Over 60 and still active
Forty years ago, Dr. Irv Binik embarked on his career as a sex therapist. With degree in hand, he went forth and started to see couples who were having issues ranging from erectile dysfunction to lack of desire. Couple after couple he further carved his niche. He was proud of the skill-set he was developing and of the help he was able to give his fellow man and woman.
“Keeping up” as men age
Regular exercise increases testosterone, so stay fit but avoid over training as this can lead to being physically tired, which can impact a man’s ability to get an erection
Eat well and maintain a healthy weight
If you have diabetes, keep your sugar levels and your weight well controlled
As men age, physical stimulation (touching) works better at achieving an erection than visual, smell and mental stimulation
Drugs such as Viagra, Cialis, Levitra, penile injections and gels are available by prescription, and implant surgery is also available if no medical treatment works
“Then it happened,” says Dr. Binik, a psychologist and director of the Sex and Couple Therapy Service of the McGill University Health Centre (MUHC). “About 15 years ago, I looked in my file at who I was going to counsel next and I saw the ages: 81 and 83. I had never counselled a couple that old before.”
Thinking to himself, “This is way beyond my experience,” he decided to proceed as he would with any of the other couple he worked with who were typically in their mid-twenties to forties. He opened the conversation with, “Tell me why you are here?” Their answer floored him. “We don’t have sex as much as we used to.”
“When I look back now I can say that it reflected the change that society was going through, which is that people over 60 can and do have sex. The expectation that sex was just for the young was being challenged,” says Dr. Binik, who links the change and openness to media images of older people getting “romantic” and, of course, the introduction of Viagra.
“This couple was healthy and in good shape, and they were simply concerned about their frequency. I ended up counselling them in exactly the same way I would any other couple, just as I have done to this day.”
Dr Binik
According to Dr. Binik, the major differences between younger and older people can be related to health, expectations and life situation. As a sex therapist, Dr. Binik looks at the psychological side of sexual relations. For the physical issues, he works with medical specialists.
On the physical side, older women can experience pain during sex as a result of decreased lubrication following menopause, or reduced sensation possibly due to neurological problems. For men, erectile dysfunction is the top culprit, which is often due to co-morbidities such as diabetes, heart disease, prostate problems, obesity, and the gradual decline in testosterone and rigidity of the penis.
Dr Carrier“Erectile dysfunction is often a reflection of the overall health of a patient. If you have a healthy man, in theory his erection could work into his 80s and even beyond without difficulty,” says Dr. Serge Carrier, an MUHC urologist. “But most men will encounter a roadblock as they age.” (See sidebar “Keeping up.”)
When Dr. Binik counsels his patients, he investigates the person as a whole. He often examines the question of frequency and studies why it may be important for the couple. He explains that there is no right number. “Satisfaction is subjective,” says Dr. Binik. “And sex is more than about getting an erection. I remind them that pleasure comes in all forms. Even though penetration may not be as frequent as when they were 35, satisfaction can be present nonetheless.”
Today, it is not that uncommon for Dr. Binik to see couples over 75. “If sexual satisfaction is important to a relationship,” he says, “they should know there is help out there. Just because you are aging does not mean your sex life needs to end.”