Sex-Agenarians!

A year or so ago, Dr Rajeev Gupta, a Ludhiana-based psychiatrist practising for the past 20 years, was faced with an unexpected complaint. It was from a wizened grandmother who had come to get her grandson examined. But she also had another complaint. "She took me aside and said, 'Doctorsaab, unko hoshiari nahi aati hai'. I was most surprised by this because till a few years ago it was unthinkable for a rural woman, that too a 70-year-old, to approach a doctor about her husband's erectile dysfunction," says Gupta.

In Ahmedabad, businessman Gopaldas Patel, 63, sought medical help because he perceived a definite decline in his sexual inclinations. "Earlier my wife and I used to make love once a week but now we hardly do it once a month," Patel complained to his doctor. He wanted him to prescribe a medicine to pep up his conjugal life. Having tried various aphrodisiacs, mostly putative ones like palang-tod paan, he had come to believe that his waning sexual competence had to have a more "scientific basis" than vague references to age.

Old age in India, till some years ago, was supposed to be a period of enjoyment. Of the fabled (but fast depleting) fruits of life. But strangely, the list didn't include sex. "It wasn't the culture here," as one sexual problem-struck gentleman puts it succinctly. The culture, however, is changing: cases like those of Gupta and Patel, doctors suggest, are becoming less novel as more and more people in their twilight years are coming to them for help. "In my opinion, today the aged are learning to fight for their sexual rights. The phenomenal increase in the number of older people seeking professional help doesn't mean that they have suddenly discovered sex. It's just that in the past they were mortified to discuss sexual problems, today they are not," explains Dr D. Narayana Reddy, consultant of sexual medicine at Chennai's Apollo Hospital.

Like Vishwanath Dayal, a former government schoolteacher in Delhi. The 78-year-old man is twice widowed, but memories aren't enough to keep him occupied in these twilight years. "I just want to be happy at this point in my life," he says, speaking in the usual language of euphemisms. "Sometimes I wish I could find a woman my age but that I think will remain a pipe dream." Free of old-age afflictions like hypertension and diabetes, Dayal is a part-time book-keeper with an apartment owners' association. It's been two years since his second wife died but his need for sexual intimacy has survived her. He has wet dreams once in a while but, as "there is no outlet", the only person he thinks he can turn to is a sexologist, who will give him a patient hearing and perhaps tell him of a woman similarly afflicted.

It's not as if the old image of self-sacrificing grandparenting is to be jettisoned, only expanded and refined to allow for the fact that old age isn't what years of brahminic conditioning had decreed it to be: a celibate sanyaasaashram. Till recently, sexual concerns of the aged were a grey area. Family physicians were either blushingly tongue-tied about them or actively discouraged people seeking medical intervention. According to Dr Prakash Kothari, whose department of sexual medicine at Mumbai's KEM Hospital revolutionised the way medicine in India looked at the workings of the libido, geriatric sexuality has been a thoroughly neglected area. "Most physicians still have a mental block. They tell their patients things like: 'So what if you can't do it at 62, we stopped at 55'."

But the availability of Indian makes of sildenafil nitrate has inspired hope. Gupta conducted a random survey in Ludhiana which threw up a revelation: not only were the elderly sexually much more enthusiastic than the young, they were also the largest purchasers of Indian erectile dysfunction correctors like Penegra, Caverta, Edegra, Andros, etc and erotic literature off the streets.

In fact, most doctors attribute the interest in prolonging sexual well-being to the rapid viagraisation of Indian society. "Viagra has brought sex from the bedroom into the living room and from there into the sexologist's chamber," jokes sexologist Paras Shah of Ahmedabad. Hard-nosed figures only reinforce the wisdom that the elderly will continue to remain a pharmaceutical goldmine. According to UN projections as quoted by the National Policy on Older Persons, India's current elderly population of 77 million will reach 100 million by 2013 and in 2050 they would constitute 21 per cent of the total population. The same policy statement adds that over 60

per cent of these people can also be expected to be physically fit,

mentally alert and capable of leading an active life. This projection has already started ringing true. "When I can eat well, drink well, why shouldn't I be able to have sex as well?" asks a retired vice-chancellor, a comfortable 65.

On the one hand, the scenario may be that of a late but golden awakening in the sunset years. But the odds against amorous senior citizens are heavy. Rajsekhar Diwakar, 64, a jewellery shop owner in Chennai, learnt about them the hard way. Married for 35 years, Rajsekhar was a happy patriarch living with wife Padma, 57, and his two sons in a four-bedroom bungalow in the city, till the grandchildren came. The grandchildren, aged four and six, were 'adjusted' with Padma in one of the bedrooms, while Rajsekhar was relegated to a first-floor guest room. The senior Diwakar's time of bonding was, therefore, confined to him tiptoeing to his wife's room when the children were asleep. Lovemaking for them became more of a shared vigil rather than the pleasurable exercise they were used to.

