Still Sexy After All These Years

What a sexual past. They reveled in the birth-control pill, free love and premarital bliss. But today, baby boomers are edging unwillingly closer to their golden years and it's their sexual future they're thinking about--as in, "I have a sexual future, right?"

There's no getting around the fact that sexual performance, interest and satisfaction can change over time. "Certain things go down with age," says John McKinlay, principal investigator of the Massachusetts Male Aging Study (MMAS), a major survey of men's health. "Number one is erections." For many men, that means two things: longer to get there, not as firm once you do. Others are less fortunate. Between the ages of 40 and 70, the probability of complete impotence triples from 5 to 15 percent, according to the MMAS. Poor health and habits--diabetes, hypertension, heart disease and smoking--are all major contributors. In women, it's hormones that go down. Estrogen levels drop dramatically at menopause, thinning the vaginal wall and causing dryness. That can make sex exceedingly painful. Some women lose interest altogether.

Until recently, problems in the bedroom stayed there. But boomers are the beneficiaries of a growing openness about sexual frustrations and the pharmaceutical rush to cure them. Since Viagra's debut in 1998, physicians have written more than 17 million prescriptions; now other oral drugs, with names like Uprima and Vasomax, are at various stages along the pipeline. The erectile-dysfunction business has brought new attention to female sexual problems, too. Viagra is now being tested in women and, although preliminary results suggest it won't work as broadly as it does for men, it could help improve arousal for certain postmenopausal women. Female versions of other male drugs are being studied as well. And there's a growing interest in testosterone, the libido booster. Its use in women has not been approved by the FDA and is controversial, but special "compounding" pharmacies will make it available in pill or cream form with a doctor's prescription.

Drugs will never be the perfect solution: they don't work for everyone, they have a range of adverse effects and they're not cheap. But the reality is that boomers and their elders are already doing pretty well on their own. A recent survey of men and women 45 and older by the AARP and Modern Maturity magazine found that while the frequency of intercourse and sexual satisfaction both decline with age, neither is defunct. About half of 45- to 59-year-olds have sex at least once a week and more than 70 percent of men and women older than 45 make love at least once or twice a month if they have regular partners. The majority still like each other, too, especially those in relationships for the long haul: 63 percent of men and 57 percent of women 75 and older gave their partners the highest marks possible for physical attractiveness. Overall, about two thirds of those older than 45 say they are extremely or very satisfied with their physical relationships. Plenty, it turns out, to look forward to.