Where Have My Orgasms Gone
Sex Medicine and Older Women AND young Ones Too!!
'Where Have My Orgasms Gone?' Sex Medicine and Older Wome AND young Ones Too!!
Pebble M. Kranz, MD
February 22, 2024
"She's, like, 90 years old. I'm not going to ask her about sex!" says the cringing resident. "She's older than my grandmother!"
Pebble M. Kranz, MD
Well, my young friend, our 80- and 90-year-old patients were in their 20s and 30s in the 1960s. You can bet some of them were pretty groovy! A Swedish study of septuagenarians revealed a shift in sexual attitudes: from 5% of 70-year-old women in the 1970s citing sex as a positive aspect of life, to 78% in 2000. Those of us in practice who came of age during the AIDS era and alongside the purity movement of the 1990s can be more sexually reserved than our grandparents. We might need to catch up. In fact, in another study, 82% of 97-year-old female participants felt that being asked about their sexuality in healthcare settings was positive.
While changes do occur in sexual physiology and behavior with age, satisfying sexual engagement may be an important factor in the general well-being and overall health of older women. Given the high prevalence of dementia among this population, it may be useful to know that positive sexual expression may delay cognitive decline. We also have evidence that sexual satisfaction is important for relational health, which in turn helps predict physical health.
Shed the Dysfunction Mindset
Our medical bias has been that a fulfilling sexual life requires a hard penis and a lubricated vagina. This view of the range of healthy and satisfying sexual expression is lamentably limited. Older adults may have more problems with physiologic arousal in the form of more erectile dysfunction and decreased vaginal lubrication, but these issues may lead to partnerships in which there is less insertive/receiving sexual play and more oral sex, cuddling, kissing, and other forms of partnered sexual play. Older adults may focus less on performance and more on intimacy. In fact, as heterosexual couples encounter these physiologic changes, their sexual behavior may begin to focus more attention to female pleasure. Good news for older women!
As described by Dutch sexuality and aging expert Woet Gianotten, MD, older adults have a lot going for them in their sex lives. Many are retired with more time available, less work stress, greater comfort and familiarity with their partners, and less insecurity about their bodies.
Common Concerns
Many older adults are having satisfying sexual play and are less bothered by changes in their sexual physiology. Still, for those who aren't happy with their sex lives, clinicians must be ready to address these concerns.
Nancy, an 87-year-old patient whose husband died 5 years ago after 59 years of marriage, has just met someone new. When they are intimate physically, she's not feeling aroused in the way she recalls, and wonders, Where have my orgasms gone?
A host of physical changes among older women can affect the sexual experience, including the vulvovaginal changes of genitourinary syndrome of menopause (GSM), incontinence, uterine prolapse, diminished sensation, and reduced overall mobility. Although aging is responsible for some of these changes, chronic diseases and medical treatments can play an even larger role.
GSM is a major contributor to sexual pain, genital irritation, and reduced arousal and orgasm. It's crazy that we don't ask about and treat GSM. Beyond the sexual impact, the vaginal dryness of GSM can contribute to urinary tract infections, which can lead to sepsis and even death! Vaginal estrogens and other GSM treatments are safe and effective in the vast majority of women. Vaginal moisturizers, vaginal dilators, and increasing genital blood flow also help improve GSM.
Vaginal dilators are used in the management of vaginal stenosis, when the vaginal skin has contracted as a result of GSM or pelvic radiation to treat cancer. Dilators are also used to treat some forms of high-tone pelvic floor dysfunction. For expert guidance and coaching on the use of dilators, seek out sexual medicine specialists and pelvic floor physical therapists. Pelvic floor physical therapy is important in the management of a wide range of sexual concerns, from reduced arousal and orgasm to almost any kind of sexual pain.
For postmenopausal women who are distressed by hypoactive sexual desire disorder, transdermal low-dose testosterone may be considered when other causes of low libido have been ruled out.
Due to changes in nerve fiber sensitivity over time, older age is an ideal phase of life to incorporate higher-intensity vibration and other sexual devices into solo and partner sex. Mobility limitations and joint pain can be addressed with devices designed specifically for this purpose or with the use of pillows and other supports.
As Betty Dodson, a staunch advocate for women's pleasure until her death in 2020 at 91, wisely said, "Masturbation will get you through childhood, puberty, romance, marriage, and divorce, and it will see you through old age." We can encourage women to see sexual play and pleasure flexibly, as a lifelong process of self-knowledge and discovery.
Basic Tips for Patients
More "fiction and friction," as coined by sex therapist Barry McCarthy, is necessary. As bodies age, more stimulation, both mental and physical, is necessary and often requires more direct physical stimulation of genitals.
More time: Everything seems to take more time as we age; sex is no different.
Incontinence concerns can be addressed by open communication and collaboration with partners, and being prepared with waterproof pads for the bed and towels.
