Gerald Haslam talks about prostate cancer and sex

Gerald Haslam, author of Grace Period, is living with prostate cancer. He wrote a stunning summary of his views of the importance of sexuality while living with cancer for my upcoming book. I know I have many readers who are looking for information on sexuality and cancer, so I'm giving you an advanced look at some of the insights he shared:

A seventyish man who was recovering from a prostatectomy asked fellow members of a prostate-cancer support group how they could have sex if they were leaking urine. He ended with a timeless observation--"My wife is willing to be pissed off but not pissed on."

Despite the laughter that followed, his was a serious problem, but the first response solved it: "Put a band on your penis --a cock ring. A lot of older guys who aren't incontinent use them to maintain erections, but if you're leaking they're a good answer, especially if you use a pump."

The first man was honest enough to admit, "I hadn't thought of that. We've never used any...devices. Of course, I've never had prostate cancer before, either." In fact, the prostate cancer world introduces many guys to devices and positions and concepts previously unimagined.

A physician pal said to me shortly after I was rendered impotent by prostate surgery and radiation, "You'd better start pumping up your penis every day, whether you're going to use it right away or not, or it'll shrivel into a Vienna sausage. As soon as you lose spontaneous erections you lose penile tone. No tone, and there'll be nothing to pump when you do want to use it."

In fact, sex seems to be the second most common topic--after cancer therapies--in discussions at most prostate cancer support groups, and I learned that many men, rendered impotent and perhaps stripped of libido by hormonal ablation, simply but not happily accepted the verdict that their sex lives were over, a defining activity lost. A dread frequently mentioned to me by my fellow prostate-cancer survivors has been not only the sudden absence of sex but of sexuality itself. This is especially grave since sex and sexuality can represent the life force's most powerful affirmation in the face of death.

Unfortunately, many of us men grow up believing that our sexuality dwells almost exclusively in our genitals, so a damaged penis may lead to a damaged personality. As one wife admitted at a session for couples, "There's not much fun in our lives anymore, and I don't just mean sex. He's just so sad." A penile fixation may also lead one to forget how much sexual satisfaction can be achieved by giving pleasure to a partner you love.

Please read my review of Gerald Haslam's Grace Period. Click here to view or order Grace Period on Amazon.

Sexual adventurer, age 58, has "every time/ everyone" condom rule

Many thanks to the people who are responding to my request for interviews for my next book! I am getting such interesting stories! For example...

When I asked Tinggi, age 58, how active his sex life was, he said, “Depends on what you mean by ‘sex’!” His erotic activity includes self-pleasuring to orgasm one to three times a day, and intercourse with one to three or more partners (male and female) per week, one to two orgasms per partner. “I tend to have several partners at the same time," says Tinggi. "I’ve been with two of my partners for five years, another for two years. All of the relationships are open and all my partners regularly have sex with others.” His sexual adventures in the past few years have included multiple partner scenes at sex parties, masturbating for four hours while riding an anal plug while being videocast globally, and nude theater performances.

Tinggi is diligent about practicing safer sex, and has not indulged in partner sex without a condom in 30 years. “My barrier policy is standard, long fixed, and known by all who have shared erotic times with me: Barriers are always used, for everyone, every time, for any genital contact,” he explained in a comment on my blog. “This ‘every time/everyone’ policy makes life simpler -- no need for elaborate calculations as to number of partners, who they were, days since last std check-up, partners since our last date, etc. When sex is likely, or probably, or possible, or even a wisp of my imagination, I bring my own supply of barriers. Should the opportunity arise, and both having shed clothes, I simply say, ‘Ok, now time to get Charles (not my name) dressed,’ and put on a condom."

When dates insist on sex without a barrier, which rarely happens, “the date becomes a chaste one and a last one.” Steady dates, people with whom he has sex repeatedly, get the same treatment each date: "every time/everyone."

“I do not ask my dates about STD check-ups, partners, etc. I am going to use barriers regardless of my date's answers. People can have an STD of which they show no signs detectable outside of a laboratory. I believe this ‘every time/everyone’ policy protects my dates, myself, and my community. A sad fact is that HIV is being transmitted in our retirement homes - by their residents. It is already there waiting for me. Barrier use can be eroticized to become a fun and arousing part of sexual interaction.”

