Episode 25: Stacy Tessler Lindau, MD: Woman’s Sexuality

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Stacy Tessler Lindau, MD, MAPP, Assistant Professor Obstetrics and Gynecology and Medicine-Geriatrics at the University of Chicago.  Dr. Lindau is one of the fastest rising young stars in the field of aging research. In this show we find out how Third Agers’ social networks contribute to their longevity and health.  What kind of diseases women face as they age.  How sexually active people are as they age.  And how you can best stay healthy.

Dr. Lindau's research and clinical work focuses on health of women throughout the life course. Her teaching and mentoring efforts emphasize geriatrics education and research predominantly in the areas of ethics, sexual health, and primary care of older women. She is also working on several projects aimed to advance the health and life quality of older women and women living with chronic illness.

Some of the research she discusses:

The percentage of those surveyed who said they were sexually active declined with age: 73% of the 57-64 age group reported they were sexually active, compared with 53% of the 65-74 age group and 26% of the 75-85 age group.

Older women were less likely to report being sexually active than older men, and were less likely to be in intimate relationships. But women, also, were more than twice as likely to be widowed as men. Here's the breakdown:

-Ages 57-64: 62% of women and 84% of men reported sexual activity in the last year
-Ages 65-74: 40% of women and 67% of men reported sexual activity in the last year
-Ages 75-85: 16% percent of women and 38% of men reported sexual activity in the last year

Don’t miss this fascinating discussion.

Transcript

Dr. Peter Brill: Hello and welcome to The Third Age with the doctor and the man from Hollywood. I’m the doctor, Dr. Peter Brill, and the man from Hollywood is David Debin. On, alright, I had to wait for the music. On this show we turn the myths of aging upside down, we sort out the scientific and the trendy, the medical and the cultural, and we tell you everything you need to know about living in the third age. Remember, we guarantee if you listen to us you will never grow old.

David Debin: I’m the man from Hollywood. My name is David Debin. The third age usually starts somewhere around age 45 or 50. It’s a time when you start to feel a strong desire for deeper meaning and fulfillment in your life. Your first age is childhood, your second age is building your career and raising your family, and the third age is a major change or transition to a whole new set of problems, values, opportunities and gratifications, whatever that means. So join us as fellow explorers in this journey to discover what brings passion, purpose and joy into this uncharted time of life.

Dr. Peter Brill: Today we’re going to talk about Dr. Stacy Tessler Lindau, one of the fastest rising young stars in the field of aging research. We’re going to find out how third agers social networks contribute to their longevity and health, health, excuse me, I can’t read today. What kind of…

David Debin: You’re not reading, this is spontaneous, yeah you’re not…

Dr. Peter Brill: I gave away the secret?

David  Debin: You gave away the secret. You’re not supposed to be reading this, you’re supposed to just say this.

Dr. Peter Brill: Alright, I’ll make up the rest.

David Debin: Okay.

Dr. Peter Brill: Actually in my backyard, I…Oh, what kind of distresses women face as they age, how sexually active people are as they age, and how you can stay healthy. This fascinating and informative interview is coming right after the break. Marisa, did you want to interrupt?

Marisa: Yeah. Well you said distresses, but I think you meant diseases.

Dr. Peter Brill: Diseases? Oh.

Marisa: Yes.

Dr. Peter Brill: Thank you.

Marisa: You’re welcome.

David Debin: What we’re trying to say is that we have a fabulous guest today who’s a leading researcher in the field of aging. She’s a young up and coming rising star and we’re very fortunate to have her with us today, and she’ll be with us pretty soon, right?

Dr. Peter Brill: And not only that but just as a sideline, we’re going to talk a little bit about how much sex people have at various ages. Now that ought to be interesting.

Marisa: Yeah.

David Debin: I’m tired of talking about sex.

Dr. Peter Brill: You’re tired of too much sex, sex, sex, sex.

David Debin: No, I’m tired of talking about it, I want to do it.

Marisa: It’s just a tease for you?

David Debin: So how do you feel today? I’m feeling a little, you know, I’m on the edge here. We got a big election going on. We don’t know who’s going to do what, every, there’s all kinds of stuff in the air, and I’m on edge, I don’t know. I voted a long time ago. I know you voted this morning, Peter.

Dr. Peter Brill: Well, you know, they were saying that people who did the absentee ballots were a couple weeks back in the conversion process, there’s so much momentum here in California.

David Debin: Right.

Dr. Peter Brill: And so, did you have trouble voting?

David Debin: No, no, I knew I voted for the right person and I still believe that I voted for the right person. So…

Dr. Peter Brill: Well I’m stunned.

David Debin: But it’s, this is going to go on for about 40 hours I understand between the East and the West and the rest of the country. We’re going to be up late trying to figure out who’s going to win. And it’s, it’s a very strange thing going on in the republican ranks, where republicans are turning against republicans, and it seems a little bit more unified at least in the democratic ranks. Don’t you think? I mean I think Hilary and Obama, you know, they can, Terry McAuliffe suggested that Obama could be a good vice presidential candidate on the ticket with Hilary. So he’s managing her campaign, so that goes to show you how much they think of, they think of Obama, right? They already ruled him out and made him vice president.

Dr. Peter Brill: Alright, so lets go back to the topic at hand.

David Debin: Okay, and what is it?

Dr. Peter Brill: We have been dealing with these, the groups that we have of people in the third age trying to help them live longer, have better lives, find more meaning, find more value in their lives, find more passion, find more joy, and I’d say what, sixty percent of people who attend our groups are women.

David Debin: I would guess so.

Dr. Peter Brill: And so we are dealing on an actual interactive basis with exactly what our guest today is doing research about.

David Debin: Well she’s doing research about men and women…

Dr. Peter Brill: Yes.

David Debin: She’s specializing in some areas with women but…

Dr. Peter Brill: Right.

