June 8, 2023

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Sex after 60 or 70 can be just as satisfying: 6 tips from a sex therapist : Shots

4 weeks ago Sechan

Older people can enjoy great sex but it starts with believing it’s possible — and communicating when you need to adapt your approach.

LWA-Dann Tardif/Getty Images


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LWA-Dann Tardif/Getty Images

Older people can enjoy great sex but it starts with believing it’s possible — and communicating when you need to adapt your approach.

LWA-Dann Tardif/Getty Images

A lot of people anticipate enjoying their golden years – but what does that look like? Time for hobbies, travel, spoiling your grandkids? What about great sex?

A study published last month in The Gerontologist looks at how well our sexual expectations match up with reality over time.

This story was adapted from the April 30 edition of NPR Health, a newsletter covering the science of healthy living. To get more stories like this delivered to your in-box, click here to subscribe.

As part of the MIDUS (Midlife in the US) study, hundreds of partnered adults ages 45 and up were asked to rate how satisfying they expected their sex lives to be 10 years in the future. Researchers then checked in with the participants a decade later.

Their findings seem to demonstrate the power of positive thinking.

Participants who were optimistic about their sex lives reported having significantly more frequent and more satisfying sex than those who had lower expectations. Also, “sexually optimistic” individuals who acquired physical limitations they didn’t have ten years before – such as pain that made it harder to lift groceries or exercise – reported having more frequent sex than people who had lower sexual expectations and no such limitations.

Natalie Wilton, a therapist who specializes in senior sexuality, says it’s no surprise that people feel pessimistic about sex as they age.

“As a society, we buy into a lot of those really dangerous tropes and stereotypes, which make it very difficult for older adults to feel open about talking about sex. Like that dirty old man’s stereotype, or the woman as a cougar, or even kind of infantilizing. We see two older adults and we’ll be like, oh, cute! They’re holding hands, right? Or when they do anything related to sex, we’re like, oh, that’s weird.”

She says these kinds of norms discourage discussion of healthy sexuality for older folks, which can hold them back when they may need to adapt their approach in bed.

Lubrication And Lots Of Communication: Navigating A New Sexual Life After Menopause

Wilton helps clients navigate the changes in their bodies – and keep their sex lives thriving. “I’m always amazed at how people are surprised about talking about sex and older adults, like it’s always this great revelation,” she says. “If something was really good right now, why would you want it to stop?”

With some adjustments, she says, there’s no reason to leave sexual satisfaction in the past. Here’s some of her advice.

1. Slow your roll

One big piece of advice she offers is planning for more time for sex. As we age, our sexual response cycle – the time it takes to become aroused before and between

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3 min read

Is involuntary psychiatric commitment making a policy comeback? : Shots

2 months ago Sechan

A homeless encampment along a street in Skid Row on Dec. 14, 2022 in Los Angeles, California. Two days earlier, LA Mayor Karen Bass declared a state of emergency regarding homelessness in the city, where an estimated 40,000 residents are unhoused.

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A homeless encampment along a street in Skid Row on Dec. 14, 2022 in Los Angeles, California. Two days earlier, LA Mayor Karen Bass declared a state of emergency regarding homelessness in the city, where an estimated 40,000 residents are unhoused.

Mario Tama/Getty Images

Many of Portland’s least fortunate live in tents pitched on sidewalks or in aging campers parked in small convoys behind grocery stores.

High housing costs and financial adversity are the primary root causes behind the burgeoning population on the streets; only about one in three people who are homeless in Portland report having a mental illness or a substance use disorder, or both.

But the combination of homelessness with substance use or untreated mental illnesses has led to a lot of very public tragedies.

People with schizophrenia, for example, have died of hypothermia on the city’s streets. Residents have given birth out in the open, to premature infants who did not survive. Methamphetamine, cheaper and more harmful than it used to be, is creating a heightened risk of overdose and psychosis.

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Mental illness can be part of the story of how a person ends up homeless — or part of the price of survival on the streets, where sleep and safety are scarce. Unsheltered residents in Portland die thirty years earlier than the average American, according to county data.

These grim realities have ratched up the pressure on politicians to do something.

In Oregon, some politicians, including Portland mayor Ted Wheeler, have proposed changing civil commitment law, so doctors have more leeway in compelling treatment for patients who are too sick to know they need care.

