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Amie Harwick

Amie Harwick is a Marriage and Family Therapist Registerd Intern working under the supervision of Moushumi Ghose, LMFT #MFC44134. She has her Bachelors of Arts in Psychology from California Polytechnic University in Pomona, California. She has her Masters of Arts in Clinical Psychology with an emphasis on Marriage and Family Therapy from Pepperdine University. She is a registered intern with the Behavioral Board of Science in California. Amie has worked with a variety of populations of clients in a variety of settings ranging from a private practice to community based mental health facilities. She has worked with a range of clients including, but not limited to, anxiety, depression, sexually exploited teenagers, juvenile sex offenders, children with trauma, court mandated adults, divorce, sexual identity issues, chronic pain, sex addiction, Bipolar disorder, displaced adolescents, and domestic violence. In Novemeber 2014, Amie will release her first book published by Quiver publishing called The New Sex Bible for Women.

8 Myths About Sex & Aging

With the baby boomer generation reaching retirement, the United States is seeing more active adults than ever,   so understanding how aging impacts sexually and intimacy is crucial – and it’s not all negative! There are benefits and positive aspects of being sexually active while getting older too. Here are eight common myths about sexuality and aging, and the facts that prove them wrong.

Myth #1: Older people do not have sex

In an article by Loren Stein, M.A. called “Sex and Seniors” in 2015 it was stated that “among 45- to 59-year-olds with sexual partners, some 56 percent said they had sexual intercourse once a week or more. Among 60- to 70-year-olds with partners, 46 percent of men and 38 percent of women have sex at least once a week, as did 34 percent of those 70 or older. “ Therefore, the sexual drive doesn’t shut off, it just slows down a little with age. The idea that adults reach a certain age and just shut down sexually is completely false. Older age does lead to a reduced frequency of sexual behaviors but does not mean that there is a cessation of sexuality or sensual desire.

According to the research published by the National Survey of Sexual Health and Behavior in 2010, about half of adults ages 50-80 have engaged in sexual intercourse within the year that they were surveyed. Women over 50 years old engage in 5% less intercourse per year as they age and 7% less giving or receiving oral sex per year.   Men over 50 years old have a yearly decrease in both intercourse and oral sex by 8%. In a study done by Karraker, A., DeLamater, J., & Schwartz, C. R. (2011), they found that the reason for the decline in sexual behavior was not aging, but other life factors that happened with getting older.   Women showed a decreased frequency of sexual behavior when widowed, for example, and men showed a decrease of sexual behavior with the increase of health issues.

Myth #2: Aging adults cannot get pregnant

The general opinion from the medical community is that once a woman is post menopausal, she is unable to get pregnant, but the times and duration of menopause vary for many women, causing the post menopausal age to range. Due to advancements in fertility treatments, women can take medications that allow pregnancy to occur much later in life. The oldest women to give birth was 70 year old named Rajo Devi Lohan in India. Several women in their 60’s have given birth in the early 2000’s with the help of In Vitro Fertilization. While pregnancy is more difficult for an older women, it is not impossible. Women have lost about 90% of their eggs by the age of 40, leaving a very slim possibility for pregnancy, but while the eggs have an expiration date, the uterus does not. According to an interview with Dr. David Adamson with Medical Daily, “The bottom line is that the uterus can function just about until the death of the woman”. While the oldest mother to conceive naturally was 59, INF, or In Vitro Fertilization, is an option at all times. There are ethical concerns about becoming a mother at an older age such as maternal mortality rate, illness during aging, and overall ability to care for a child. The United States will not allow a child to be adopted to a women over 50 for those ethical reasons.

Myth #3: STI rates must be low in older adults

According to the Benjamin Rose Institute on Aging, the rate of Sexually Transmitted Infections in the over 50 population in the United States is growing at a faster pace then the population of people under 40.   There are many reasons for this rise in contracting STIs among this generation. First, the baby boomer generation is aging, creating a large population of people over 60. Second, new trends in medical advancements with performance enhancing drugs are causing an even higher rate of sexual intercourse with people as they age. Third, there is rising number of mid-life divorces. These newly single middle aged and older adults are now looking for dates online through websites, and even mobile apps. This quick method of connecting has caused more availability to date, more access to partners, and ultimately more sexual behavior. Lastly, these individuals may have less sex education than younger adults.   If they were in a marriage for the first part of their lives, they did not have partners other than their spouse at the start of the HIV/AIDS crisis. The use of barrier protection and other methods of contraception were far less widely used years ago. Therefore, if these newly divorced individuals are behaving in the same sexual way that they did when they were younger, they will be at a higher risk of contracting a sexually transmitted infection. Because older women have less concern about getting pregnant, they may not prioritize barrier methods to protect against infections.