David Debin: But she’s doing research with men and women, but probably sixty-forty, which is what we see anyway.

Dr. Peter Brill: Yeah, she probably just researches forty percent of her time on men and sixty percent on women.

David Debin: Hey, we, you know, oh, and by the way, I got to tell you a little bit of synchronicity. I went to a speech, which I really wanted you to go to last night, Stanislove Gruff…

Dr. Peter Brill: Mm.

David Debin: was speaking at the Lebaro Theatre…

Dr. Peter Brill: Yeah.

David Debin: and I didn’t have a ticket and we were on line and I was with our friend Bernie Denial, and we were waiting in line, we didn’t have tickets, we didn’t know if we should go up, we’d have to wait on it very long, and then the woman standing next to us on line said, “I have…

Dr. Peter Brill: An extra ticket.

David Debin: extra tickets”, and it turned out to be a woman who was in one of our workshops who recognized me from the workshop, and she had those extra tickets, we all sat together and we had a wonderful time and she just, you know, she said that as a result of the workshops she’s, you know, she’s getting out more and doing more things.

Dr. Peter Brill: That’s wonderful. Well it’s time now David.

David Debin: It’s time for the news story and in honor of today’s discussion, this is something that’s really interesting, it’s not that funny, but it’s very interesting. A playground for pensioners has opened in a Manchester park in England, and here’s a fabulous picture of two third agers on a swing in the playground, and it’s actually a great, great thing physically, psychologically and for connectedness, people are going to this playground. It’s called The Old…

Dr. Peter Brill: What a great idea.

David Debin: That could be a tipping point I believe.

Dr. Peter Brill: What a great idea.

David Debin: Yeah, that’s what I was going to show you. What do we see there? Okay. The Older People’s Play Area on the Dam Head Estate in Blacklease kidded out to strengthen hips, tone legs and train the upper body. It was set up by the local residents association who were inspired by a similar playground in Germany. It’s cost, at a reasonable cost to bill, $15,000 dollars or something like that, got six pieces of equipment, and there they are, they’re just, they look like kids, they got their arms in the air…

Dr. Peter Brill: Yeah.

David Debin: their legs are out…

Dr. Peter Brill: Yeah.

Marisa: Yeah.

David Debin: they’re laughing and I think it’s a fabulous…

Dr. Peter Brill: They’re having fun. Wouldn’t it be great if you had some play, you know, like the kind of playground equipment we have, but it was safe for people this age and helps strengthen you.

Marisa: Yeah.

David Debin: Yeah. I think it’s a great idea, and we’re going to talk more about all of this…

Dr. Peter Brill: But David it wasn’t funny.

David Debin: It wasn’t funny? Well, the second story is about police searching a downtown home find a man hiding fifteen plastic bags of crack cocaine in his buttocks.

Marisa: Fifteen pounds?

David Debin: Fifteen pounds of crack cocaine in his buttocks, so, you know, there’s…

Dr. Peter Brill: That is funny.

David Debin: Yeah, there’s just, you know…

Marisa: Is he also on the internet for pornography?

Dr. Peter Brill: Our guest today is Stacy Tessler Lindau, MD, MAPP, assistant professor of obstetrics and gynecology and medicine geriatric, better geriatrics at the University of Chicago. Dr. Lindau’s research, boy I’m shook up about the election today too David, Dr. Lindau’s research and clinical work focuses on the health of women throughout their life course. Dr. Lindau’s teaching and mentoring efforts emphasize the geriatric education and research predominantly in the areas of ethics, sexual health, primary care of older women. She’s also working on several projects aimed at, to advance the health and life quality of older women and women living with chronic illness. Welcome to the show Dr. Lindau.

Dr. Stacy Tessler Lindau: Thank you.

Dr. Peter Brill: Well we’re quite, you’re quite the rising star in the field. What drew you to this field?

Dr. Stacy Tessler Lindau: Well, you know, I gave a talk not long ago to a group of psychotherapists and psychoanalysts in Chicago, which was very intimidating because I’m sure they were all looking at me wondering what one person asked, which is, “What’s a nice girl like you doing in a place like this?” And talking to a bunch of people who studied with probably Freud himself, if not his deciphals, it was intimidating, and I, you know, the way that I came to study aging was really through my interest in sexuality in later life, and the reason I became interested in that was really very simple. In medical school, as you know, we’re taught how to talk to patients and how to take their history, and I remember being taught that sexuality was an important part of health and that we had to talk to older patients about these issues…

Dr. Peter Brill: Mm hmm.

Dr. Stacy Tessler Lindau: And I remember going into the hospital and asking these questions and then watching my teachers model the ideal interviews and leave out the questions, and I thought “What’s going on here?” You know, I’m buying into the message and they don’t do it, and when I asked “Why don’t you ask these questions about sexuality?”, they said, “Well, older, sick, there’re too many people in the room, it would be embarrassing”, and I just, I really became interested at that point. You know, I thought it was unfair. I thought, you know, on the one hand this is what we ought to do is be respecting people and respecting this is an important part of their health, and on the other hand we find all kinds of excuses not to talk to people about it. So my research in this area really began about fifteen years ago when I was in medical school because of those experiences.

Dr. Peter Brill: I see. Yeah, you know, it was interesting you’re talking about the psychotherapist and the psychoanalyst. Harold Leaf was one of my teachers at the University of Pennsylvania told me he had the shortest psychoanalysis in history from the New York Analytics Society, and during the time he was in analysis he got married and divorced and his analyst never asked him a single question and never discussed his marriage or his sex life during the entire psychoanalysis.

Dr. Stacy Tessler Lindau: Well what were they talking about?

Dr. Peter Brill: That’s what I wondered. I was too intimidated at that point to ask. So what have you learned in your studies?

