 I know what you’re thinking. Sex after forty, the best you ever had—either this guy is on something or he doesn’t know much about sex. Humor me, will you. Read on. You can always stick to your initial opinion, but the information in this book might change your mind. Many misinformed skeptics believe that the quest for sexual intimacy after 40 is an exercise in futility. One guy in his mid-forties lamented, “My body has changed so much since I was twenty. And it’s going down hill every day. What do I have to look forward to?” Obviously, I think the answer to that question can be “Plenty! The best sex you ever had—if the biology and psychology of the middle years are understood.” And I even thought this before Viagra was available. My definition of intimacy isn’t grandiose either. I define intimacy as the ability to care for the partner at least as much as the self, some of the time. No impossible or unrealistic expectation there. Does that sound like you? How do you like having equal billing with your partner? Of course, sex definitely occurs without intimacy, and intimacy can occur without sex. In this post my focus is on developing the ability to fuse the two frequently, in the face of what may appear to be daunting midlife obstacles.  Developmental Considerations We’re not born with the capacity for sexual intimacy. It emerges out of adolescent and young adult sexual experience. Although adolescents sometimes care about their partners, gals do more than guys. (Sorry, guys. But we are different and not always in a good way.) Most adolescents have a pressing need to gain sexual experience, to learn how to use their body as a sexual instrument with others. One sixteen year old girl was determined to begin experimenting sexually. She set her sights on a handsome high school senior. Unrestrained by badly needed parental prohibitions, she succeeded in getting his attention, but was surprised and disappointed when she discovered that he was a virgin too and more anxious than she was. Not much to learn there. But she did go on to find a number of guys to educate her. Eventually, after a few rather pathetic performances, which not everyone will admit to, the initial stage of bumbling through is over. But, even then, driven by the relentless demon of youthful biology, conquests, rather than caring sex, continue to be a prime directive well into the twenties. As one twenty-two year old put it, “My dick’s got a life of its own. It takes no prisoners. Line ‘em up! Knock ‘em down! Then on to the next!” Now, while you’re taking stock of your own experiences and trying to prove to yourself, and me, that I’m wrong, why not be complete honest? I’m talking to you women, too. Come on. Confess that the desire for self-centered, your-partner-is-a-piece-of-meat kind of sex never completely goes away.  I do realize that the capacity for genuine intimacy is apparent in some high-functioning individuals in the late teens and early twenties, but it doesn’t become a sustainable capacity until well into the twenties or later. As casual sex becomes nothing new and increasingly emotionally empty, the need for emotional involvement with a partner that you love or at least care about grows and begins to become a priority. “If I let myself go to bed with one more man who doesn’t really care about me, I’ll scream,” said twenty-four-year-old Rhonda. “I feel so alone inside. I want someone to love me.” Slowly, but surely, the emptiness of one more “my place or yours” and the desire for a solid, sustaining relationship grows and pushes men and women toward commitment. Now don’t get upset, I’m going to show you that commitment is good for you. As a result of a rare, fifty-plus-year longitudinal study of male development, Harvard psychiatrist George Vaillant concluded that “There is probably no single longitudinal variable that predicted mental health as clearly as a man’s capacity to remain happily married over time.” I can hear the moans out there.  Another famous psychiatrist, Erik Erikson, read the palms of those who did not develop a capacity for intimacy in their twenties and thirties and saw a midlife reeking with the smell of the curdled cream of self-absorption and isolation. Marriage, that often reviled and frivolously regarded institution, is the best decision to promote development that most young adults can make. Within its supercharged confines, slowly but surely, like the day-long simmering of a homemade pasta sauce, the rawness of youth is transformed into the savory smoothness of adulthood. Profound mental and emotional changes occur. As the partners dare to share and experience together their innermost sexual desires, their fantasies expand to incorporate the sensuousness of the other. Thirty-year-old Jane had only experienced sex in the missionary position before she married Brad. He was less inhibited than she was and introduced masturbation on the freeway. (Not the safest thing to do, but it does happen!) and quickies on the living room floor. As she became more comfortable with her own fantasies and gradually shed her inhibitions, Jane began to take the lead. No Plain Jane anymore, she surprised Brad with a suggestive call from a motel room known for its vibrating beds and x-rated films.  