Thriving after 60

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Tamika Perry and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Tamika Perry.

CARMENN MILES
Hello and welcome, everybody, to this edition of Docs in a Pod presented by WellMed. I'm Carmenn Miles alongside our co-host and guest today, Dr. Tamika Perry. You can find Dr. Perry at WellMed at Redbird Square in Dallas, Texas, where she cares for her patients. If you happen to be listening to Docs in a Pod for the first time, you can catch episodes of this award winning podcast every Saturday on your favorite listening platform. As a matter of fact, Docs in a Pod is also now available on Amazon Music, audible, iHeart radio with Spotify soon to follow. So hey, there's really no excuse. You can find us just about anywhere, including the radio in several Texas markets. Each week we're here to discuss health and wellness topics, especially those that impact the senior community. Our goal really is to share practical information on how we can all live healthier, happier lives and to help us better manage some of those chronic, pesky conditions that so many of us deal with. We're super excited to have you listening in today. Thank you again for joining us. As mentioned, our co-host and guest today, she's in the hot seat across the board, is none other than the Dr. Tamika Perry. Dr. Perry is an associate medical director at WellMed in the DFW area as I mentioned earlier. She oversees several large clinics in the Optum Care North Texas region. She's board certified in both family medicine and osteopathic treatment. Additionally, she earned a Master of Public Health from the University at North Texas Health Science Center. She says she was inspired to enter a career in medicine to help provide quality health care to the Disenfranchised, and boy, is she fulfilling what she set out to do at WellMed at Redbird Square. She enjoys working with families and communities as a whole and building relationships with her patients. Outside of medicine, she's a proud mother, a card carrying member of Beyonc's Beehive and she absolutely loves to travel the world. Hello, Dr. Perry, I'm glad that we could nail you down between your heavy travel schedule in between caring for patients. How are you today?

DR. TAMIKA PERRY
Good. I feel like we're fancy now. We're on all these platforms. I am excited about today's topic.

CARMENN MILES
I am too. You're in the hot seat today, Dr. Perry, as both be co-host and our guest medical professional. As you said, we've got a great topic for discussion today. We're going to chat about a little bit of everything as it pertains to thriving after the age of 60, such as maintaining relationships, continuing to connect with others and a bit of a challenging stereotype for many older adults, and that's sex after 60. We're a little spicy today.

DR. TAMIKA PERRY
A little bit spicy, but not too bad. From a very practical, very medical sense, one of the biggest myths is that people stop having sex after 50 or 60 years of age. The reality is that many people still have sex until their 80s and beyond if you're physically capable of doing it. ItÕs a healthy part of aging. It contributes to emotional intimacy, quality of life, and overall well-being. When we have sex, we release endorphins, epinephrine, norepinephrine, serotonin. It makes us happy. So, I wholeheartedly encourage my patients if their bodies will allow to continue those intimate relationships as long as they feel comfortable doing such. We want to make sure that medically that we put them in a place if they're comfortable doing such, they are allowed to. They feel comfortable doing that.

CARMENN MILES
Let's talk about the comfortability. I'm interested to hear that. Are your patients really comfortable having that discussion with you, Dr. Perry?

DR. TAMIKA PERRY
You'd be surprised. I have a lot of ladies and ladies tend to outlive men a little bit, so their husbands have passed on or whatever happened to their long term relationship, and they'll start dating again. So, they'll be a little embarrassed and say, I want to start dating and eventually, I want to start having sex. What does that mean for me and my body at 65, 70, 75, 80? So, you have to realize that there are changes that go on, right? Especially for a man and a woman.

CARMENN MILES
Before you go there, Dr. Perry, let's take a moment to welcome those who may have just joined us and are wondering, what on earth are we talking about? You're listening to the award winning Docs in a Pod presented by WellMed. Our podcast is available wherever you listen to your favorite podcasts, and we recently expanded to Amazon Music, audible, iHeartRadio, with Spotify a soon to follow. So again, hey, there's really no excuse. You can find us just about anywhere, including on the radio in several Texas markets. I'm Carmenn Miles alongside co-host and guest today, Dr. Tamika Perry at WellMed at Redbird Square in Dallas, Texas. We're chatting about thriving after 60, staying connected, building relationships and sex after the age of 60. Dr. Perry, the song ÒLetÕs Talk About SexÓ became really one of their biggest international hits in the early 90s. The message was centered around encouraging open conversation and dialog about relationships and good health practices, communication and safe, healthy sex at a time when talking about sex was really a bit taboo. Look at us now discussing sex after 60 on Docs in a Pod. Let's get back into it where you left off.