Dr. Stacy Tessler Lindau: Well, the initial study that we did fifteen years ago was a study, really I think the important way to start this sort of research was face to face interviews with older people, this was in the New York City area, just talking in an open ended fashion about sexuality in later life and focusing it on whether people had problems, whether they discussed these problems with their partners or whether they discussed these issues with physicians, and what I learned was in that initial study that older people were willing to talk about these matters, that they felt that these, the issues of sexuality were not being well attended to, people had concerns, and people also described many ways in which their sex lives and their intimate lives got better as they got older. Certainly there are ways in which things didn’t get better, but I was heartened and interested to hear that there were many ways in which people perceived getting older to be good for their sex lives, and certainly…

Dr. Peter Brill: Well that, that we want to get out right away. What, in what way is getting older better for your sex life?

Dr. Stacy Tessler Lindau: You know, men and women both talked about things like knowing their bodies better, knowing each other better, kids being out of the house, so they had privacy, retirement giving people more time to enjoy their relationships, to travel to romantic places or just to get to know each other in a new way. These are some ways in which people felt that getting older was actually good for their intimate sexual lives.

Dr. Peter Brill: In what ways does it not get better?

Dr. Stacy Tessler Lindau: Well, from those early interviews, and we obviously have, now we’ve just completed this national population based study which is really a better way to talk about the data, but I would say the original interview, people talked about things like, you know, illness or medications, treatments for conditions like cancer interfering with their intimate and sexual aspects of their lives. Not always though. We did a study specifically looking at intimacy and sexuality among people with lung cancer, among people and their partners, and people talked about ways in which the intimate parts of their lives actually got better or where they were more appreciated once one of the partners was diagnosed with a life threatening illness.

Dr. Peter Brill: Isn’t that amazing, you know. You hear that described all the time by people, you know, the quality, you know, the value of living gets much greater when you get clear that it might be taken away from you.

Dr. Stacy Tessler Lindau: Right, how do we instill that feeling, you know, everyday without being sick, you know, the live everyday to its fullest feeling.

Dr. Peter Brill: Well that’s what David and I, you know, in our foundation we’re, we start looking at longevity and the attitudes and behaviors that cause people to live longer and be happier and, you know, we’re trying to find ways to do that. How can you help us with that? What, how do your studies help us?

Dr. Stacy Tessler Lindau: Well, you know, if we look at the national data that we collected in a study called The National Socialized Health and Aging Project, we see that really the majority of adults ages 57 to 85, these are community residing adults, people not living in nursing homes, value sexuality and value this aspect of their life even if they’re not sexually active…

Dr. Peter Brill: Mm hmm.

Dr. Stacy Tessler Lindau: We see that among people with partners, that on average people are having sex once a week, a couple times a month and that this isn’t a whole lot different among sexually active people among the younger part of the population.

Dr. Peter Brill: They’re too busy when they’re young, and they’re too tired when they’re older.

David Debin: That’s a good way…

Dr. Stacy Tessler Lindau: Well I try not to put a judgment on whether that frequency is good or bad, I mean obviously it’s an individual and a couple decision. But I think most people are surprised to find that, you know, if one remains, it’s remaining active and having a partner that really determines whether, the frequency of sexual activity. Now for women, especially older women, many are not active because they don’t have a partner. Women outlive marriage and unfortunately outlive their partners, and so this is a factor that older women have to face. Some have to find ways to substitute for those relationships and some people of course find relationships later in life.

David Debin: You know, I’ve hear conflicting, conflicting figures about this. We know that the average life expectancy for men and women is different, but when you look at the figures there’s only about two years difference in that as I see it. Is that, do you, is that about true?

Dr. Stacy Tessler Lindau: Well, you know, you bring up a really interesting issue, so we have seen that women in the United States on average have a longer lifespan than me and this trend has been going on for years. I, I’m not a expert demographer, but I thought the range was more in the four to seven year difference with women living longer, I think around 84 and men around 77 or 79. But what we’re seeing now is that men are catching up to women in the United States, so the difference in the lifespan is shrinking, and…

David Debin: Yeah, but…

Dr. Stacy Tessler Lindau: and women are not gaining in the US, but if you look at virtually every other industrialized country in the world including Canada, the lifespan of women continues to increase. In the United States it’s not, and I, we need to understand why this is.

David Debin: Well why do, I mean you’re right in there trying to figure among those who are trying to figure out why that is, what do you think is going on, what’s the difference?

Dr. Stacy Tessler Lindau: Well, you know, I think speculating here and stepping outside the kind of interical ways of these things…

Dr. Peter Brill: That’s okay, we’ll forgive you.

David Debin: That’s all we ever do is speculate here.

Dr. Stacy Tessler Lindau: You know, this gets, this is where one starts drawing their own personal experience to explain the way the world is, but, you know it, being a working woman and working mother and having recently had a child, you know, I think the way that we handle women in the workforce in the United States, especially in regards to balancing work with family obligations really is different when we compare ourselves to all the other industrialized nations around the world…

Dr. Peter Brill: Absolutely.

Dr. Stacy Tessler Lindau: And so I wonder to what degree workforce and work related strain and responsibilities may explain to some degree the lack of, you know, the differences in lifespan comparing US women to others.

Dr. Peter Brill: Plus the medical care system which, you know, is heavily focused on pathology and unevenly distributed.

Dr. Stacy Tessler Lindau: Well, you know, I think that that’s right, I think that despite the fact that the vast, that the larger proportion of the population 65 and older are women, you know, really helps research, even demographic research is heavily male centric. You know, we spend a lot of money studying, for example, retirement and how retirement affects health in later life…

David Debin: Lets get to that in a second…

Dr. Stacy Tessler Lindau: Yeah.

David Debin: Actually we’re going to go to a commercial and I’d like to come back and talk about that retirement. So stay with us please Dr. Lindau, and we’ll be right back with The Third Age.