Myth #4: Older women do not desire sex

Many people feel that as women age, specifically in a marriage, that they lose all sexual desire. This is not the case.   As mentioned, women, as well as men, have a slight decrease in the amount of sexual behavior as they age yearly after 50.   Women still have the ability to feel sexual and intimate desire throughout their entire life. As women reach menopause, their naturally produced estrogen decreases, causing less natural lubrication during intercourse. This is a common issue and many physicians prescribe estrogen creams to insert vaginally, or simply recommend an over the counter personal lubricant. While desire may decrease, desire also ebbs and flows. Many reasons that women report feeling less sexual with age has to do with cultural pressures, emotional issues within a relationship, self esteem, and medical problems.   The North American Menopausal Society states that desire is a combination of drive, beliefs, and motivation. While drive is biological and may be impacted by hormone change over time, beliefs and motivation are psychological and able to change based on perception. Women have a lot more control over their sexual desire while aging then previously though.

Myth #5: Older men have constant Erectile Dysfunction

Just as it may be a common assumption that women lose all sexual desire as they age, many believe that it is a natural occurrence for men to have erectile dysfunction as they age.   While more men experience erectile dysfunction at older ages as opposed to younger ages, it is not a natural part of aging. Only 5% of men under 40 experience erectile dysfunction, but 44% of men in their 60’s have experienced it.   According to research done at Harvard Medical School, the reason for this is that erectile dysfunction reflects the impact of the chronic diseases that are common with age.   The most important are atherosclerosis and hypertension, which affect blood vessels, and diabetes, which strikes both blood vessels and nerves. Medications that older men take can interfere with sexual function, including some that treat high blood pressure, heart disease, anxiety and depression. In addition to medical causes, about 30% of erectile dysfunction stems from a psychological cause. Aside from ED, there are other changes that do naturally occur with men’s erections as they age.   Their erections may not be as firm, and foreplay may need to be extended to allow longer time for a satisfying erection.

Myth #6: People over 50 don’t have casual sex

The divorce rate for people in the middle and later stages of their lives has increased with the aging of the baby boomer generation.   This new population of single adults in their 50’s through their 70’s has created a more sexual group of aging adults. 23% of men over fifty that are having sex report that their most recent sex partner was with a “friend or acquaintance”. Women over 50 report casual sex about 13% of the time.   There is also a growing number of adults over 50 that enjoy a relationship with a “friends with benefits” dynamic. Especially for much older adults, getting married, or remarried, may not be the goal. They report wanting to enjoy the intimacy and companionship, but without the need to create a family or other aspects that are typically the goals of younger adults. One reason why many people think that older adults do not age engage in casual sex is that it is a topic that people do not talk about. Terms such as “dirty old man” and “cougar” stigmatize and degrade the sexuality of sexual older adults.   Increased cultural dialogue about aging and sexuality will increase awareness and reduce stigma.

Myth #7: Urinary Incontinence causes older adults to have accidents during sex

Some older adults experience urinary incontinence which impacts sexuality.   This can cause feelings of shame or discomfort and get in the way of the possibilities of great sexual experiences. Women that struggle with incontinence experience coital incontinence 10% to 27% of the time. There are several reasons why urine may leak during a sexual encounter. Pressure on the abdomen can cause leakage of urine during sex. Other reasons include overactive bladder, weakened pelvic floor muscles, and complications of prostate issues, including prostate cancer. While women have reported loss of urine throughout the duration of the sexual encounter, older men have reported loss of urine during foreplay. A study by Guay, A., and Seftel, A. (2008) showed that 38% percent of older men that had no daytime incontinence had experienced a loss of urine during foreplay.   While this is an issue that can have an effect on aging adults, there are solutions to not let it hinder enjoyable sex.   One can prepare for sex by avoiding large amounts of fluids before being sexual and putting down a towel for a precaution.   Talking about it reduces feelings of shame and secrecy. An older couple can experiment with different positions that are less likely to put pressure on the bladder, such as rear entry and side by side positions. Women and men can be proactive about their pelvic floor muscles by practicing kegel exercises. If a man or a women uses catheters for incontinence, there are several options available to incorporate this during sex.   A catheter can be bent and taped to create room for intercourse.   Some couples find that eroticising the catheter use reduces shame and increases pleasure.