Without such changes, they argue, people with untreated addictions or mental illnesses are stuck cycling between the streets, county jails, and state psychiatric hospitals.

Private opulence, public squalor: How the U.S. helps the rich and hurts the poor

“I think we can do better by people than allowing them to flounder,” says Janelle Bynum, a state legislator who represents suburbs east of Portland.

Bynum was the sole Democrat to sign on to a pair of bills, introduced by Republicans earlier this year, that would expand the criteria for involuntary commitment in Oregon. “My intention was to signal how cruel I think our current system is,” she says.

As multiple crises spill into streets, calls for change

Half of the country’s unsheltered people live in California, and though only about a quarter or third of them are estimated to have a serious mental illness, they are the ones residents are most likely to encounter in California’s cities. Mayors from San Francisco, San Jose, and San Diego have all expressed frustration that the threshold for psychiatric intervention is too high.

“When I’m often asked, ‘Mayor, why aren’t you doing something about this

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3 min read

Inflation and money woes are forcing Americans to delay medical care : Shots

3 months ago Sechan

Substitute teacher Crystal Clyburn, 51, doesn’t have health insurance. She got her blood pressure checked at a health fair in Sarasota, Fla.

Stephanie Colombini/WUSF


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Substitute teacher Crystal Clyburn, 51, doesn’t have health insurance. She got her blood pressure checked at a health fair in Sarasota, Fla.

Stephanie Colombini/WUSF

At a health-screening event in Sarasota, Florida, people milled around a parking lot waiting their turn for blood pressure or diabetes checks. The event was held in Sarasota’s Newtown neighborhood, a historically Black community.

Local resident Tracy Green, 54, joined the line outside a pink and white bus offering free mammograms.

“It’s a blessing, because some people, like me, are not fortunate and so this is what I needed,” she said.

Green said she wanted the exam because cancer runs in her family. And there’s another health concern: her breasts are large and cause her severe back pain. A doctor once recommended she get reduction surgery, she said, but she’s uninsured and can’t afford it.

In a recent Gallup poll, 38% of Americans surveyed said they had put off medical treatment last year due to cost, up from 26% in 2021. The new figure is the highest since Gallup started tracking the issue in 2001.

A survey by The Kaiser Family Foundation last summer showed similar results. It found people were most likely to delay dental care, followed by vision services and doctor’s office visits. Many didn’t take medications as prescribed.

The health screening event is part of an ongoing effort provide health services to low-income Floridians who are uninsured. Attendees could have their blood pressure checked or receive screenings for diabetes. A bus also delivered mammogram services.

Stephanie Colombini/WUSF


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The health screening event is part of an ongoing effort provide health services to low-income Floridians who are uninsured. Attendees could have their blood pressure checked or receive screenings for diabetes. A bus also delivered mammogram services.

Stephanie Colombini/WUSF

The neighborhood screening event in Newtown — organized by the non-profit Multicultural Health Institute in partnership with a local hospital and other health groups — is part of an effort to fill in the coverage gap for low-income people.

Tracy Green explained that her teeth are in bad shape too, but dental care will also have to wait. She doesn’t have health insurance or a stable job. When she can, she finds occasional work as a day laborer through a local temp office.

“I only make like $60 or $70-something a day. You know that ain’t making no money,” said Green. “And some days you go in and they don’t have work.”

If she lived in another state, Green might have been able to enroll in Medicaid. But Florida is one of eleven remaining states that haven’t expanded the program to cover more working-age adults. With rent and other bills to pay, Green says her health is taking a backseat.

“I don’t have money to go to the dentist,

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3 min read

Bringing Medicaid behind bars has wide bipartisan support : Shots

3 months ago Sechan

When he was in prison, Lee Reed was in agonizing back pain. His doctors there told him he needed back surgery, but because he was so close to his release date, they said he’d have to get it done on the outside. Reed saw that surgery as his ticket to being able to get a job and effectively reenter society.

Amy Osborne for Tradeoffs


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Amy Osborne for Tradeoffs

When he was in prison, Lee Reed was in agonizing back pain. His doctors there told him he needed back surgery, but because he was so close to his release date, they said he’d have to get it done on the outside. Reed saw that surgery as his ticket to being able to get a job and effectively reenter society.