Dr. Peter Brill: Welcome back to The Third Age. I’m one of your co-host’s, Dr. Peter Brill. I’m here with the man from Hollywood, David Debin and Marisa Scobasi. We have our guest today, Stacy Tessler Lindau, MD, who is a rising star in the area of aging research, women’s sexuality, aging people sexuality, and many other topics…

David Debin: And not only sexuality, yeah, aging…

Dr. Peter Brill: I mean you’ve done fabulous, yeah, aging in general.

David Debin: Your resume, we were looking at it…

Dr. Peter Brill: Yeah.

David Debin: It’s just really amazing that the length and breadth of the studies that you’ve done on aging. How did you become so interested in old people like us? You’re a youngster.

Dr. Stacy Tessler Lindau: Well, thank you. I think, you know, we’re all younger than somebody else, so, yeah…

David Debin: That’s a good point. That’s a very good point.

Dr. Stacy Tessler Lindau: And I myself being almost 40 and proud of it, just having had a baby, I think of myself as geriatric obstetrics person…

David Debin: Uh huh.

Dr. Stacy Tessler Lindau: being an OBGYN and interested in geriatrics. But, you know, I had three terrific grandparents who loved life and I think really set an example for me for what, for how wonderful aging could be. I had terrific mentors in medical school who were very devoted to the field of geriatrics and really understood the massive and unprecedented shift in the population of the United States, you know, that we’re facing, and I feel like it’s a population that has been not appropriately respected in terms of their health care and their social needs and so I’m motivated to do something about that.

David Debin: So you grew up with great models of aging. Do you think that if more people had grown up with better models of aging people would be a little bit more happy and less infirm, live longer have more joy in life?

Dr. Stacy Tessler Lindau: Well, I, you know, I think that’s an interesting hypothesis. I certainly think that to, you know, our hopes and expectations for our lives are largely shaped by, by examples set before us, so I think that’s very possible. You know, one of my mentors is Dr. Robert Butler…

Dr. Peter Brill: Oh, sure, yeah.

Dr. Stacy Tessler Lindau: who is, he was…

Dr. Peter Brill: He’s been on this show.

Dr. Stacy Tessler Lindau: Oh has he?

Dr. Peter Brill: Yeah.

Dr. Stacy Tessler Lindau: Well I’m not surprised, he’s a champion of the issues that concern you, and…

Dr. Peter Brill: Yeah.

Dr. Stacy Tessler Lindau: he and his late wife, Merna Lewis, wrote the first really widespread book on sexuality in later life. In any case, he coined the term, as you know, ‘agism’…

Dr. Peter Brill: Mm hmm.

Dr. Stacy Tessler Lindau: And, really. he talked about, you know, negative views of aging in the same way that we think about racism or sexism, and I think although he coined that term back in the late 60’s, we’re still very much struggling with that phenomenon. People are scared of getting older because, you know, getting older means getting closer maybe to the end of one’s life.

David Debin: It also means, it also means because of what we experience being discounted to a great degree, being undervalued, you know. People feel that they become invisible sometimes as they get older.

Dr. Stacy Tessler Lindau: And people talk about that, people I’ve interviewed and patients have talked about, especially women, the experience of physically getting shorter due to bone loss…

David Debin: Mm hmm.

Dr. Stacy Tessler Lindau: becoming less visible, you know, I’ve had people talk about sitting at the table in a restaurant, you know, their upper body feels so short they almost feel like a child sitting at the table, and frankly we need to think about the way older people feel and interact with the world socially because they’re such a huge portion of our population. And I think that, you know, if nobody else does, entrepreneurs will take note of this quickly and start changing the world, you know, the infrastructure in a way that people can get around and enjoy life to the fullest.

Dr. Peter Brill: Let me ask you a question that I, part of your research has been about social networks or social support…

Dr. Stacy Tessler Lindau: Yup.

Dr. Peter Brill: with aging. Can you take us through some of that? I’ll tell you what has me interested, well I’m interested obviously as a psychiatrist, but it’s also a phenomenon that I’ve seen in our groups, which is some of these women, and I’ve seen it in some of the talks we give when I’ve asked them, some of these women literally have no one who ever touches them. They don’t have anybody who holds them, they don’t have anybody who hugs them…

Dr. Stacy Tessler Lindau: Right.

Dr. Peter Brill: and I wonder, you know, about the social connections and how that affects aging and people’s happiness.

Dr. Stacy Tessler Lindau: Yeah. You know, the study that we conducted with support from the National Institutes of Health I think is very, very unique in the depths of the information we obtained about people’s social relationships. The investigators of this study were intridous tailored group of people including sociologists and physicians and others, and really my sociology colleagues are the experts in the area of social networks and social support, but what I’ve learned from working with them is not, is probably something you wouldn’t find surprising, is that the more social support people have, the stronger their social networks, the healthier they are or the better they are able to cope with illness. And so finding ways to strengthen those relationships is important. We also, you know, we ask a lot of questions about sexuality in the study, but we also ask people questions about non sexual physical intimacy, questions like the ones you were just mentioning. You know, how often do you hug another adult or snuggle with a grandchild or, you know, these kinds of activities, and then we’ll be able to look at how, we haven’t yet analyzed those in detail, but we’ll be able to look at how those non sexual kinds of physical contact are, what they do for health in later life because those are interventions people can use if, you know, we find ways to connect older people with younger people or with pets or other things, those are things we can do to help improve quality of life and reduce loneliness as people get older.

Dr. Peter Brill: Or maybe we just need some groups where people come and they hug each other.

Dr. Stacy Tessler Lindau: Well that sounds good to me.

