The sexual role models that we conventionally see are 18- to 30-year-old people. We seldom have a picture or vision of 60-, 70-, 80-, or 90-year-old people enjoying sex. Society in general and particularly the medical community is guilty of assuming that when you retire from your job, you also retire from your love life and your sexual life.

Young people often act as if they invented sex. However, according to a recent anonymous questionnaire of men and women from ages 80 to 102, sexual activity was so common that perhaps the role model for intimacy should be shifted from young people.

One of the problems with sex is the false image conveyed by our "R"-rated movies that seem to specialize in heavy breathing, thumping bed springs, and sensual, sweating, moaning young bodies that turn intimacy into an athletic performance. Actually, good meaningful sex is less perfor-mance-oriented. It can be done very quietly without much hubbub. If sex enhances you as a person and enhances the other person and enhances your togetherness, then it's a good thing. It really doesn't make much difference whether or not you have had an orgasm, or if you did it in 12 different positions, or even if you had an erection or whatever. Sex is a close, intimate, loving relationship between a man and a woman who are unafraid of doing the things that please each other.

WHAT ABOUT SEXUALITY IN LATER LIFE: Most older people are able to lead an active, satisfying sex life. Older women do not usually lose their physical capacity for orgasm, nor do older men lose their capacity for erection and ejaculation. However, we can expect a gradual slowing of response in the physical body. When problems occur, they are usually the result of disease, disability, drug reaction, or emotional upset.

Those changes that do occur in women (shape, flexibility, and lubrication of the vagina) can be traced directly to lowered levels of the hormone estrogen during and after menopause.

Older men may take somewhat longer to attain an erection than when young. The erection may not be quite as firm or as large as in earlier years. There can be a shorter ejaculation sensation, the loss of erection following orgasm may be more rapid, and a longer period of time passes before an erection is again possible.

EFFECTS OF ILLNESS OR DISABILITY: Even the most serious diseases rarely warrant stopping sexual activity. Here are some that are used as an excuse:

• HEART DISEASE, especially if a heart attack has occurred, leads many older people to give up sex for fear of causing another attack. The risk is low; in fact, an active sex life may decrease the risk of a future attack.

• DIABETES is one of the few diseases that can cause impotence. Once diabetes is diagnosed and controlled, however, potency in most cases may be restored.

• STROKE rarely damages physical aspects of sexual function, and it is unlikely that sexual exertion will cause another stroke. Using different positions or medical devices that assist body functions can help make up for any weakness or paralysis that may have occurred.

• ARTHRITIS can produce pain that limits sexual activity. Surgery and drugs can relieve these problems, but in some cases the medicines used can decrease sexual desire. Exercise, rest, warm baths, and changes in position and timing of sexual activity (such as avoiding evening and early-morning hours of pain) can be helpful.

• HYSTERECTOMY, if performed correctly, does not harm sexual functioning. Those women who believe that they have been damaged by a hysterectomy, or men who consider their partners "less feminine" after this surgery, should seek counseling. The same is true of mastectomy.

• PROSTATECTOMY rarely affects potency. Except for a lack of seminal fluid, sexual capacity and enjoyment after a prostatectomy should return to the presurgery level.

• ALCOHOL reduces potency in men and delays orgasm in women. It is the most widespread drug-related cause of sexual problems. Tranquilizers, antidepressants, and certain high blood pressure drugs can cause impotence; other drugs can lead to failure to ejaculate in men and reduced sexual desire in women.

• EMOTIONAL problems. Remember, all men are impotent at times due to tiredness, tension, illness, or alcohol. Usually, potency returns by itself, but if a man is too worried he may continue to be impotent due to his fear alone.
  
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