Such was the extent of Rajsekhar's frustration that he paid his way to sexual release and in the bargain contracted gonorrhoea. But what was worse was when the family found out Rajsekhar's little secret. "What is the need for him to crave for sex even after the birth of grandchildren? Instead of turning to spiritual matters, he has become a lech. It is a disgrace for the family to have an elder like this," says his elder son Kannan. Padma too shares her son's view. Rajsekhar, meanwhile, is alone in the midst of an acute depression for which he is undergoing psychiatric medication.

Such incidents, however, are not the exception. "Most of the old people who come to me are either severely distressed or disappointed or disgusted with their lives," notes Dr P.L. Khanna, a private consultant of sexual medicine in Delhi. Om Prakash Sharma, a retired government employee, and Kusumlata, both 64, are an example of the prevailing prejudice. Today, after having spent 45 years in each other's company, they share a discord instead of the love and understanding old age is supposed to bring. Sharma, however, takes the problem in a philosophical vein. "Although my wife is not much interested in sex, I don't blame her because I think it is natural for women to lose interest in sex after menopause." The couple sleep in different rooms because Kusumlata thinks that their grown-up children "shouldn't even get a hint" of their being sexually active.
People like Om Prakash and Kusumlata may be nursing their own curious baggage of double standards but they are nowhere close to giving up what nature has intended for them to enjoy till their last day. They are, thanks to the awareness now available to them, eager to surmount their problem. Largely because of therapists like Dr Khanna, who strongly believe that "sex has no expiry date".

But an optimistic outlook like this isn't always enough. Ramesh, 61, and Kamini Viswanathan, 56, had to pay a heavy price for their optimism. The couple's 32-year-old householder son recently moved back to Chennai with his family. Initially, everyone was happy at the thought of the family being together. But the happiness was short-lived. Not only did son and daughter-in-law occupy the seniors' bedroom, they shunted them to the children's quarters. Whatever little moments of togetherness they could manage were between accommodating the children's sleeping schedules.

One night, unable to stand the artificial separation, Ramesh decided to go the whole hog because he was "sick of having sex with clothes on". But as luck would have it, their grandson woke up and started crying. This woke up the granddaughter who also began bawling. In the melee, Kamini got entangled in her saree, tripped over and tore a ligament in her right leg. As she could not get dressed fully, she was discovered by the son and his wife who rushed to the room on hearing the commotion. "I could never forget the look my son and daughter-in-law had, when they realised what had happened," remembers Kamini. "Instead of helping me dress up, my daughter-in-law said that had she found her mother in such a situation she would've had her admitted to a mental asylum." Says a morose Ramesh: "I felt like a criminal in my own house. I wouldn't wish this for my worst enemy."

After attending to Kamini's leg, the junior Viswanathans took the older couple to a doctor to get them treated for their "hyper-sexuality". According to the daughter-in-law, the seniors erred "because they have no work except eating—that is why they've been struck by madam (colloquial for excessive lust)". Says Shah: "People are flabbergasted by the idea of their parents being sexually active. Tragically, older people who express an interest in sex are thought to be either perverts or senile."

If such attitudes reek of insensitivity on the part of the younger lot, there are real medical problems that affect the old. The biggest dampener to sexual fulfilment is pathological erectile dysfunction among men and vaginal dryness caused by menopause among women. Rarely, a large prostate tumour or cancer in the spinal cord or penis can also cause impotence. Sometimes, surgery for prostate, bladder removal, ostectomy, pelvic, colon and rectal cancers may also cause impotence by damaging nerves or blood vessels. Radiation, hormone and chemotherapy can also cause impotence. But most of these problems are not beyond correction.

What's more, the interest in sex is hard to let go. "Those who come for sexological consultation are usually interested in keeping their sexual functions alive despite the years. Some are more enthusiastic because they feel time is running out and their options diminishing with each passing day," opines Dr Shashank Samak, a Pune-based sexologist.

Dirty old folks they certainly are not, but the reputation has stuck because of younger people who think geriatric sex is an oxymoron. "That view needs to be changed," stresses Dr Kothari. "People should realise that these are actually the golden years of sexuality because of many factors. One: there is no desire to hurry up; two: there is no fear of pregnancy; and lastly: the couples have a better understanding of each other." This precious secret has only now begun to catch up.