David Debin: That’s what, that’s what our groups do anyway, you know…

Dr. Peter Brill: Yeah, they do before every group, you know, people hug each other on the way in and the way out, but…

David Debin: People come in and they look forward to it because, you know, it’s that, it’s that contact. You know, there’s a wonderful spiritual leader from India, Amma, Amma G…

Dr. Stacy Tessler Lindau: Mm hmm.

David Debin: I know, I’m sure you know who that is, and she’s sort of like a Mother Teresa, but she’s rounder, you know, bigger. But she, she’s, everybody goes to her and they get this incredible hug, you know, and that’s what it’s all about, did you get hugged by Amma G, and what is that, why do people line up for hours and hours and go to these huge gatherings just to get a hug from this person? Because there’s something in that physical contact…

Dr. Peter Brill: Or does somebody call you when you’re sick? Does somebody show up and bring you things? Do you feel that there’s somebody out there who cares about you?

Dr. Stacy Tessler Lindau: Right, and these are questions that we have to, I want to get back to the hug…

David Debin: Yeah.

Dr. Stacy Tessler Lindau: because it touches on something that we’re really interested in and the study that we recently did is so unique for this reason. We wonder how it is that social relationships, hugs, friends, sexual partners, how do those relationships get under the skin, so to speak, to affect somebody’s health?

Dr. Peter Brill: Yes, exactly.

Dr. Stacy Tessler Lindau: How does a hug changes somebody’s physiology or their biology?

Dr. Peter Brill: Yes, yes.

Dr. Stacy Tessler Lindau: And that’s the, that’s where we can go with this data set, because not only did we ask people questions, we collected all kinds of biological measures including measures of sensory function, like a sense of smell, sense of touch, sense of taste, and we’ll be able to look at whether those aspects of sensory function are different in people who have close social relationships or good sexual relationships versus people who don’t have those relationships…

Dr. Peter Brill: Well I can’t wait…

Dr. Stacy Tessler Lindau: So that’s a really exciting feat.

Dr. Peter Brill: Well I can’t wait ‘til the results come out, I’ve wondered that all the time myself. We’ll give you a chance, we did a lot on sexuality last week. We had a lady in here who, who’s written a really good book, Is It Hot In Here or Am I Just Hot?

Dr. Stacy Tessler Lindau: I need to read that one.

Dr. Peter Brill: Yeah, it’s really a good book and she’s very practical and has a lot of good advice, you know, one of these people who kind of just reads everything, and… Hey, well lets quote a little bit from your study on sexuality, we’ll give you a chance to. Go ahead. What are the percentages of people who are socially active at various ages and how does it differ from between men and women?

Dr. Stacy Tessler Lindau: So we see that, you know, sexually, among sexually active people there are more men than there are women, but overall about 75 percent of people said that they had a spouse or other intimate relationship, and about 75 percent of those said that they were sexually active within the last 12 months with their partner. Like I said, men were more likely to have a partner than women at all ages, and of those who were sexually active about half of men and women reported that they had at least one sexual problem that they would regard as bothersome. Now that’s not good because among all those people who weren’t sexually active we expect some of them stopped being active because of problems, so we think that, you know, half the population in this age group with a sexual problem is probably an underestimate. And not surprisingly we see among men that erectile difficulties are the most prevalent problems and they affect other types of functions, such as ability to experience orgasm and satisfaction with their sex life. For women the problems were more diffuse. More than a third of women reported being bothered by having low desire, women reported having difficulty with vaginal lubrication, and about a third reported that they had an inability to experience orgasm. These are high numbers, and even among people who are sexually active and with problems, it was the minority who had ever talked to a physician about these problems.

David Debin: Before you go on we’re going to have to jump into a break, but…

Dr. Peter Brill: We’ll have to break up…

David Debin: you got Peter all ready to go. Maybe since you started talking about orgasms and Peter, now he’s…

Dr. Peter Brill: Yeah, something got me interested.

David Debin: he took a deep breath and he started to ask a question. We’re enjoying this conversation with Dr. Lindau. It’s David Debin, Peter Brill. We’ll be right back with The Third Age.

Dr. Peter Brill: Welcome back to The Third Age. I’m one of your co-host’s, Dr. Peter Brill. I’m here with the man from Hollywood, David Debin and Marisa Scobasi. We have our guest today, Stacy Tessler Lindau, MD, who is a rising star in the area of aging research, women’s sexuality, aging people sexuality, and many other topics…

David Debin: And not only sexuality, yeah, aging…

Dr. Peter Brill: I mean you’ve done fabulous, yeah, aging in general.

David Debin: Your resume, we were looking at it…

Dr. Peter Brill: Yeah.

David Debin: It’s just really amazing that the length and breadth of the studies that you’ve done on aging. How did you become so interested in old people like us? You’re a youngster.

Dr. Stacy Tessler Lindau: Well, thank you. I think, you know, we’re all younger than somebody else, so, yeah…

David Debin: That’s a good point. That’s a very good point.

Dr. Stacy Tessler Lindau: And I myself being almost 40 and proud of it, just having had a baby, I think of myself as geriatric obstetrics person…

David Debin: Uh huh.

Dr. Stacy Tessler Lindau: being an OBGYN and interested in geriatrics. But, you know, I had three terrific grandparents who loved life and I think really set an example for me for what, for how wonderful aging could be. I had terrific mentors in medical school who were very devoted to the field of geriatrics and really understood the massive and unprecedented shift in the population of the United States, you know, that we’re facing, and I feel like it’s a population that has been not appropriately respected in terms of their health care and their social needs and so I’m motivated to do something about that.

David Debin: So you grew up with great models of aging. Do you think that if more people had grown up with better models of aging people would be a little bit more happy and less infirm, live longer have more joy in life?

Dr. Stacy Tessler Lindau: Well, I, you know, I think that’s an interesting hypothesis. I certainly think that to, you know, our hopes and expectations for our lives are largely shaped by, by examples set before us, so I think that’s very possible. You know, one of my mentors is Dr. Robert Butler…

Dr. Peter Brill: Oh, sure, yeah.