Elders and Sexuality: panel in San Francisco 7/26/07

(updated 7/17/07)

(San Francisco Convention & Visitors Bureau Photo)

I'm pleased to be on a panel of experts on Elders and Sexuality: The Evolution of Desire in the Later Years: A Public Panel on Sexuality and Aging, Thursday evening July 26, 2007 6:30pm-8:30pm at Laguna Grove Care, 624 Laguna Street, San Francisco, CA 94102, sponsored by Pacific Institute and the California Institute of Integral Studies. Here's the panel description:

How do cultural values and institutional settings affect the social value placed on sexuality among the elderly? What are the sexual needs and expressions among our elders? And what is the potential and possibilities of sexual expression later in life? Join us for a public panel that will explore such topics as:

* Facts and Fictions of Sexuality and Aging
* Addressing Cultural Challenges and Affirming Sexual Needs
* Sexuality in Residential Care Facilities: Philosophies from the Pacific Institute Perspective
* Transcendent Sex in Later Life: Experiencing Spiritual Awakenings through Sexual Expression

Panelists:

Dr. Liz Macera is the Co- director of the Gerontological Nursing Program at UC San Francisco. Dr. Macera is currently working on a grant funded research project on intimacy issues in assisted living environments, where she will be interviewing AgeSong residents for the data collection for this research.

Joan Price is the author of “Better Than I Ever Expected: Straight Talk about Sex After Sixty” and an advocate for ageless sexuality. She was interviewed about senior sex and dating on ABC Nightline. Joan's mission is to change society's view of sex and aging, one mind at a time. One of Joan's blog readers called her "the beautiful face of senior sex, who shows up whenever the age group is ridiculed."

Dr. Nader Robert Shabahangi, is current President and Co-Founder of EHI and President and Founder of the Pacific Institute. A licensed psychotherapist with a Ph.D from Stanford University, Nader is a leader, trainer, and writer on applying the Existential-Humanistic approach to the treatment of elderly in the United States and Europe.

Moderator: Elizabeth Shaver,PhD cand. MFT, is a psychotherapist specializing in sexuality, trauma, and relationship issues. A researcher and adjunct faculty at the California Institute of Integral Studies, she has been a professional trained in the field of Holistic Sexuality, working with victims of sexual abuse and sexual offenders. She contributed to Dr. Jenny Wade's seminal research on transpersonal sexual experiences in Transcendent Sex: When Lovemaking Opens The Veil.

Sexual Desire Then and Now

How would you define and describe "sexual desire"?

Thirty years ago. I would have said, "Sexual desire is a driving urge of attraction. I feel tingling in my genitals, and a feeling of physiological hollowness yearning to be filled. I fantasize touching my lust object, kissing him, discovering (or rediscovering) what he looks like, smells like, what noises he makes, how he makes love." There was an urgency to my desire, a need.

Today, at age 63, I'd answer differently: "Sexual desire is a yearning for intimacy, for touch, for bonding with my beloved man. I fantasize arousing him, connecting with him, becoming joined in intimacy and ecstacy. It is both physical and emotional, though without the electric arousal I used to feel. The sexual urge for me now starts in my heart rather than my genitals and spreads to my whole body, slowly, like a slow-motion wave washing gently over me."

What about you? How would you define and describe sexual desire now, compared to when you were younger?

No Sex for 12 Years, Now Vagina Too Tight for Penetration

Frustrated in Florida, age 61, had not had sex for nearly 12 years, until recently. She wrote in an email to me:

Apparently one's vagina does change after not using it for a long period of time. I always thought sex was like riding a bicycle, but it is not. One can't just get back on and ride! I experienced such pain during the attempted penetration that we had to stop. What a disappointing and embarrassing moment. My partner was very understanding, however I was just frustrated and disappointed.

I went to my GYN for an examination soon after and explained my circumstances. She gave me a thorough exam and said although I had many tiny lacerations and redness, my vagina seemed normal. She explained how one's vaginal lining becomes thin after menopause and her advise was to abstain from sex for two weeks, using lubrication to aid in healing.

When we engaged in sex again, very gently, I was once again disappointed with the level of pain even though using lots of lubrication. We once again had to stop.

So now I am wondering if there is some way I can stretch my vagina for it seems like it has shrunk. (Perhaps it is just my imagination running wild!)

Have you had anyone else write you with a similar problem and if so is there a solution? For your information I have never been on hormones and my partners
penis is of normal size.

No, it's not your imagination, and yes, it's true that the vagina will seem to shrink after a long period of abstinence, especially after menopause, and penetration will be painful or sometimes impossible. I did, in fact, deal briefly with this in my book, Better Than I Ever Expected: Straight Talk about Sex After Sixty. I had interviewed a 75-year-old woman who had been celibate for 38 years and was in a new relationship. She was unable to have intercourse because her vagina had dried and narrowed to the point that penetration was impossible. She sought help from her gynecologist (a wonderful woman who has bought dozens of copies of Better Than I Ever Expected to give to her patients!), who helped her with stretching exercises.

