"Sexual Desire and Sexual Response in the Hormone Jungle and Hormone Desert Oasis"

[AlaskaAngel]

Hi StephN,

Both the first endo I saw there (a woman who no longer works at the cancer center) as well as the most recent gyno I saw there were competent and compassionate, but neither of them were savvy about the sexual effects on older chemo patients, with the first making noises about Rx-ing the usual psych drug, which I used (to no effect), and the second Rx'd a bit of topical estrogen to the vagina, basically to no effect.

The counseling center psych docs recognize the inequity of the situation, and one at least was willing to provide some counseling privately, but the center itself is not funded to handle the problems that need addressing over time.

Survivorship gets short shrift and no one is being honest about the true long-term effects because they don't have to deal with them.

I was very low-key, supportive, and non-confrontational at the newbies session, in order not to discourage them from independently considering treatment, despite my own personal views about it.

It was yet another example of how prevalent the practice is NOT to hire female nurses who have done treatment themselves, for oncology services. The perception by treatment-naive nurses is based on what their employing physicians do, which is to minimize discussion about it and divert discussion in other directions.

A.A.

[StephN]

AA - Thanks for the further explanation.

I see you even have your exercise schedule on your signature now.

How are you coming with the weight and energy level now that you have done that for a while?
Or are genes and the other effects still winning out?

[AlaskaAngel]

Diet and exercise for age 61 does NOT add up to 36-26-36.... *sigh*

I ran into the problem that adding more exercise (to not just maintain, but lose weight) was tearing up my joints to where it was hard to rest without pain, so one hour a day of low-to-moderate impact is where I max out, which doesn't equate to weight loss. And without more exercise, I ran into the problem that I had to limit my diet to 800 calories a day just to maintain, not lose weight. The metformin seems to help some with limiting hunger, at least. And hopefully it is busy knocking out cancer cells as well.

How are you doing?

A.A.

[Jackie07]

It is a hot topic regardless if one has/had cancer:

Sex in the second half of life
Sexuality is not just for the young. Results from a University of Chicago survey published in 2007 suggested that over half of Americans remain sexually active well into their 70s. That said, sexual activity does subside with age. Biological factors tug in that direction, as do social arrangements: older people, especially women, often end up single when a spouse or partner dies. But researchers at Indiana University report that 20% to 30% of long-lived Americans are sexually active into their 80s.

Now suitable for study
It wasn’t long ago that older people weren’t included in studies of sexual behavior because they were seen as largely irrelevant to the topic: 59 was the upper age limit of a landmark study of American sexuality conducted in the early 1990s. However, the University of Chicago survey focused exclusively on older adults, including just over 3,000 Americans ages 57 to 85. The results lent some legitimacy to the subject of sexuality of older people. Here are some of the main points:

Sexual activity tapers off with age. Both surveys show a decline in sexual activity with age, although the drop-off isn’t as steep as one might expect, and a significant minority (especially men) defies the trend. In the Indiana study, 35% of the men ages 80 and older reported that they had intercourse a few times or more in the past year. In the University of Chicago study, 38.5% of the men ages 75 to 85 reported having sexual activity with a partner in the previous year.

Older women are less sexually active than older men. Both studies show that older women — even the “young old,” in their 60s — are less sexually active than men of the same age. The gender gap widens as people get older.

Partnered sex gets high marks. In the Indiana study, over three-quarters (78%) of the men ages 50 and over rated their most recent sexual experience with a partner as either extremely or “quite a bit” pleasurable. About two-thirds (68.2%) of the women in that age group rated their most recent experience with a partner that highly.
Yet, a sizable minority of the men (43%) and women (36%) in the Indiana study reported that their most recent partnered sexual activity was with someone other than a spouse or long-time partner. This category included casual or new acquaintances, friends, and “transactional” partners — people who engaged in sex in exchange for something, often but not always money.

Masturbation is common. Most men (63%) and almost half of women (47%) in the 50 and over age group reported masturbating in the past year, according to the Indiana survey. As with other sexual activities, the percentage declined with age.

Good health matters. The University of Chicago researchers found a strong association between good health and sexual activity, particularly among men. Diabetes seems to have a greater negative effect than either arthritis or high blood pressure on both genders, but especially on women. In the Indiana survey, a woman’s evaluation of her last sexual experience did not vary with her self-reported health status.

Sexual problems are common. Half of those who participated in the University of Chicago study reported having at least one bothersome sexual problem. Among men, the problems included difficulty achieving and maintaining an erection (37%), lack of interest in sex (28%), anxiety about performance (27%), and inability to climax (20%). Among women, the common problems were lack of interest in sex (43%), difficulty with lubrication (39%), inability to climax (34%), lack of pleasure from sex (23%), and pain during sex (17%). In the Indiana survey, 30% of the women ages 50 and over said they experienced some level of pain during their most recent sexual experience with a partner.

Many men take something to improve sexual function. In the Indiana survey, 17% of men ages 50 and older took an erectile dysfunction drug in connection with their most recent sexual experience with a partner. In the University of Chicago study, 14% of the men and 1% of the women reported taking medications or supplements to improve sexual function during the past year.

[Harvard Medical Review, July 17, 2012]