Dr. Stacy Tessler Lindau: who is, he was…

Dr. Peter Brill: He’s been on this show.

Dr. Stacy Tessler Lindau: Oh has he?

Dr. Peter Brill: Yeah.

Dr. Stacy Tessler Lindau: Well I’m not surprised, he’s a champion of the issues that concern you, and…

Dr. Peter Brill: Yeah.

Dr. Stacy Tessler Lindau: he and his late wife, Merna Lewis, wrote the first really widespread book on sexuality in later life. In any case, he coined the term, as you know, ‘agism’…

Dr. Peter Brill: Mm hmm.

Dr. Stacy Tessler Lindau: And, really. he talked about, you know, negative views of aging in the same way that we think about racism or sexism, and I think although he coined that term back in the late 60’s, we’re still very much struggling with that phenomenon. People are scared of getting older because, you know, getting older means getting closer maybe to the end of one’s life.

David Debin: It also means, it also means because of what we experience being discounted to a great degree, being undervalued, you know. People feel that they become invisible sometimes as they get older.

Dr. Stacy Tessler Lindau: And people talk about that, people I’ve interviewed and patients have talked about, especially women, the experience of physically getting shorter due to bone loss…

David Debin: Mm hmm.

Dr. Stacy Tessler Lindau: becoming less visible, you know, I’ve had people talk about sitting at the table in a restaurant, you know, their upper body feels so short they almost feel like a child sitting at the table, and frankly we need to think about the way older people feel and interact with the world socially because they’re such a huge portion of our population. And I think that, you know, if nobody else does, entrepreneurs will take note of this quickly and start changing the world, you know, the infrastructure in a way that people can get around and enjoy life to the fullest.

Dr. Peter Brill: Let me ask you a question that I, part of your research has been about social networks or social support…

Dr. Stacy Tessler Lindau: Yup.

Dr. Peter Brill: with aging. Can you take us through some of that? I’ll tell you what has me interested, well I’m interested obviously as a psychiatrist, but it’s also a phenomenon that I’ve seen in our groups, which is some of these women, and I’ve seen it in some of the talks we give when I’ve asked them, some of these women literally have no one who ever touches them. They don’t have anybody who holds them, they don’t have anybody who hugs them…

Dr. Stacy Tessler Lindau: Right.

Dr. Peter Brill: and I wonder, you know, about the social connections and how that affects aging and people’s happiness.

Dr. Stacy Tessler Lindau: Yeah. You know, the study that we conducted with support from the National Institutes of Health I think is very, very unique in the depths of the information we obtained about people’s social relationships. The investigators of this study were intridous tailored group of people including sociologists and physicians and others, and really my sociology colleagues are the experts in the area of social networks and social support, but what I’ve learned from working with them is not, is probably something you wouldn’t find surprising, is that the more social support people have, the stronger their social networks, the healthier they are or the better they are able to cope with illness. And so finding ways to strengthen those relationships is important. We also, you know, we ask a lot of questions about sexuality in the study, but we also ask people questions about non sexual physical intimacy, questions like the ones you were just mentioning. You know, how often do you hug another adult or snuggle with a grandchild or, you know, these kinds of activities, and then we’ll be able to look at how, we haven’t yet analyzed those in detail, but we’ll be able to look at how those non sexual kinds of physical contact are, what they do for health in later life because those are interventions people can use if, you know, we find ways to connect older people with younger people or with pets or other things, those are things we can do to help improve quality of life and reduce loneliness as people get older.

Dr. Peter Brill: Or maybe we just need some groups where people come and they hug each other.

Dr. Stacy Tessler Lindau: Well that sounds good to me.

David Debin: That’s what, that’s what our groups do anyway, you know…

Dr. Peter Brill: Yeah, they do before every group, you know, people hug each other on the way in and the way out, but…

David Debin: People come in and they look forward to it because, you know, it’s that, it’s that contact. You know, there’s a wonderful spiritual leader from India, Amma, Amma G…

Dr. Stacy Tessler Lindau: Mm hmm.

David Debin: I know, I’m sure you know who that is, and she’s sort of like a Mother Teresa, but she’s rounder, you know, bigger. But she, she’s, everybody goes to her and they get this incredible hug, you know, and that’s what it’s all about, did you get hugged by Amma G, and what is that, why do people line up for hours and hours and go to these huge gatherings just to get a hug from this person? Because there’s something in that physical contact…

Dr. Peter Brill: Or does somebody call you when you’re sick? Does somebody show up and bring you things? Do you feel that there’s somebody out there who cares about you?

Dr. Stacy Tessler Lindau: Right, and these are questions that we have to, I want to get back to the hug…

David Debin: Yeah.

Dr. Stacy Tessler Lindau: because it touches on something that we’re really interested in and the study that we recently did is so unique for this reason. We wonder how it is that social relationships, hugs, friends, sexual partners, how do those relationships get under the skin, so to speak, to affect somebody’s health?

Dr. Peter Brill: Yes, exactly.

Dr. Stacy Tessler Lindau: How does a hug changes somebody’s physiology or their biology?

Dr. Peter Brill: Yes, yes.

Dr. Stacy Tessler Lindau: And that’s the, that’s where we can go with this data set, because not only did we ask people questions, we collected all kinds of biological measures including measures of sensory function, like a sense of smell, sense of touch, sense of taste, and we’ll be able to look at whether those aspects of sensory function are different in people who have close social relationships or good sexual relationships versus people who don’t have those relationships…

Dr. Peter Brill: Well I can’t wait…

Dr. Stacy Tessler Lindau: So that’s a really exciting feat.