DR. TAMIKA PERRY
I'm so glad you brought it up about safety because we'll talk about that too. From a girl perspective. What happens where there's decreased levels of estrogen? There are decreased levels of testosterone. With decreased estrogen levels, you may have vaginal dryness, decreased libido, decreased sensation. With a decrease testosterone, and yes, women have testosterone too, just like men, you're definitely going to have a decrease in libido. So, if you're experiencing any of those symptoms and it is disrupting the normal flow of your sexual life, or you want to start to revitalize your sexual life, but you're having no symptoms, definitely talk with your physician because there are hormonal and non-hormonal remedies that we can do to help with some of those. Things like black cohosh can help with hot flashes. SSRIÕs, which are Serotonin Selective Reuptake Inhibitors and are antidepressants, but they will help with hot flashes in addition to some of the mood changes that may come along with this post menopause stage of life. There are replacements that we can do topically. Of course, talk with your doctor because there's not a one size fits all for everyone. If you've had histories of certain cancers or you're a smoker, hormone replacement be for you. We still want you to have that conversation because there's more than one way to skin a cat, right? So, have that conversation with your provider so you know what the most conducive way for you to get over these menopausal symptoms and to be able to have a healthy sexual life. At some point in life, and this is what studies and surveys have said, sex becomes less about performance and more about connection. A lot of surveys about seniors and sex, the seniors say they have a lot less anxiety when it comes to sex. They're not concerned that they should have this show that it was that was worthy of being televised. It's a connection with the person, and that's great. We've talked about on previous shows how one of the most important aspects of vitality in life is a human connection. So, if you can take it to the next level with sex and a healthy manner, why not?

CARMENN MILES
Yeah, less performative and more about just connection overall.

DR. TAMIKA PERRY
That relationship you have with that person in particular. Now, we talk about guys and their physiological changes that happen. Some studies suggest that you start to lose testosterone in men as early as their late 30s, and then it just progresses over time. You need less and less testosterone, less libido. There may be erectile issues. Well, we definitely have something for erectile issues now. Least most erectile issues.

CARMENN MILES
Are we going to get into that a little bit.

DR. TAMIKA PERRY
Yes. Speaking of that class of medicine, there are several of them out there. There are 4 or 5 of those medicines in that particular class that gentlemen can take to help bring back blood flow to their manly area so they can maintain and achieve an erection and follow through with the active sex. Wonderful, right? However, we still have to be careful, because now that we have a conduit in which gentleman can achieve erections again after a point in their life where they may have lost that ability, now we have to talk about safe sex. Because with the advent of Viagra and all of its brothers, there's been an uptick in gentlemen and ladies with STDs later in life.

CARMENN MILES
Wow.

DR. TAMIKA PERRY
Because they follow through with the act. Safe sex, like you mentioned earlier, is paramount. So, if you have a new partner, I recommend this any age in life, please, please, please use condoms. If you've gotten to the point in your relationship where you feel like this is it, that's going to be the one person I'm monogamous with, and condoms may fade in and out the picture, I would recommend testing. You can have a disease state or entity for a very long period of time and not realize it. Early in my career, I had a young lady, and I say young, she was 65 and she said, I haven't had a pelvic exam in 10 or 15 years. My husband has been dead for eight years, but I feel like I need a pelvic exam because I've always had this little bit of a discharge and now it's just more than usual. Well, she had an STD and she had effectively for like eight years. It's not like she was doing anything bad, she just didn't know she had it. She just took for granted that that little bit of discharge was normal, then it got worse and worse and worse. Of course, over time it became a little bit problematic. I say that not that anyone is doing anything malicious to you with ill intent, you just want to make sure that you protect yourself. If you get to the point where you feel comfortable enough to say, I want to have sex without a condom, male or female, then it would behoove you for you and your partner to be tested for STIs.

CARMENN MILES
Are most of these STDs treatable? We're going into a break, but I'm just curious to hear that.

DR. TAMIKA PERRY
They are treatable. We'll talk about after the break. The ones that are not treatable or that we can treat, but you still get you still have for the rest of your life.

CARMENN MILES
Perfect. Let's take just a quick break, but please stay with us as we continue this great discussion on thriving after 60. You're listening to Docs in a Pod presented by WellMed. We'll be right back.

AD
For over 35 years, WellMed has redefined health care for older adults and people on Medicare. We're physician led and nationally recognized as an Age-Friendly Health System. Our doctors take time to listen and support your unique needs, working with Medicare and select Medicare Advantage plans to keep you healthy and independent. With 24/7 support, telemedicine, in-home, and office visits, care is always within reach. WellMed. Compassionate care, proven results. Visit wellmedhealthcare.com to learn more.