As the years go by, each partner is increasingly identified with the other. Together, they look back on the wake of an ever-lengthening shared past and they work for and anticipate an enmeshed future. As they playfully possess each other’s bodies and produce children, the deeply ingrained infantile ignorance about the opposite sex is slowly replaced by the awesome adult acceptance of the equal and complementary nature of ying and yang, of the male and female genitalia. Crossing the Rubicon: Maintaining Intimacy in Midlife As forty approaches, a new set of developmental challenges, full of potential and promise, as well as apprehension and anxiety, begin to dominate relationships between the sexes. Whereas young adults are preoccupied with developing the capacity for sustained intimacy, individuals on the fringe of forty are struggling with the ability to maintain intimacy in the face of powerful physical, psychological and environmental distractions. These include changes in the body due to aging and psychological unavailability because of preoccupation with the realistic demands of work, children and elderly parents. “You ought to lose some weight” he said. “I will if you will,” she said. “It takes you so long to get turned on,” he said. “I wouldn’t talk if I were you, Mr. Viagra,” she said. “Let’s go away for a weekend. We never have any time to ourselves,” she said. “I’ve got to work,” he said. “You’re always working,” she said. “Janet goes to college next year,” he said. “Come to bed now. We’ve got some time now,” he said. “I have to call my mother,” she said. “You always call your mother,” he said. “She’s old and alone,” she said.  In newer relationships, issues unique to second beginnings that interfere with closeness abound. They include the absence of a history together, the absence of old friends in common, age and generational differences between the partners and the problems of constituting a blended family. “Your friends don’t like me,” she said. “How could they, you hardly talk to them,” he said. “I want a baby,” she said. “I’ve already done that,” he said. “Besides you brought two of them with you.” “But not with me,” she said. “Your son is knocking at the door again,” he said. “He seems to know when we’re having sex and he doesn’t like it.”  I know what you’re thinking. I said that these were the best years of your life, didn’t I? And you’re moaning to yourself, “If this is a description of how great things are as I get older, the hell with it! Just give me some casual sex, and I’ll pass on the rest.” Well, read on. The key to maintaining sexual and emotional intimacy in midlife is knowledge of the normal changes in sexual functioning after forty, the ability to communicate needs and desires and a sense of humor. After all, it’s only sex! Sex and Aging: Good News! “The loss of sexuality is not an inevitable aspect of aging,” says researcher Helen Singer Kaplan. In fact, the majority of healthy people remain sexually active on a regular basis until advanced old age. (Yes, even your mom and dad, and grandma and grandpa). But the subject must be approached a bit differently than at twenty, because the aging process does bring with it certain changes in the appearance of the body and the physiology of male and female sexual responsiveness. Here’s more good news. We age from the outside in. In utero the outer, or ectodermal, layer of the embryo develops into skin, the sensory organs and nervous system. Since these organs are the first to age, plastic surgeons have a field day in our forties as women, and some men, rush to smooth out facial wrinkles, tuck tummies and shore up sagging bottoms. In our fifties, it’s muscles, bones and connective tissue, products of the middle or mesodermal layer, which begin to give out, resulting in sore backs and heart attacks. But still cooking with gas, even if the packaging is a bit frayed, are the inner or endodermal functions of eating and sex, life’s two greatest pleasures. In regard to sexual functioning, researchers across the decades from Kinsey to Masters and Johnson have arrived at the same happy conclusion: in the presence of good health, the majority of people remain sexually functional and active on a regular basis until virtually the end of life. Or, to be more specific, when they have partners, 70 percent of healthy seventy-year-olds remain sexually active and have sex at least once a week. If they don’t have partners, they always have themselves. Masturbation is a life long sexual activity. Even for those in their eighties and nineties.  