Dr. Peter Brill: Well I can’t wait ‘til the results come out, I’ve wondered that all the time myself. We’ll give you a chance, we did a lot on sexuality last week. We had a lady in here who, who’s written a really good book, Is It Hot In Here or Am I Just Hot?

Dr. Stacy Tessler Lindau: I need to read that one.

Dr. Peter Brill: Yeah, it’s really a good book and she’s very practical and has a lot of good advice, you know, one of these people who kind of just reads everything, and… Hey, well lets quote a little bit from your study on sexuality, we’ll give you a chance to. Go ahead. What are the percentages of people who are socially active at various ages and how does it differ from between men and women?

Dr. Stacy Tessler Lindau: So we see that, you know, sexually, among sexually active people there are more men than there are women, but overall about 75 percent of people said that they had a spouse or other intimate relationship, and about 75 percent of those said that they were sexually active within the last 12 months with their partner. Like I said, men were more likely to have a partner than women at all ages, and of those who were sexually active about half of men and women reported that they had at least one sexual problem that they would regard as bothersome. Now that’s not good because among all those people who weren’t sexually active we expect some of them stopped being active because of problems, so we think that, you know, half the population in this age group with a sexual problem is probably an underestimate. And not surprisingly we see among men that erectile difficulties are the most prevalent problems and they affect other types of functions, such as ability to experience orgasm and satisfaction with their sex life. For women the problems were more diffuse. More than a third of women reported being bothered by having low desire, women reported having difficulty with vaginal lubrication, and about a third reported that they had an inability to experience orgasm. These are high numbers, and even among people who are sexually active and with problems, it was the minority who had ever talked to a physician about these problems.

Dr. Peter Brill: You said, was it a third of women are inorgasmic in their later years? Is that what you said the number was? I missed it.

Dr. Stacy Tessler Lindau: Yeah, well, we, what we see is that a third of women who are sexually active, meaning they have a partner, report that they have an inability to experience orgasm.

Dr. Peter Brill: What percentage would report that lets say at age 25 or age 40?

Dr. Stacy Tessler Lindau: You know, that’s a great question. The latest data we have on that are data from 1992, so they’re nearly fifteen years old, makes it hard to say what women today would say about that. The number is somewhat lower, but not shockingly lower.

Dr. Peter Brill: Yeah, that’s what I thought. ‘Cause we used to run all these groups for inorgasmic women when I was at Penn, and there were a large number, but that was a number of years ago.

Dr. Stacy Tessler Lindau: You know an interesting thing about, a difference among women versus men is that when you as a woman whether or not she’s ever had an orgasm, some actually reply with, “I’m not sure.”

Dr. Peter Brill: I know.

Dr. Stacy Tessler Lindau: “I don’t know”.

Dr. Peter Brill: That means no.

Dr. Stacy Tessler Lindau: Well you ask men this, but you ask men this, well I don’t know, it’s funny, I had the same conversation yesterday, I mean, you ask men that question and they know…

Dr. Peter Brill: Yes.

Dr. Stacy Tessler Lindau: yes or no if they’ve ever had an orgasm, you know, some women experience orgasm, but it doesn’t match up to what their expectations are given what they see on TV or read in books or hear when they talk to friends, and so they’re not sure that what they’re experiencing is, you know, they don’t know if it’s an orgasm but not such a great one or, you know, if they’re not experiencing one, I don’t think it’s, you know, it’s not the women…

Dr. Peter Brill: How do you know they’re experiencing it if they don’t?

Dr. Stacy Tessler Lindau: Well I think that’s a very good question. I mean, some researchers have done physiological studies and other things…

Dr. Peter Brill: Yeah, no, Masters and Johnson, yeah.

Dr. Stacy Tessler Lindau: Yeah. But it is, it’s a difficult thing to know and one of the difficulties of doing sexuality research of course is how do we best objectively measure many of the things we’re trying to study.

Dr. Peter Brill: One of the things that came up in our group, which, in groups of where women who didn’t have partners, and we would have these long discussions with them about whether they needed to be in love with people, because they felt that unless they were in a committed relationship they couldn’t have sex.

Dr. Stacy Tessler Lindau: Mm hmm.

Dr. Peter Brill: I don’t know, do you have an opinion about that? I guess you can’t have, I’m asking the clinician now…

David Debin: She’s married and she has a child. You’re asking her if she can have sex…

Dr. Peter Brill: She’s also an OB, yeah, right. She’s an OBGYN, people come to here, they’re going to ask these questions.

Dr. Stacy Tessler Lindau: You know, I try to stay, you know, when it comes to talking about sexuality, I think we have to be very careful about, you know, prescribing what’s normal, what are normal expressions of sexuality. I think we, I try to stay in a range of what feels good to an individual, what feels like respectful sexual relationships, what feels positive. You know, it’s very difficult to render judgment, but I will say among older women many are faced with the option of having sex with somebody, you know, with whom they’re not married or not having sex at all…

Dr. Peter Brill: Exactly.

Dr. Stacy Tessler Lindau: and this is a reality of later life sexuality, so I certainly, I wouldn’t want to impose…

Dr. Peter Brill: We certainly won’t want to condemn them, would we?

Dr. Stacy Tessler Lindau: We wouldn’t want to condemn them, and I wouldn’t want to impose marriage as a requirement in order to be able to experience intimacy and sexuality in later life. And part of the reason, some women would like to marry their new partners in later life, but, you know, families and children get involved and they worry about the implications for them, should their parents remarry, and you know, in some cases older people hide their intimate relationship from their family because of these types of concerns, and I see that as a real shame and a way in which people, older people aren’t able to experience the full value of these relationships in later life.

Dr. Peter Brill: You know what we also found is that a fairly hefty percentage of people are alienated from one or more of their adult children. It ranges something in 50 to 70 percent.

Dr. Stacy Tessler Lindau: Really?