CARMENN MILES
We're back on Docs in a Pod. I'm your host, Carmenn Miles, along with our resident co-host and guest today, Dr. Tamika Perry. We're chatting about thriving after the age of 60.

DR. TAMIKA PERRY
We were talking about earlier, STIs in the senior population. It's not like seniors have different STIs or sexually transmitted infections. They may get than the non-senior population. Of course you can get any. That's why it's important to get yourself checked on a regular basis, especially if you're dating or your partner may have passed away and you haven't been sexually active in a long time, you still want to get yourself checked. Why? Because some STIs, you may be asymptomatic for a long time. If we start with the big one, HIV, you may have cold or flu like symptoms within two weeks of that sexual encounter, and then you may be asymptomatic for a very long time, and you may just be mistaken that cold or flu like symptoms. I just got a flu. It's done and it's over with. But you were really HIV positive. So, that's why it's important to self-checked on a regular basis. You may have been exposed to HSV 2, herpes simplex virus 2, which at one point the Center for Disease Control said that 50% of the sexually active population had but a significant portion of those individuals were unaware. You may have been exposed. Had the initial cluster, a rash, in the genital area, didn't realize what it was and it went away, didn't come back for a long time. But during that time, you could be shedding a virus in low lying levels. So, you just have to be aware of what's going on with you. That's why, once again, I cannot stress the importance of being checked on a regular basis and most certainly if you enter into a relationship with someone and you think sex is going to be involved.

CARMENN MILES
Communication matters, right?

DR. TAMIKA PERRY
Communication matters. With your partner, with your doctor. Do not ever be afraid to tell your doctor anything. I always tell people we are not your judge, jury, executioner, we are just your doctor. We are way low on the totem pole. But you have to tell me everything so I know what to do for you appropriately and in which direction treatment, testing, advice. But I only know unless you disclose these things to me. If we pivot for a second, you can always think about sex, or if we talk about the men in particular, think about the penis as a check engine light for the body. I say that because if it's not working properly and despite if I've given you Viagra or sildenafil, which is a generic Viagra, but is still not working, then I need to think about, does he have underlying vascular disease? Is it a sugar issue? Is it a blood pressure issue? Is it an infection issue? Same thing for a woman. If you have persistent vaginal symptoms despite being treated for perimenopausal symptoms, kind of a check engine light. What's going on? What else do I need to check and see? So, the inability to successfully have sex after 60 may not just be age. It may be your body saying, hey, we need to do something different. The reason you can't have sex and youÕre peeing a lot and you always have a rash in your genital area is really diabetes. Once again, these things need to be disclosed to your physician. A lot of my guys, their main concern is I can't have an erection anymore. Let me help you out with that. But as a clinician my main concern is besides you being 70, why? Is it because of sugar? Is it because of high blood pressure? Is it because of vascular disease? What is the issue? Are we having an infection? Is it a prostate issue? Why can't we see an active erection? So, always think about that. If my happy parts are not working, is there something else going on in my body?

CARMENN MILES
Is it typically that something is something else is going on in the body, or is this just a natural thing that happens over time?

DR. TAMIKA PERRY
It is a natural thing, but we should still always check for those other things. Growing of hair is a natural thing that happens over time like me wearing these fancy glasses that are really just fancy bifocals without the light is something that happens over time. But I still get my check to make sure that I don't have any retinal problems. That I don't have premature cataracts. It's a gauge to say, what is really going on here? Is this normal aging of my car, or does it need to be tuned up in a in a different manner?

CARMENN MILES
We talked a little bit about communication, and I'm thinking about the partner. About communication and that emotional intimacy when you're with a partner who maybe is struggling with some of these symptoms that you've mentioned. What are some conversations that can be had? How do we approach our partners who are struggling with maybe erectile dysfunction or any of the other conditions that you mentioned? Can you talk about that a little bit?

DR. TAMIKA PERRY
Yeah, you can always say I heard on Docs in a Pod, this may be something bigger.

CARMENN MILES
Have you had your sugar checked lately?

DR. TAMIKA PERRY
You can say, more than us having sex, I'm concerned about your overall health, so let's just go get this checked out and make sure. While you're there, if there's nothing physically wrong outside of these new normal changes of aging, then we're definitely going to help you out with that situation.

CARMENN MILES
Yeah, it's important to build that trust. In that, you're strengthening your emotional bonds supporting each other through some of those challenges.