Myth #8: Sex is dangerous for older adults

Aging by itself does not cause a danger. The potential risks for older adults are when they have fallen out of shape or have developed a medical condition or disability, but this also does not make sex dangerous or impossible. Older adults that struggle with high-risk conditions should exercise precaution, just as they would with any other physical activity that they want to engage in. Because older women tend to suffer with lower bone density post menopause, it may not be advisable to engage in acrobatic sex.   Men with high blood pressure or heart conditions should exercise caution when having long duration or highly aerobic sex.   Older adults who have a disability can modify their practices and setting to support a healthy sex life such as having bed modifications or using sex aides and toys.   But the bottom line is that sex for older adults can be enjoyable and satisfying.



Is Hep C A Sexually Transmitted Disease?

While most people know by now that Hepatitis C is not efficiently transmitted through sex, there are still many sexual, romantic, and interpersonal complications that one may experience after a Hepatitis C diagnosis.  The real risk is that the infected person has a more compromised immune system and may be more susceptible to infection and symptoms of other STIs he or she may contract.  The most significant sexual problem is the psychological impact of the infected person with wanting and getting love, intimacy, and sex.
Hep C is a contagious liver disease that is primarily spread by contact with infected blood. It can last a lifetime, or shorten a lifetime, causing liver complications such as cirrhosis and liver cancer. Over 3.2 million Americans currently have Hepatitis C, and one of the biggest predictors for successful coping with the disease is a strong support system of physicians, friends, family members and partners.

Hepatitis C has a stigma in our society based on misconceptions that we need to correct. Let’s set the record straight by tackling some common false beliefs about Hep C and the real facts behind them:

    1.    “It comes from unhygienic or dirty conditions.”

Hep C does not come from unhygienic conditions. It comes from blood that is infected. A surface that looks clean, but has been exposed to infected blood, can contain the virus from 16 hours to 4 days. Conditions that look dirty, dusty, or unclean in other ways do not present a risk unless infected blood has been exposed.

    2.    “It is a sexually transmitted illness.”

In the past, Hep C was listed with everything from HIV to Gonorrhea as an STI, or sexually transmitted illness. As of today, the CDC states that Hep C is not efficiently spread through sex. A recent study has shown that monogamous couples with one infected person showed zero transmission over the course of the study. Certain behaviors such as anal sex and rougher sex increase the likelihood of risk.

    3.    “It is a death sentence.”

In 2014, a new cocktail of medications was approved by the FDA making the most common and hardest to treat genotype 97% curable in three months, as opposed to the past treatments that were curable 70% and took 6-12 months of a treatment course. Hep C is now a curable illness.

A person living with Hep C may experience feelings and thoughts that will have an impact on their ability to create and maintain close interpersonal relationships. They may identify as being a sick person, causing them to isolate themselves and even feel more ill. They may feel shame due to stigma or previous lifestyle choices
Hep C may have a great impact on one’s sexuality. Some common struggles that one may have include:

  • Fear of transmission to uninfected partner
  • Fear of being judged for illness during sexual encounter
  • Physically a person may be more tired
  • Like having sex on the flu, with a hangover

If on treatment, men have less erections and ejaculations.  Women may experience vaginal dryness, which can lead an overall decline in sexual desires. Depression is also a side effect of the treatment, which can lead to a lower sex drive. Many people on treatment take an antidepressant to help with this side effect.  Unfortunately, a side effect of many antidepressants is a lowered sex drive.  They may feel shame about their body and the changes from liver disease or treatment such as hair loss, weight loss, and more.
There is an impact on close personal relationships and intimacy that can result from shame and depression. Infected persons may withdraw from friends and family. Comparing genders, a study by the Center for Women’s Studies in 2011 stated that “The task of managing both health and relationships was undertaken by women much more commonly than by men. Finding love and becoming a desirable partner, sometimes engaged people in new ways with their health.”
Helping a partner with the illness is not an easy task, but one that is needed for the emotional and psychological wellbeing of one’s partner. The three components that will increase emotional resilience and ultimately have a positive impact on a relationship with an infected person are:

   1.    Education

Encourage your partner and family to read about the illness. Accompany your partner to the doctor and ask proactive questions. Try to have an understanding of the illness.

    2.    A Healthy Lifestyle

Encourage your partner to eat healthy, exercise, and avoid alcohol. A healthy lifestyle will help to lessen symptoms and make the infected person more comfortable.

    3.    Support Systems

Support from the person’s partner, family, friends, and doctor are all important. Be perceptive to possible symptoms of depression, hopelessness, or even suicidality. Help them connect to a mental health professional if needed.
While the prognosis for Hepatitis C has improved, it is still prevalent and has an impact on not just the 3.2 million infected persons, but their partners and families. Healthy and proactive behaviors from the infected person and their support systems will help the prognosis, increase intimacy, and feelings of connectedness.