When sex drive brakes to a stop
Many older patients have the same complaint about loss of interest and performance.
By Steve Dudley, Special to the Los Angeles Times
May 2, 2011
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Think back to things you used to like that now hold no appeal to you. It could be playing with toy soldiers or marbles, or launching yourself off a rope swing on a hot summer's day. (OK, that last one still sounds good, even to this half-centenarian.)

Now imagine a man going to a psychologist and saying: "I seem to have lost my interest in marble-playing. Back in my heyday, third or fourth grade, I was the terror of all the kids at recess. My collection of aggies and puries was second to none."

"That must have been something," says the psychologist.
"Yes it was" — eyes glazed over with a faraway, nostalgic look — "but it's not like that anymore. I still have a few marbles, haven't lost them all yet" — chuckles at his own joke — "but I just don't enjoy shooting any more. If truth be told, it's downright boring."
"Have you always felt like this?"

"Heck no! Time was, I could play marbles for hours, but the interest has faded."
"Lots of other people have felt that way too. But they work through it, and with enough diligence they can recapture some of their joy."
"Is there something wrong with me? Perhaps there's a blood test to show that I need a medication."

"Much of the time, all the tests come back normal. I think what you need is just to get out there and play marbles. Do the action enough, even if you don't feel like it, and you'll slowly start to regain that interest."

Next, a distraught woman comes in because she has finally let her subscription to Teen and Tiger Beat lapse after 20 years because she never read them — the new teen heartthrobs just don't do it for her like Bobby Sherman used to. After that comes a man who just can't understand why he doesn't like to sit in front of the TV for six hours every Saturday morning watching "Speed Racer" and "Scooby-Doo" cartoons.

Gently, skillfully, this expert psychologist works with these folks, many for years, to help get them closer to where they once were. Not everyone is a success story, but most make progress. Our friend with the marbles can now play for up to 20 minutes without wishing he were reading the sports page. That guy who used to watch cartoons is happy to report that he's developed a passion for the Road Runner and Rocky and Bullwinkle, though it's still only limited to an hour at a stretch.

Silly? Of course. Most of us understand that as we grow, we put away childish things. New interests come along. Old ones fade. And that's OK.

Except it's not OK when it comes to sex. Time and again, people come to me with the complaint that it's not like it used to be. Their interest has dropped way off or is nonexistent. What's wrong? Isn't there some sort of pill that they can take? How are their hormones? Maybe a shot could help.

Of course, sex is something that many hold nearer and dearer to their hearts and passions than marbles or reruns of "The Jetsons." But maybe, just maybe, the issue is the same. The only difference is that with sex, the letting-go process is resisted every step of the way. We know we should want sex: We're not youthful, manly, womanly, virile if we don't want it or don't want it much. Madison Avenue and Hollywood could not run without sex.

I suspect that if we could get past those psychological pressures many people would be a lot more contented. But it's not an easy place to get to. Though we can see what we've left behind, we have no clue about what is to come — and it is hard to imagine that it is better.

Try telling a 25-year-old surfer that someday his board will be a relic in the garage and he'll prefer growing prize dahlias, baking the perfect custard peach pie or reading Will Durant's "Story of Civilization" to catching the perfect wave off of the Banzai Pipeline. Tell a 7-year-old kid that, sure, he loves baseball cards and digging holes to China, but one day he'll be interested in romance, finding a rewarding career and going on long runs. He'll tell you he'd rather dig a hole, thanks.

Don't get me wrong. I am not saying that sex stops at 60. But there is no question that it is qualitatively and quantitatively different than it is for a younger person. Most people don't want to accept that. Hence the surge in pharmaceuticals and supplements focusing on "sex for life."

Often, my professional encounters on this topic start out with a cryptic "personal" as the stated reason for the doctor's visit. That's usually a tipoff right away.

People of all ages ask me if there is something that can be done for them. They hark back to how things used to be. Some are very detailed and describe with almost engineering exactness where they perceive the problem to be. Some are more vague and simply state, turning a bright crimson, that things aren't the same "down there."

I try to set them at ease with a clinical approach, just as I do with chronic health conditions such asdiabetes or blood pressure. I may order a few tests, use their problems as a springboard to get them to focus on their health in general. After all, excess alcohol intake and diabetes can affect sexual interest and performance.

But most people are doing everything right. They are just getting older. I might try to broach this whole getting-older subject; some take it better than others. I might try a lighthearted approach and tell them that George Burns used to sing of how he wished he were 80 again; they don't like to hear it. Sometimes, I point to all the other enjoyable, rewarding things they can do. But there is such resistance to letting go, to letting sex loosen the tightness of its grip on us.

I may not be the best one to give advice on this subject. What do I know? Still, I think we can do a disservice by trying so hard to facilitate people holding on to something that naturally diminishes with time. Perhaps if they were to let go, their hands would then be open to grasp on to something newer and richer. Don't ask me what. I'm not quite at the growing-dahlia stage. But I do make a great peach pie.

Dudley is a family physician practicing in Seattle. He likes to bake.

doctordudley@comcast.net

Copyright © 2011, Los Angeles Times

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