Age and Gender Related Variables “Vive la difference!” say the French. A good idea if the differences in sexual functioning bring pleasure, not pain. In actuality, I’m not sure the French care about the difference. However, the best way to insure that “la difference” continues to add spice to sex in midlife is to understand the changes in sexual functioning that normally occur with age and accept them in one’s self and one’s partner. And yes, again, I’m talking about both sexes. This developmental task is easier said than done because it involves accepting the partial loss of functions that are enormously important to self-esteem in adolescence and young adulthood. Fulfillment in midlife, particularly sexual fulfillment, begins with accepting a constantly changing reality and ends with actions that are consistent with that reality. There are certain inevitable age-related changes in sexual physiology that affect men and women differently. According to Kaplan, male sexuality peaks sharply at around seventeen. Yes, that’s correct. Age seventeen. Come to think of it, seventeen is a long time ago when you’re fifty. But don’t despair. It could be worse. And I didn’t say that it was all good news. After age seventeen, male sexuality gradually declines. The good news is that the decline is very gradual, with sexual function continuing into the eighties and nineties, and even beyond! And here’s more good news. Women don’t reach their full sexual potential until their late thirties or early forties. Then they slow down to a lesser degree than men. If that’s the case, why is it that most of my male patients and friends constantly grumble that they don’t get enough? Maybe they say that because they have trouble keeping up with their just-peaking wives and girl friends. As disquieting as this information may be to the male ego, all is not lost. The best sex you will ever have is mature, midlife intimacy, not the hormonally driven, bunny-rabbit-readiness of adolescence.  The Human Sexual Response Cycle: Desire, Excitement, and Orgasm Desire The effect of age on sexual desire is highly variable in both sexes. In some individuals, there is little change with the passage of time, while others appear to lose their sex drive entirely. For healthy individuals of both sexes in their forties and fifties, desire is instantaneous upon seeing a “hot” body, often considerably younger. This often leads to the production of stimulating, very self-centered fantasies. In polite society, we refer to this phenomenon by referring to such individuals as “cougars” and “dirty old men.” The production of testosterone in both sexes is a major biological factor in maintaining sexual desire. Most women produce enough adrenal sexual hormones (the adrenal glands produce male and female hormones in both sexes) after menopause to retain their interest in sex. Before menopause, that function is performed by the ovaries. In males, there is no abrupt drop in testosterone levels in midlife similar to the estrogen loss females experience at menopause. The hormonal basis for male sexual desire remains intact, but psychological factors can produce a loss of desire that resembles aspects of the female climacteric. Excitement Vaginal lubrication is dependent on estrogen. In middle-aged females, diminished ovarian estrogen production results in gradual and progressive vaginal thinning and dryness, first noticed in the forties by the beginning occurrence of raspy, sandpaper-like intercourse. Estrogen replacement therapy and/or vaginal lubrication can diminish or eliminate these effects. In middle-aged males, the male excitement phase, erection, is affected by aging, but not as severely as changes in vaginal functioning. If men are not using Viagra or similar drugs, and there is no reason why they shouldn’t, men may require other physical and psychic stimulation in order to attain and maintain an erection. In the teens and twenties a mere look or a fantasy is enough to spontaneously spring the penis[L1] to attention. This ever-ready sexual response gradually diminishes until, by sixty, most men seldom, if ever, erect spontaneously as they approach a partner. Nor can they count on remaining erect without sexual enhancing drugs or continuous physical penile stimulation. I know, all men want to perform like they did forever. But it’s not to be. Coping with the “Big I” Women worry about losing their beauty, men about losing their erections. Impotence, the “Big I,” one 50 year old called it. As with many other debilitating myths about middle age, this one can be assigned to the junk pile. Listen to what Masters and Johnson have to say about the functioning of the middle-aged penis. Every male subject beyond the age of 40 in their study, irrespective of reported levels of formal education, regardless of whether the man had ever experienced an instance of erectile difficulty, consistently believed that impotence was directly associated with the aging process. Masters and Johnson suggest that the fallacy that impotence is be expected as men age is probably more firmly entrenched in our culture than any other misapprehension. And this was before Viagra. Despite all this reassurance, I know it doesn’t sound like the best sex ever to you. But if you accept the