Finding What Works for You continued...

"We don't necessarily get worse, but our physiology changes as we get older," Bortz says.

"One myth to put aside is that sex equals intercourse," Blank says. "I call it the tyranny of sexual intercourse. Alternatives to intercourse are not just for people who don't want to get pregnant or get a disease. The most healthy thing is for people to put aside the idea that if intercourse isn't working for you, you can't be sexual. Intercourse should never be the goal. If some sexual activity is uncomfortable or doesn't work, try something different."

"There are a wide range of sexual enjoyments that people practice, and we as physicians should not assume that, because all we know is the old missionary position, our patients are bad for liking other things," Morley says. "Our job as physicians is to facilitate and improve and counsel where possible."

This may mean different things for different people.

"Wherever you are starting from, expand," Blank urges. "My biggest pleasure is when I see somebody who has been really shut down and helping them make baby steps toward changing their sex lives. We have learned so much from people in the disability community. I know a quadriplegic man who has no feeling below the neck, but he can have orgasms from having his neck nuzzled. You adapt. For example, if your partner is very overweight, there are a lot of things you can't do. So what? There are a lot of things you can do. Find a way to enjoy yourself with whatever limitations you may have."

Restarting Stalled Sexual Energy

What can you do if your sexual pilot light has gone out? For many people, the answer may be communication -- something that doesn't come in a pill bottle.

"The worst sexual dysfunction in this country is our inability to talk about sex," Blank says. "To make the leap from not talking to talking is huge. People have to know they are not the only one who is considering being sexual. They need to know that they can do it without any risk to their health, and more importantly, with no risk to their self-esteem. One of the problems with people who are now older is there is even less talk about sex than there was before.

"The cure for the sexual problems and lack of interest in older people is the same as it is for younger people," she continues. "Get informed, and find a way to talk about it with somebody, not necessarily a therapist but a friend or somebody. Screw up your courage and talk to them."

Communication can also help overcome another problem -- feeling that nobody will find your older body sexy.