Dr. Pabasara Ginige, Senior Lecturer and Honorary Consultant Psychiatrist, University of Peradeniya, Sri Lanka
Speech delivered at Ageing without limits: A policy dialogue on feminization of ageing held on 8 July 2019 at BMICH, Colombo, organized by UNFPA, Ministry of Small Industries and Social Empowerment and Help Age
Find the Sinhala translation here වියපත් වීමේ ස්ත්රීකරණය; කාන්තා ලිංගික හා ප්රජනන සෞඛ්යයට එහි බලපෑම
Female sexuality is a very sensitive topic. It has developed so many myths about female sexuality over many generations. If I am to share one just to start off, in 138 AD, great physician of the time, Galen stated that women must have orgasm in order to reproduce.
I am given the topic of talking about sexuality of ageing females. There are lots of ageist stereotypes. There are lots of myths regarding aging females. These Myths regarding sexuality may be trans-generational. They move from generation to generation. Internalized social, political, religious, cultural factors and the media portrayal of later-life sexuality contribute to ageing women’s sexuality and moral values. You may remember that an aged female has a stereotypical petticoat role in any teledrama or movie.
This is alarming, sexual inactivity goes up with our age. It is higher in concern to women. Logically speaking, the physical changes that occur with menopause interfere with sexual responses. However, female sexual satisfaction does not decline noticeably with age. Sexual activity plays an important role in relationships among over 60 populations, according to some surveys done across different cultures.
Let me share with you some daunting results found in researches. Believe me, as a physician who attends to sexual problems in both men and women, I see this research findings replicated in my day to day clinical centers. Low sex drive is correlated with the number of years been in a monogamous relationship. Women’s sexual interest on steady partners may plummet even quicker than men’s. Even hormonal decrease of menopause can be entirely overridden by the appearance of a new partner.
In our discussion we have an active dialogue going on ‘can Sri Lankan ageing women benefit from these findings’. Let me share our latest findings on the sexual response cycle. The key ingredient of this cycle is the emotional intimacy. Despite the age and despite the fact that some of your organs are not functioning properly as when you were young, you get this emotional connection at 65 or 75.
Most of women are inactive and abstinent because of male partner’s erectile difficulties; decline in sexual drive or because of absence of a partner. Particularly in our country, 30-year war left behind many widows. And of course the equilibrium of the emotional component of a relationship changes when ill health prevails. Ill health of the women as well as the ill health of the partner impact. That is why we, women have to be very careful about cervical and breast cancer.
Culture influences women’s perceptions on menopause and its impact on health, self-Image and sexuality. Those who are in the audience might have had chance in viewing the movie Pavuru Walalu. It beautifully covers a theme that Sri Lankan cinematography has never touched. May be I am not going to tell you about it. You can find it out and watch it.
Our ageing women show lesser tendency of taking opportunity to seek new companionship, intimacy, sexual relationship and social interactions. Do our ageing women go on finding dating? Do they know about apps for that? Some do not know how to go online.
World population is ageing. Feminization of ageing is happening. Ageing pyramid is going to be a square. Are we going to do only spiritual activities? What about our lives? What about going out being a little naughty, not too much? Do it our way. I know many young ladies who are ready to meditate in years to come. Population is changing. The country is changing. Do the ladies have a concept of regular exercise and healthy eating habits? Now of course I see general public are given lot of promotion on how to live healthy. Those things are really good and that is the message that we have to give. Hormone replacement therapy and cosmetic surgeries are there. How many of 60+ women can afford to have them even if they know about it? Those are the questions we may have to discuss.
I screen some ladies who are coming to the teaching hospital where I work at the OPD. A little survey among above 60 women revealed that only 20% are sexually active while 80% were sexually inactive. Reasons for sexual inactivity are husband’s death, lack of interest and desire and most of them believe that the sexual activities are not appropriate for their age. The best Sinhala term for that attitude is “Akepai.”
We have to be cultural sensitive. We cannot be going out of way. Ageing has a powerful impact on the quality of relationship and sexual functions. Initiate a discussion on sexual concerns of ageing population together with cultural concerns. I am a teacher at Medical Faculty, Peradeniya. We teach Old Age Psychiatry to young medical undergraduates in all universities. We should enlighten them to start up a dialogue about ageing female’s sexuality.
When we go to the field to gather data for researches, these sixty plus ladies are very sweet to tell “Come on madam, at this stage what sex”. That is our culture. We the doctors and the policy makers cannot ignore the fact that this is a very sensitive issue. The doctors have to be culturally competent. We have to rethink and redefine the sexual concerns of ageing females in policy development at high level. So I open the forum for an opportunity for a dialogue.
Transcribed by Rajendra Wijesinghe