Dr. Peter Brill: Yeah. And so, they, alienated in the sense they see them maybe once a year or they’ve lost contact with them or…

Dr. Stacy Tessler Lindau: Wow, that’s a high number.

Dr. Peter Brill: It’s really sad.

Dr. Stacy Tessler Lindau: Mm hmm.

David Debin: It’s a very high number.

Dr. Peter Brill: It’s one or more, I mean it may just be one.

David Debin: Yeah.

Dr. Stacy Tessler Lindau: Right. That’s a high number. Well, you know, spousal relationships and children are very for people as they get older…

Dr. Peter Brill: Yes.

Dr. Stacy Tessler Lindau: especially when it comes time to make important decisions about health or if it comes to the situation where you need somebody to make the decision for you when you can’t make them, and older women are often time experience late life illness and face death and dying without their most important life partner. You know, men tend to have partners throughout their life and have a wife or an important relationship by their side through illness, women, more often than not, don’t have these kinds of support.

Dr. Peter Brill: Yeah, that was part of my marriage contract with my wife.

Dr. Stacy Tessler Lindau: That she, that you out, she outlive you?

Dr. Peter Brill: Yes, I get to die first.

David Debin: Do you? Go on.

Dr. Stacy Tessler Lindau: It is interesting that we sometimes see cases where partners of a couple die just within a few days of each other.

Dr. Peter Brill: Yeah…

David Debin: Oh yeah, that’s…

Dr. Peter Brill: Much more than chance, but, you know…

David Debin: I’ll tell you something else that we found out, which is a really, was really an eye opener to me. We found out from directors of memorial homes and cemeteries that there is, more people die during the months of February, March and April than any other month. February and March…

Dr. Peter Brill: You want to avoid the income tax?

David Debin: February, no, February and March, no, this is a, this is a, I’m talking about a statistic…

Dr. Peter Brill: Yeah, what explains it?

David Debin: February and March more people die.

Dr. Stacy Tessler Lindau: So why do you think that is?

Dr. Peter Brill: Yeah.

David Debin: Well, I don’t know what it is, I heard one opinion ventured yesterday by a woman who has a memorial home and she said she thinks it’s because people, if they’re getting, if they’re getting to the point where they’re, where they’re terminal they will put off their death until that, the holidays are over…

Dr. Peter Brill: Yeah.

David Debin: You know, they want to be with their family for that last…

Dr. Peter Brill: families, last time.

David Debin: that last time…

Dr. Stacy Tessler Lindau: Mm hmm.

David Debin: and for some reason, and for some reason then everybody starts to go, and it is a very common thing where a long, in a long term relationship the spouse follows very shortly in death.

Dr. Peter Brill: By the way, one inspiring thing we found in some of these, we had a couple people on from a nursing home in the area and one was I think at 85, one was almost 90 I think, and…

David Debin: Oh yeah, right.

Dr. Peter Brill: and both of them were in love. They found partners in the nursing homes that they fell in love with.

Dr. Stacy Tessler Lindau: Mm hmm.

David Debin: Yes.

Dr. Peter Brill: Now isn’t that inspiring?

Dr. Stacy Tessler Lindau: Well I think it’s, I think there’s a growing reality, and it’s interesting that you bring that up because the first, the earliest research about sexuality in later life, in the medical literature, heavily focuses on the quote/unquote “problem” of sexuality inside nursing homes.

Dr. Peter Brill: Yeah.

Dr. Stacy Tessler Lindau: What are staff to do if residents pursue sexual contact with staff, with nurses or other people? What are staff to do if residents fall in love and want to have sexual relationships inside the nursing home where people don’t have privacy? And this is really regarded as, on the one hand a problem for staff to deal with, on the other hand a human rights issue. Shouldn’t people in their, in their homes, whether it’s in an institution or a private home, be able to express themselves sexually and have the privacy to do so?

Dr. Peter Brill: Absolutely. As far as I’m concerned, absolutely. I’ll come down, I don’t see, I don’t have to do it from research, I could just stay here.

Dr. Stacy Tessler Lindau: Well, you know, it’s a human rights issue…

Dr. Peter Brill: Absolutely.

Dr. Stacy Tessler Lindau: and interestingly, I don’t know if you saw this, Sandra Day O’Connor, there was a story about her and her husband in the New York Times not long ago, and she talked about her husband finding new love in a nursing home…

Dr. Peter Brill: Yes.

David Debin: Yes, and…

Dr. Stacy Tessler Lindau: That was very impressive.

David Debin: And there’s a picture, and there’s that picture Away From Her with Julie Christie, which is, she’s up for an Academy Award for that.

Dr. Stacy Tessler Lindau: Right, right, and this is a growing reality.

David Debin: Yes it is.

Dr. Stacy Tessler Lindau: Yup.

David Debin: We want to thank you Dr. Stacy Tessler Lindau, and we want to ask you if there’s, any of our listeners are interested in more of the knowledge you’ve gained, is there a website they can go to or something?

Dr. Stacy Tessler Lindau: Well wouldn’t it be great if I had my own website, they can…

Dr. Peter Brill: Yeah, I looked for it this morning.

Dr. Stacy Tessler Lindau: I do. I have a web page, which is my humble research web page at the University of Chicago, so if they search by my name on the University of Chicago, they’ll find me there.

David Debin: Okay…

Dr. Stacy Tessler Lindau: And…

David Debin: And you’re writing a book now?

Dr. Stacy Tessler Lindau: I’m working on writing which is a tremendous challenge, but yes, I’m working on it and you’ll be among the first to know since I know how interested you are. But the article that we wrote is published in the New England Journal of Medicine in August of last year, and I’m happy to share that with anybody who’s interested.

David Debin: Well thank you for spending the time with us. We really enjoyed the conversation.

Dr. Stacy Tessler Lindau: Thank you, thank you so much. It’s been a joy.