Ask about medical intervention–related sexual side effects. A wide range of medications can decrease desire and arousal and delay orgasm. If a change in sexual function occurred with starting a medication, it may be worthwhile investigating alternatives or, if possible, discontinuing a medication. Surgical and procedural changes to the anatomy also can affect sexual function. While correction may be impossible once certain changes have occurred, clinicians can provide patients with both validation about the problem and hope that, for the most part, with creativity and flexibility, pleasurable sexual experience is possible in all bodies.
Medscape
This is an interesting topic and one I've been kicking around writing about for some time. Irrespective of my sex, personal or otherwise, I have been playing with my live in female "companion" who really does not have a body I find sexy, or a face, or head, to boot, but she does have big tits and although, up to meeting me, she has never orgasmed once, with either of her previous 2 husbands, both now deceased, I changed that.
Women have sensitive tits, they are like men's balls, which can be very sensitive too, but in a different way.
If you are in a relationship, irrespective of sex, play around with her nipples and see how she responds to gently pinching them. Over time, she might very well get minor orgasms, from the pain aspect of the pinching exercise and then switch tits to maintain and progress in the orgasms cycle and when you think she is ready move your spare hand down to her vagina, from above and gently insert a spare finger in there, aiming for her "wee hole' which is like a miniature penis, with just the same feelings that men have, when aroused.
Use a good dob of Vaseline or Petroleum Jelly on your finger and move your finger down to just above her cunt hole, then gently move up, using a circular motion to find sensitive places between her cunt lips and when you find one, slowly, gently, rub that area and watch her orgasm. Tell her to be loud, because you want to be part of what she is experiencing and you will find that she is a groaner or a screamer as she orgasms and she can orgasm many times, doing just that, while at the same time you are pinching her nipple, much harder and pulling her tit, at the same time, up towards her shoulder - the more painful, the more pleasure, she gets, generally and tits recover qickly for the next sexual activity.
Some nights, I get my "companion" to orgasm 10 times or more and she says that each orgasm she feels from the top of her head to the tip of her toes, which is totally unlike anything a man feels, just the moment of orgasm as the penis "explodes cum", for want of a better explanation and once only, not multiple times, which women can easily achieve.
Depending on your "companions" vagina, she might have inner cunt lips - you can see those when you look. My current companion does not have any inner cunt lips, possibly because in times past, she had a Hysterectomy - anyway, her body gives me zero arousal, so I put my thumb up her cunt hole, well Vaseline first and orgasm her that way too, which is fun for me anyway, but she orgasms anyway, so win/win for both of us - but I digress.
Buy a hard penis shaped vibrator, the one which is about 6 inches long and takes 2 or more "C" type batteries. You can buy them from eBay to keep bedroom activities private from your neighbors. Put in new batteries and gently massage out her inner cunt lips with your fingers and then get the vibrator going full blast (the control for it is generally in the lid), put your trigger finger on one side of an inner lip, with plenty of Vaseline for lubrication (most important) and the vibrator going full blast on the other side of that lip, so that her lip is ensconced between finger and vibrator and feel for the engorged vein in the upper part of the lip and keep your finger on that - she will jump around and jerk, horizontal, while you are doing that, but she will orgasm many times, over and over - but anywhere up to 100 orgasms over a 3 hour period, if you last that long, but when she says STOP - STOP, because you will want her co-operation to do it again as will she, as she builds her trust in you, this new way.
Personally, I call it playing a female's body like a Piano and I like the noise she emits, as confirmation I am an excellent lover, for the neighborhood to hear - much laughter.
Eventually, from multiple orgasms, she will pass out, so cuddle her from behind, don't touch any sexual spots and let her sleep in your arms exhausted until she re-awakens - then get her to lay face down, naked, on the bed.
Our bodies are covered with a fine hair, you probably can't see it, but if you run your hand over her back, about 1mm off her body, she will feel it. Gently, starting at the back of her neck, move your hand downwards, slowly, in a circular motion, looking for and finding sensitive spots on her back. When you find one, move your hand in circular motions, slowly, "1mm" off her back, just augmenting those fine hairs at that sensitive spot, until the sensitivity goes away, then on to the next sensitive spot. As you do this, she will continue to orgasm uncontrollably and over the hours you progress, she will continue to orgasm uncontrollably, until you reach the soles of her feet, when you run out of body to play with.
When you touch her ear with a finger, or her nose, she will orgasm, this after 300 or 400 orgasms, one after another and she will regard you as a God or Godess, but limit the "massage" to once a week, otherwise she pulls all of the muscles in her chest which might entail a hospital visit, which is avoidable otherwise - Just saying.
Added to which "Age" has nothing to do with it - Female with "Companion" go for it, any age and enjoy your life, while you have it - you don't need a Guy, as long as there are two of you and one is a female, enjoy what God has given you, is my suggestion.
We are in our late 70's and I "do" her most nights and she sleeps in her own bed sexually shattered, most nights - I don't get anything out of it, except the satisfaction of a job well done, which is enough for me. I had a reputation once, it is good to keep it polished and ready to go, at a moments notice, but this time, for my companion to enjoy.
Much Laughter.