I'm disappointed that your gynecologist is not this helpful. Telling you you're "normal" while you have lacerations and pain is not helpful, is it?


Please read Step-by-step program for Vaginal Renewal by Myrtle Wilhite, M.D., at A Woman's Touch, a wonderful sexuality resource center in Madison, WI. It tells you step by step how to massage and stretch your vagina. Dr. Wilhite permitted me to quote an abridged version of these steps in Better Than I Ever Expected, and I'm repeating them here for you:

* External Moisturizing and Massage: Increase the suppleness and blood circulation of the skin of your vulva and vagina with a five- to ten-minute massage with a moisturizing sexual lubricant like Liquid Silk®, a water-based lotion that will soak in and moisturize your skin, won't get sticky, and will help you massage with very little friction.

Push in to the skin with circular strokes, and massage what's underneath the skin, rather than brushing across the skin. Include the inner lips, the hood of the clitoris, the head of the clitoris and the perineum.

To complete your external massage, massage into the opening of the vaginal canal, using the same circular strokes. The massage itself does not need to be self-sexual in any way, but if that is comfortable for you, by all means explore these sensations.

* Internal Vaginal Massage: To massage inside your vaginal canal, we suggest using a lucite dildo which is very smooth and will not cause friction or tearing. Choose your size based upon how many fingers you can comfortably insert into the opening of your vagina.

After a session of external vulva massage, apply the same massage to the inner surfaces of your vagina with your dildo with lubricant applied on both skin and dildo. Rather than pushing the dildo in and out, use a circular massage movement. You are increasing skin flexibility so that your body can adjust to comfortable sexual penetration if you choose it.

You might also choose to use a slim vibrator for massaging the vaginal walls. Coat it in Liquid Silk and then insert it gently. Turn it on and let it run for about five minutes. You don't need to move it around, just lie there and let it do its work.

* Orgasm: For women who stop having orgasms, the blood vessels literally can get out of shape, preventing future orgasms. If you are able to bring yourself to orgasm, do so at least once a week (for the rest of your life). (Seriously.) This is preventive maintenance of your body.

* Kegel Relaxation: Kegels increase both the strength and flexibility of your pelvic floor muscles. Pay attention to the relaxation and deep breath part of the exercise. Learning to relax your pelvic floor will help you to avoid tensing up before penetration. (In Better Than I Ever Expected: Straight Talk about Sex After Sixty I also give Dr. Wilhite's tips for perfect Kegels.)

I plan to go into more detail in the new book I'm writing, which goes more deeply into the challenges of staying sexually vibrant in an aging body, and how to cope with these challenges.

Best wishes for a joyful resolution to this problem -- please keep me posted.


--Joan

What makes a 60+ woman attractive?

Erica, age 64, got out of a bad marriage with her zest for life (and sex) intact. She experienced some exhilarating (though short-term) sexual relationships through online dating, but ultimately quit trying to find her match after too many rejections. Now she tells me,

I think my main problem is feeling attractive to the opposite sex at my age. I notice that there are older women who attract men no matter how old they are. They have what I call the “it” factor. They’re not necessarily beautiful, but they radiate self confidence. My friend’s mother had men pursuing her into her 80s. I never had the the “it” factor when I was young and pretty, so how am I going to get it now when I really have good reasons not to feel attractive. I’d like to see that question answered.

I've studied such women by the way and I do have a few clues. My friend's mom was a former glamour girl who had been pursued by men her whole life and she retained that charm and youthfullness until she died. She dressed in ridiculously youthful clothes but I guess men liked that. She acted as if she was gorgeous even when she was very old and always just assumed she'd be the center of attention wherever she was.

Another friend--around my age-- has ALWAYS been very attractive to men even though she's short and dumpy with not great skin. She's also very charming (charm is key), has a sense of personal style (both these women do) and radiates friendliness combined with a rather haughty attitude that she is the arbiter of intelligence and what matters in life that gets men (and women in fact) working for her approval.

Such women are very seductive--and the key is they don't try to attract men, they don't care if men are attracted to them, that's the self-confidence factor. They're just charming, outgoing and friendly. I've also noticed (and was once told by a woman who attracted a lot of guys) that being very friendly is key. Men want to be around women who make them feel accepted.

I'm kind of shy so have trouble with friendliness. What's helped me is owning an extremely cute dog. He's a conversation starter and I'm much less shy when he's with me.

I'd love to hear more suggestions that don't rely on looks, or pretending you're someone you're not.

I'd like to hear from other women who are either in Erica's situation or feel they've overcome those feelings. I'd also like to hear from men who can identify or describe the "it" factor in women who attract them despite not being young or conventionally gorgeous.

I look forward to hearing from you,

Joan