November 11, 2003

The physical problems of aging complicate sexuality (and heighten the poignancy of my quest). Helen Fisher, the anthropolgist who studies sex and love, celebrates technology’s help:

Testosterone creams and patches now keep the sex drive active. Viagra and other medications enable seniors, largely men, to perform in bed. Estrogen replacement therapy keeps women’s arousal mechanisms in gear. And with a host of other innovations, from plastic surgery and unguents to clothing of every imaginable texture, shape, and style, men and women can express their sexuality and fall in love almost until they die.[1]

I’m not so gung-ho. Jesse has stopped taking Viagra because of the headaches it gives him. Estrogen replacement, once so widely touted, increases risk of heart disease, breast cancer and stroke. Genetic polymorphisms in my hormone systems make supplementation for me problematic. Xenoestrogens are all too common in the chemical stew we live in these days. DES-damaged babies, fish in polluted streams with weird sex changes … these are just the tip of the iceberg. Other human effects under study include breast cancer, declining sperm count, fetal brain and spine damage…. and more every day.

For me, estrogens mean violent migraines. One whiff of automobile exhaust, tobacco smoke, pesticides, solvents and glues … among a multitude of other common smells … and I can be in bed for days. You probably didn’t even know those all emit estrogens; you probably don’t even notice the worst one for me: vinyl. Ubiquitous vinyl.

But there is one kind of estrogen I do take: estriol. Not estradiol; don’t confuse them: estriol. I started taking it (in a water-based gel) because the walls of my vagina have become thinner, less elastic and more fragile. The inside front of my vagina cushions poorly now, and easily gets pinched when rubbed against the pubic bone. Jesse’s cock rubs there — but now I have to be very careful to limit this maneuver: I bruise quickly, to the point I can’t handle the pain.

After some experimenting, I found a dosage that would help my vagina without making me sick. It was such a tiny amount that the pharmacy said it should have no effect. But it did for me, just enough to barely tolerate vaginal intercourse. An additional benefit I discovered: it controls the vaginal candidiasis that plagued me most of my adult life.

The walls of my rectum are similarly out of condition. The wall between it and my vagina has prolapsed in a rectocele. And I get chronic fissures and/or hemorrhoids, which medications help little (plus I react to the chemicals in them). I used to like stimulation of my rectum in sex play, but now I’m only interested in fantasy.

The bottom line is that some level of pain is now almost a constant part of intercourse.

My priorities in sex are different now.

• Safety is very important.  Respect for the fragility of my body, care for the dynamics of our dance.
• Purpose? What am I doing this for? Fun and adventure don’t work any more. Relationship does, if the relationship is worth it. In younger days, since Jesse and I had decided we had an open marriage, I experimented with a lot of other sexual relationships. Now it’s hard to imagine a second friend I’d be willing to share my sexuality with. Most people don’t have the time/attention/dedication to make more than one real committment — if that; I feel blessed that Jesse and I share one.
• Because of the problems with estrogen, I could have to stop taking it at any time, and lose intercourse. I am exquisitely aware that each time could be the last.
• With no drive, sex has become entirely a sacrament. Very rarely, something turns me on. But I don’t feel hunger for sex the way I used to.
• Orgasm? Sometimes I just get tired of working so hard to achieve it.
• What I feel is mystery.

It keeps changing. I have to hang loose.

Sex is more difficult these days … and I appreciate it more.


[1] Fisher, 2004, 214.