Nov. 13, 2000 -- When I asked my 77-year-old friend Peter Kranz of Darien, Conn., about his sex life, he was immediately forthcoming. "We make love twice a day," he said.
"You do this every day?" I asked.
"The schedule is not written in stone," Peter explained. "But we do make love every day."
Michael Roizen, MD, would say that sex is keeping Kranz young. In his best-selling book, RealAge -- Are You as Young as You Can Be?, Roizen makes the case for the antiaging effects of sex after surveying the available literature. "Having sex at least twice a week can make your RealAge 1.6 years younger than if you had sex only once a week," Roizen says. He defines 'real age' as "an estimation of your age in biologic terms, not chronologic years."
Although Roizen's statistics are sketchy, he derives his figures primarily from a study done in Caerphilly, Wales, and published in the December 1997 British Medical Journal under the title, "Sex and Death: Are They Related?" One of the few efforts to examine the relationship between sex and mortality, the study found that men who reported at least two orgasms a week at the time of the study had less than half the risk of dying from various causes over 10 years of follow-up than those with a lower frequency of orgasm. Drawing on the researchers' remark that the evidence suggested a dose-response relationship -- meaning in this case that the more orgasms a man had, the longer he lived -- Roizen concluded that someone like my friend Peter, who has sex every day, could have a Real Age as much as 8 years younger.
At first blush (and Peter's candor did make me blush), my friend is a convincing example of Roizen's argument. He is youthful-looking, energetic, and actively involved in many interests. Peter still works as a developer of computer systems. He has had a steady, positive relationship with his wife who, at 77 also, still commutes to Manhattan for her own job at a major nonprofit institution.
But although Peter enjoys his sexual interludes immensely, he also does many other things to remain youthful. He watches his weight and caloric intake very closely and makes sure he stays slim. Over the last decades, he has been involved in strenuous earth and rock-moving activities in his own backyard; and he also splits wood when it is needed. He has exercised steadily and intensely over the years.
So does sex itself really extend our lives or prevent heart attacks? This claim is difficult to prove. Yes, sex and good health are usually linked -- in most of the studies and our observations -- but which one is the chicken and which the egg? Does sex contribute to good health or does good health make regular sex possible?
How Sex May Keep You Young
One of the first longitudinal studies of aging begun at Duke University in the '50s and reported in the December 1982 journal Gerontologist found that the frequency of sexual intercourse (for men) and the enjoyment of sex (for women) predicted longevity. Other studies have found that sexual dissatisfaction was a predictor of the onset of cardiovascular disease. A study published in the November-December 1976 journal Psychosomatic Medicine compared 100 women with heart disease (acute myocardial infarction) with a control group and found sexual frigidity and dissatisfaction among 65% of the coronary patients but only 24% of the controls. In these studies, though correlations were found between the frequency and/or enjoyment of sex and longevity or other outcomes, they do not answer the "chicken and egg" question.
In a long-term study published in book form as Secrets of the Superyoung, David Weeks, MD, head of old age psychology at the Royal Edinburgh Hospital in Scotland, found that "the key ingredients for looking younger are staying active ... and maintaining a good sex life." In a study of 3,500 people, ages 30 to 101, Weeks found that "sex helps you look between four and seven years younger," according to impartial ratings of the subjects' photos. Theorizing on his findings, Weeks, a clinical neuropsychologist, attributed this to significant reductions in stress, greater contentment, [and] better sleep.
Michael Roizen's reading of the research and his clinical work have led him to believe that sex keeps us younger because it "decreases stress, relaxes us, enhances intimacy, and helps ... personal relationships." Although no study has yet proven a cause-and-effect relationship between good sex and longevity, there seems to be a beneficial system at work here -- a sort of virtuous cycle of sex and health reinforcing one another.
Sex and Seniors
Although it may gross out 20-year-olds to hear it (especially about their parents), older people do continue to have sex, according to the MacArthur Foundation report "Successful Aging" by John W. Rowe, MD, and Robert L. Kahn, PhD. They cite a Duke University study published in the November 1974 Journal of the American Geriatrics Society that found that "at age 68, about 70% of men were sexually active on a regular basis" but that this number dropped to 25% by age 78.
A more recent study, published in the January 1990 issue of the Archives of Internal Medicine, reported that nearly 74% of married men over 60 remain sexually active, as do 56% of married women. And an April 1988 study on "Sexual Interest and Behavior in Healthy 80 to 102-year-olds" published in the Archives of Sexual Behavior found that 63% of men and 30% of women were still having sexual intercourse. "Given that by the age of 80 or older there are 39 men for every 100 women, lack of oppportunity may well account for a large portion of such gender differences," says Cindy M. Meston, PhD, in her paper on "Aging and Sexuality," published in the October 1997 issue of the Western Journal of Medicine.
While men may experience a gradual decline in sexual libido as their testosterone levels slowly diminish, women experience a wider range of effects as a result of the more complex hormonal changes that occur with menopause. Some, like Eileen Smith, 70, a nurse in Laguna Beach, Calif., experience no decrease in sexual desire through the years, although she attributes that to the fact that she began hormone replacement therapy at the first sign of hot flashes. "In my own case, intensity of desire was not tied to menopause," she says, "but rather to the quality of the relationships I was having at different times in my life." The mother of two and grandmother of four, she said that years after her divorce, when she was "crazy in love" at age 60, she experienced sexuality "as hot as ever."
Other women may respond to the lower testosterone levels that sometimes occur after menopause with a decrease in desire. Judith Gerberg, MA, a career counselor and president of the Career Counselors' Consortium in New York, found that a hysterectomy 10 years ago left her totally depressed and disinterested in sex or anything else. Despite treatment with estrogen, her apathy continued. She did not give up on finding a solution and kept consulting physicians until she found one who was an early proponent of the use of small doses of testosterone to restore sexuality in middle-aged women.
When she began taking Estratest, a combination of estrogen and testosterone, all aspects of her sexual functioning returned. "I was sexy as ever," she says. "Joy returned. I was energized. I stopped worrying all the time." In her work as a career counselor, she now advocates that women suffering similar problems explore hormone therapy with their gynecologists.
Use It or Lose It
For both men and women, the best way to maintain sexuality in later years is never to stop making love. "The vagina is one organ where use makes a difference," says Susan Love, MD, in Dr. Susan Love's Hormone Book. "Sexual exercise -- either masturbating or having sex with a partner -- will increase your natural lubrication." Men, too, may find that arousal comes more easily when sexual activity is maintained regularly, although the normal sexual diminution that comes in their 70s and beyond may require some adjustment and variation.
My friend Peter Kranz explains his method. "We make love twice every day, but I don't finish twice a day, just once. We go to bed around 11 p.m. After a few hours sleep, I wake my wife up, and we have intercourse for 20 or 30 minutes. Then we go back to sleep till the alarm goes off in the morning. We make love again upon awakening, and then I generally do finish off."
And one of Roizen's enthusiastic correspondents, 87-year-old Joe, who had sex regularly until his wife died at age 83, gives his sexual recipe. "This year I met a 56-year-old lady full of energy who had never married," he says. "Since I lost my erection in my 70s, I am able to excite her with my hand and by oral sex." Joe adds that until her relationship with him, she had been in a physical "cocoon," due to lack of sex. But after two months, "She came out of the cocoon ... and her juices started flowing."
Jeffrey Blum, PhD, is a psychotherapist in private practice in New Canaan, Conn., who treats individuals, couples, and families. He is the author of Nothing Left to Lose: Studies of Street People and Living with Spirit in a Material World as well as numerous magazine articles.