fact that you’re not twenty (or better yet, seventeen if you’re a man) and you’re beyond your thirties sexual peak if you are a woman, understand the physiology involved and work together, then you can have the best sex ever. Orgasm Orgasm is produced by the rhythmic contractions located at the base of the penis and around the vaginal entrance. In males, the refractory period—the interval after orgasm during which a second orgasm cannot occur—increases from just a few minutes at the magical age of seventeen to as much as forty-eight hours by age seventy. Women do not have a significant refractory period at any age. Eat your heart out, guys. They remain capable of experiencing multiple orgasms throughout life. Problematic Adaptations Individuals and couples with significant sexual inhibitions ride the sexual crest of the hormonal wave of young adulthood and perform adequately, but run aground on the androgynous shoals of midlife. They usually have sex in the missionary position; avoid oral and manual stimulation; mate in silence, fantasizing, if at all, in a vacuum; and feel guilty about sexual pleasure, particularly from masturbation. Spurred on by their biologically-generated excitement, they perform for each other with restricted adequacy until the skill required to play the game increases. Then, since they cannot use fantasy and direct genital stimulation to adapt to the age-related sexual changes that intrude on their fragile equilibriums, the sexual house of cards they built together over the years begins to collapse. Men with such conflicts avoid intercourse because of their diminished ability to erect spontaneously and their partner’s dislike of stimulating them orally or manually. “I asked my wife to help me get ready,” said one forty-five year old. “After thinking about it for too long, she agreed, but she didn’t even look at me while she was doing it. Some turn on.” Women avoid intercourse out of embarrassment over the appearance of their bodies—they do not, cannot and should not expect to look like they did when they were twenty-five. Middle aged women often believe that they are no longer attractive to their partners. Sometimes they have reason to be concerned. Further, without adequate physical and mental stimulation and the introduction of lubricants, the quasi-pleasure of intercourse becomes a painful experience to be avoided. As intercourse becomes less and less frequent, both physical and emotional intimacy withers as the partners retreat into masturbation or the void of sexual and emotional abstinence. Healthy Adaptations Loving couples who do not have significant sexual hang ups intuitively adapt to the midlife physical changes. The woman provides more active and intense manual and oral penile stimulation without being asked. She does not expect her partner to maintain his erection as long as he did in the past, minimizes occasional impotence, and encourages pleasurable encounters that do not have to end in ejaculation. The man encourages the use of lubrication without criticism or recrimination, penetrates more gently, and responds to his partner’s desire for sex more often than his lengthened refractory period allows by participating in foreplay or intercourse without the expectation of ejaculation[L2] . This Is As Good As It Gets So why is sex after forty the best you ever had? Well, the equipment still works, although it needs a little help from time to time. You have a wealth of experience and have allowed yourself to sample the full range of sexual possibilities, something you couldn’t have done at twenty even if you thought you could. And last, but not least, you’ve developed the capacity to care for your partner, not just some of the time, but a lot of the time. The result is one of the richest experiences of fulfillment that human existence has to offer—touching and caressing, the union of bodies, the crescendo of orgasm, and the mingling of minds—all within the comforting security of the acceptance of each other’s physical and mental imperfections and a shared history that binds adulthood’s most important experiences into a rich, meaningful whole. I’ll stack it up against the wanton sex of youth any day. Fortunately, there’s no need to choose, since the one leads to the other. Intercourse coupled with a Vulcan mind-meld is the best sex you ever had and it’s as good as it gets. Enjoy! If You Would Like to Know More If you would like to read more, consider reading the following books referred to in this work. Erik Erikson, Childhood and Society, 2nd ed. (New York, Norton, 1963) Helen Singer Kaplan, “Sex, Intimacy, and the Aging Process,” Journal of the American Academy of Psychoanalysis 18(2) (1990). William Masters and Virginia Johnson, Human Sexual Response (Boston: Little, Brown, 1966. George Vaillant, “Natural History of Male Psychological Health, XII: A Forty-Five-Year Study of Predictors of Successful Aging at Age 65,” American Journal of Psychiatry 147 (1990), pp. 31-37. 
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