January 19, 2004 Health

	photo essay
	Animal Attraction There's more than one way to make hay, as birds, bees and bonobos know
	graphic
	Where Our Sex Drive Comes From Mapping the origins of sex drive on the human body
	remedies
	Love Potions A guide to some of the medical treatments available for what ails our libidos
	self-test
	The Passionate Love Scale Determine just how you feel about that special (or ex-special) someone

For women, there are no magical routes to arousal. So far, Viagra-type drugs haven't worked for them. On the contrary, an indifferent partner who suddenly becomes amorous can ruin a relationship. Divorce lawyers talk these days about Viagra affairs and split-ups. Some doctors are prescribing testosterone as a libido booster for so-called low-T women, helping push up testosterone sales some 17 times in the past decade to about $400 million annually. Variously given as a pill combined with estrogen or as a patch, cream or injection, testosterone remains unproven as a sex aid. Meanwhile, it can cause oily skin, unwanted facial hair, a lowered voice and an upsetting onslaught of sexual fantasies.

But these risks haven't slowed the run on sex-enhancing nostrums, from herbal supplements like horny goat weed to topical Viacreme, many of them sold on the Web. How good are they? Probably not much better than the monkey testicles worried men had sutured onto their own testicles in the 1920s. ConsumerLab, a White Plains, N.Y., testing firm, found when it sampled Web-peddled human growth hormone (HGH) supplements that they contained no more HGH than a hamburger.

Most gerontologists recommend exercise and a healthy lifestyle as a far better route to prolonged sexual happiness. Says Dr. Jeffrey M. Drazen, editor in chief of the New England Journal of Medicine: "You're better off spending your money at a gym." Heeding his own advice, Butler, 76, the former director of the National Institute on Aging and founder of the International Longevity Center in New York City, and his wife, 64, exercise daily, stressing aerobic fitness, strength, flexibility, balance and posture. On weekends they go off with a walking group. And their sex life? "Just great," says Butler.

Workouts of the imagination can help too. "Take a vacation; make out in the car," sex therapist Cynthia Lief Ruberg, co-author of Pathways to Pleasure (PEC Publishing; 223 pages), tells elderly clients who complain they're in a rut. Or try new ways of doing the same old thing. In Married Lust: 10 Secrets of Long-Lasting Desire (Hearst Books; 224 pages), Pamela Lister and the editors of Redbook prescribe new sex positions, from tender to kinky, as "a perfect antidote to the encroaching dullness of routine." (Their survey shows women favor the missionary position, while men tend to want the woman on top.)

As for balky erections, Viagra alone may not suffice. "Men feel they're expected to perform, which can create a situation called spectatoring," explains Tampa's Dr. Saks. "Rather than being in the game and enjoying the passion, you become a spectator, watching and observing and anxious, worrying about your performance and your partner's acceptance. You can't get an erection even with Viagra." One answer may be more direct stimulation by a sympathetic, caring partner. "You have to start slowly, with touching, and take the pressure off," says Saks. "People make sex too much work."

That's a lesson the aging sometimes forget. Too often they fail to appreciate their own sexual needs or powers, succumbing to old myths about declining sexuality. Freud was sure female sexuality ended at menopause—a time, he huffed, when women become petty, stingy and sadistic and acquire other "anal-erotic" traits. But the evidence suggests quite the opposite. "Many [seniors] still want and seek orgasms when they're in their 70s and 80s," says Dr. Kevan Namazi, former chair of the gerontology department at the University of Texas Southwestern Medical Center at Dallas.

But satisfaction can come in unexpected ways. As Peggy Brick, co-author of New Expectations, a frank handbook for sex counselors for seniors from SIECUS (the Sexual Information and Education Council of the United States), points out, "What's appropriate sexual behavior for a 21-year-old is not appropriate for a 70-year-old." Given the diminished male ability to produce erections, many older couples rely on what sex counselors call "outercourse." Instead of penetration, says Brick, who at 75 remains an active sex educator, outercourse involves other types of pleasuring, such as touching and cuddling. "[Without] the pressure on men to produce an erection," she says, "[sex] can be much more satisfying."

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