual touch. Oral, manual, or whatever, there are all kinds of ways to enjoy your body and each other. But,, you know, you need to be responsible too at any age.

Betsy Greenleaf, DO, FACOOG (Distinguished)

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 among our celebrities as they are 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 you’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.

Pepper Schwartz, PhD

No. I mean, there’s so much pressure to look flawless. I’m always wondering, though, when I see some people like that or think I was raised or whatever, I assume that these people are so wealthy that they would get the very best doctors, you know, so you 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 Fonda looks beautiful. She wrote about all the surgeries, 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. But 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 yourself, you don’t want someone else, you know? But you’re fighting wrinkles and things like that. My guess is that Jane does so much bodywork that her body isn’t as good as her face. You know, she’s made that’s a part of who she is, it’s part of who she wants to be.

She says she’s done. She’s very public about this stuff. But the things we will do to ourselves, to look good in our own eyes. So often it has nothing to do with how our partners 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 better. We look better and when I’m on television. Oh, my God. It’s just plastered all over me. And, you know, it does look good on that but anyhow it fits 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’s sexy is, is a sexy does what? Sexy is a sexy. And I mean, 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, you know, I kind of like I get you whether you’re a woman who wants women or women wants men or lord knows there’s a spectrum on all of this. That’s 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, you know, I’ll see very beautiful women and very handsome men who have zero sexuality and the emanating out of them. Excuse me. I’ve got dogs. Yeah. By the barking. So I mean the Europeans are much better on this stuff. They’ve had I mean if you remember art films from many years ago. There would be women who were past 50 and who were the romantic 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 the love interest but not anything like how many aging male stars are. You know. I’m somewhat encouraged. I’ve been trying to do this with my own chat show to no avail they just say, we know how you feel Pepper. But to get older people in these reality shows and The Bachelor for the first time. Something called the Golden Bachelor. He’s 71, a very handsome man. And I was wondering like, okay, who are they going to pair 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 up as low as five eighty, or 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 fit 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, I want to sell that inner self part. And that’s what’s really going to let women and men extend their sexual being away longer.

Betsy Greenleaf, DO, FACOOG (Distinguished)

You know, it’s funny I was, you made me think about it, I started taking pole dancing classes to get fit. So we have fitness pole dancing here in New Jersey. Actually, there are a couple of places in Washington State. When I was out there I’d check them out. But I remember the first time I walked in I was so nervous because I’m in my fifties. And I’m thinking to myself, Oh, 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 was in her seventies who just kind of ran circles around the rest of us and just exuded this confidence, that just is absolutely amazing. You know, and then there’s a couple in their sixties, and then there’s another couple in the fifties. And we do have the 20-something-year-old but we have the whole range, so it’s been really nice to see that.

Pepper Schwartz, PhD

That is cool. Strong as you do that.

Betsy Greenleaf, DO, FACOOG (Distinguished)

It’s a lot harder than I thought. I don’t like the idea of exercise. I was like, I’m going 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’s been, it actually motivates me to do other exercises because I need to get the strength and do all the things and I’m still not anywhere close. But, you know, it’s a is a fun way to exercise.

Pepper Schwartz, PhD

I’m just thinking down that upper body strength you need to do that, those things. I think that’s very cool.

Betsy Greenleaf, DO, FACOOG (Distinguished)

So is there anything that I didn’t ask you about aging and sexuality that you really wanted us to know about?

Pepper Schwartz, PhD

What I do want to say is if you have some problems, there are people who like yourself who specialize in sexual medicine. Unfortunately, not a lot of them, but they’re there. And if women 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 pills. They can do suction. I mean, there are things that if they really want to make sure they can have an erection, they can do a lot. Not everything, because there is some, you know, prostate cancer operations that they really. But even then, the tissue 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, but they have to feel like, okay, I just do it in new way. I mean, it’s tough for people. There’s a lot you can do in terms of your, you know, getting your body back in shape.

I knew I had a friend who turned out she and her husband hadn’t had sex for ten 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. They had a beautiful love story. So 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.

Betsy Greenleaf, DO, FACOOG (Distinguished)

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?

Pepper Schwartz, PhD

Well, they can go to DrPepperSchwartz.com or PepperSchwartz.com. You can go to married at first sight check on them. 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 has a lot of suggestions about how to deal with various levels of couple problems. So I’m around if you want to find me, I’m not too hard. eal with various level of couple problems. So I’m around if you want to find me, I’m not too hard. 

Betsy Greenleaf, DO, FACOOG (Distinguished)

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 appreciate it. So 

Pepper Schwartz, PhD

I have a lot of fun.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I want to just remind everybody to stick around because we have more amazing sessions coming right up.