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As We Age, Sex Changes (Tuesday, June 7, 2022 at 10:20am)

Margaret, photographed for Relate’s Let’s Talk the Joy of Later Life Sex campaign. Photograph: Rankin/Relate

She (not pictured) came in for her yearly exam.

At age 75, she was doing great, full of gratitude and groundedness. As required by Medicare, there were forms to complete and boxes for me to check off, which can consume most of the visit meant for health and wellness. In my usual contempt for this, I quickly knocked off the “must do” and proceeded to ask her about her heart. Her emotional heart. “I want a partner and to feel love, but that would mean sex and sex outside of marriage is a sin.” Her marriage was rough, abusive and something she avoided since. “Sex only belongs in marriage”.

That took me by surprise. I work so much within a sex positive context that I forgot how this deeply held religious belief system affects people. These values were so ingrained in my patient that it has kept her alone and avoiding men for almost 40 years.

What is sex exactly? The act of penetration? Orgasm? Can intimate touch, naked cuddling, holding hands be sex? Is sex defined as ending with male ejactulation? Is it limited to reproductive activities? And why would God want us to be embodied in this way via a legal document? Why is pleasure a sin?

Sex can be sacred and it also doesn’t need to be. Sex can be orgasmic and it also doesn’t need to be. Sex can involve penetration but it doesn’t have to.

As we age, sex changes. The act considered sinful, a penis penetrating a vagina, while not for everyone, can become more challenging. Hormones change making the vagina drier and smaller without regular use.

Men can lose their ability to maintain an erection and stamina isn’t the same. Sex for my patient would not be easy, she hadn’t been touched in years and would need hormones and pelvic therapy. Yet, the desire for intimacy, touch and pleasure remained.

We want connection, love and pleasure. Our bodies want it as much as our minds. I believe that our souls do too. I’d like to believe that God wants this for us as well and “He” doesn’t require a legal document. By reframing the idea that sex is sinful outside of marriage into intimacy is something God wants for us, maybe a 75 year old woman can find love.

By the end of the visit, she decided that rather than “partner” in which the expectation of sex was implicit (for her) she wanted a “companion” in which it was not. Hand holding, cuddling, and intimate touch felt good. She was ready to allow men back into her life without fear of acting outside of her belief system.

And yes, it was interesting for me to hold space for someone telling me that having sex outside of marriage was sinful.

Much love and blessings,


Feel free to reach out to me, I would love to keep in touch via Instagram @SexMedDoc and @MakeTimeForTheTalk and via Facebook @

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