Amy Osborne for Tradeoffs

Lee Reed spent his first night after getting out of a state prison sleeping in the stairwell of a parking garage in downtown San Francisco.

Just a few days shy of his 62nd birthday, Reed had nowhere else to go. During his two decades in prison, his mom and wife had died, and he’d lost touch with most of his family.

“I had nothing. I had nobody,” Reed said.

But he wasn’t alone on that first night. He had the same companion he’d had for years: agonizing back pain.

“Imagine somebody standing on your foot, and you can’t stop that pain,” Reed said. “It’s going to be there when you wake up. It’s going to be there when you go to sleep. Half the time I never even got out of bed while I was in prison because I couldn’t stand up, it was so painful.”

Frail people are left to die in prison as judges fail to act on a law to free them

Reed’s doctors in prison told him he needed back surgery, but because he was so close to his release date, they said he’d have to get it done on the outside. Reed saw that surgery as his ticket to being able to get a job and effectively reenter society.

But without health insurance or a support network, being able to do any kind of work seemed impossible as he laid down in the concrete stairwell, his prison-issued walker his only blanket.

“I was tired, and I was literally ready to give up,” Reed said.

Medicaid can be a bridge to a healthy life outside

Around 600,000 people leave prison in the U.S. every year, and another 10 million are released from county jails. Like Reed, many of them suffer from chronic physical, mental and substance use conditions. Research shows they are also at an extremely high risk of hospitalization and death; one study from Washington state found that recently incarcerated people were 12 times more likely to die in their first two weeks after release from prison than the general population.

That’s why in January, federal health officials for the first time signed off on having Medicaid pay for services for some people in state or local jails, prisons or juvenile facilities. The goal is to

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3 min read

Why doctors don’t openly defy abortion laws, even when patients are at risk : Shots

5 months ago Sechan

American Medical Association President Dr. Jack Resneck recently recounted how doctors around the country are facing difficulties practicing medicine in states that ban abortion.

Nicole Xu for NPR


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Nicole Xu for NPR

American Medical Association President Dr. Jack Resneck recently recounted how doctors around the country are facing difficulties practicing medicine in states that ban abortion.

Nicole Xu for NPR

Since Roe v. Wade was overturned, 13 states have banned abortion except in the case of a medical emergency or serious health risk for the pregnant patient. But deciding what cases qualify for a medical exception can be a difficult judgement call for doctors.

News reports and court affidavits have documented how health care workers sometimes deny women abortion procedures in emergency situations – including NPR’s story of a woman who was initially not treated for her miscarriage at an Ohio ER, though she’d been bleeding profusely for hours.

In Missouri, hospital doctors told a woman whose water broke at 18 weeks that “current Missouri law supersedes our medical judgment” and so she could not receive an abortion procedure even though she was at risk of infection, according to a report in the Springfield News-Leader.

That hospital is now under investigation for violating a federal law that requires doctors to treat and stabilize patients during a medical emergency.

And a survey by the Texas Policy Evaluation Project found clinicians sometimes avoided standard abortion procedures, opting instead for “hysterotomy, a surgical incision into the uterus, because it might not be construed as an abortion.”

“That’s just nuts,” Dr. Matthew Wynia says. He’s a physician who directs the Center for Bioethics and Humanities at the University of Colorado. “[A hysterotomy is] much more dangerous, much more risky – the woman may never have another pregnancy now because you’re trying to avoid being accused of having conducted an abortion.”

Her miscarriage left her bleeding profusely. An Ohio ER sent her home to wait

Reports like these prompted Wynia to publish an editorial in the New England Journal of Medicine in September, calling for physicians and leading medical institutions to take a stand against these laws through “professional civil disobedience.” The way he sees it, no doctor should opt to do a procedure that may harm their patient – or delay or deny care – because of the fear of prosecution.

“I have seen some very disturbing quotes from health professionals essentially saying, ‘Look, it’s the law. We have to live within the law,'” he says. “If the law is wrong and causing you to be involved in harming patients, you do not have to live [within] that law.”

These issues have raised a growing debate in medicine about what to do in the face of laws that many doctors feel force them into ethical quandaries.

Medical organizations raise the issue

At the American Medical Association’s November meeting, president Dr. Jack Resneck gave an address to the organization’s legislative body, and recounted how doctors around the country have run into difficulty practicing medicine in states that ban abortion.

“I never imagined colleagues would find

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