DR. TAMIKA PERRY
Absolutely. This goes for men and women. Women over time have a tendency to lose their libido. Men lose your libido too. It presents a little bit differently. Men usually lose their achieve and maintain your erection. We lose our desire to actually have sex. Both of those issues can be addressed. They can be addressed where that desire comes back and when that erection comes back. We just need to make sure, did I lose my desire to have sex because of depression or is this because of perimenopause and lack of hormones? So, we have to figure out like what does make me do that? Did my partner lose his ability to achieve an erection because his hemoglobin A1C is 15? Or is it because he's 60? You need to discern that with a medical professional. I think it always comes from a place of love, understanding, communication when you when you present it to your partner as, I just want to make sure that we're as healthy as we possibly can be at this point in life. So, let's go speak to your doctor about it. Sometimes people are embarrassed to speak about it, but you wouldn't be embarrassed to tell me that your vision is changing. You wouldn't be embarrassed to tell me that you have a sore throat. Do not be embarrassed to say this either. In fact, a healthy sex life, evidence has suggested that it reduces stress, improves sleep, lower blood pressure, improves mood, increases oxytocin, the good hormone, strengthens relationships, improves self-esteem, and promotes pelvic floor muscle activity which makes you stronger. Makes your pelvic floor stronger. You can hold your urine better. So, this is all from a good, healthy sex life. If people had a good, healthy sex life, they might not need me, Carmenn.

CARMENN MILES
That's true. You talked about strengthening your pelvic floor. You probably have more to say on that, but I do want to pivot to physical activity and some healthy habits and diet. I'm curious to know how that affects or affects your overall well-being as it pertains to sex.

DR. TAMIKA PERRY
I'm glad you say that. So, healthy diet. You don't want a diet that's high in inflammation, fat, sugar. This goes away from your body being healthy overall and it goes away against sexual health. You definitely do not want to smoke. Smoking will not only increase vaginal dryness, it can decrease erection in men. So, if you have some issues in that area, one of the things that your clinician should go over is what we call your social medical history. Your social history is, am I married? Am I working? Do I smoke, drink or do any drugs? Have I ever smoked, drank or did any drugs? Then you might want to make a decision at this point, what is more important to me? The cigarettes or my boo? What is more important? You also mentioned about overall health and sex. Remember, sex is a cardiovascular activity. Yes, ma'am. Sex is the good kind of exercise. I have had and I have patients into their 80s who are still sexually active, sexually satisfied, very, very, very, very happy.

CARMENN MILES
That's fantastic. You mentioned something about depression. I want to hear about mental health. Stress management, I imagine, can take a toll on your sex life.

DR. TAMIKA PERRY
When you're having sex, in particular when you have an orgasm, there is a release of oxytocin, serotonin, epinephrine, and norepinephrine from your gut and your brain. These are your happy hormones. In fact, when a person is clinically depressed, we give them a Serotonin Reuptake Inhibitor, meaning we allow the serotonin less in your brain longer. Your brain pushes all your happy hormones out. Not all of them, but it pushes out a significant amount of happy hormones for your body to enjoy during a sexual encounter. It reduces stress. It makes you feel better. It literally makes you feel better mentally and physically.

CARMENN MILES
What about staying socially engaged. Does that help?

DR. TAMIKA PERRY
It does.

CARMENN MILES
You can get in the habit of being at home and not staying socially engaged. I think that too, you'll tell me from right or wrong, affects whether or not you really want to engage in sexual activity at all. Especially for women when you speak about libido.

DR. TAMIKA PERRY
Absolutely. A lot of the ladies are widows because once again, we outlive our husbands. So, I always encourage all of my patients, men or women, to become social. Join a senior center. Join a book club. Whatever you like to do. The gym. Become social and who knows, you may find your next boo there.

CARMENN MILES
Exactly. We are basically out of time. That was a lot of great information in a short period of time. We probably need to revisit this topic soon, but unfortunately for today, we're out of time. It's been a great conversation with the one and only, Dr. Tamika Perry at WellMed at Redbird Square in the great city of Dallas, Texas. Thank you for your time, Dr. Perry, and for so willingly sharing your expertise. Thank you to those who tuned in for this episode on thriving, sex after 60. Listen, here's what's important. Connection at every single age is important. Don't disengage in your life. We encourage you to be intentional about nurturing your relationships and creating new connections. Listeners, don't be a stranger. Subscribe to this podcast so you never miss an episode. If today's show helped you, sharing is caring. Tell your friends and family where to find us every Saturday on any podcast listening platform, now including Amazon Music, audible, iHeartRadio and Spotify to soon follow. You can also catch us on the radio in several Texas markets. You're listening to the award winning Docs in a Pod presented by WellMed. Until next time, stay well.

OUTO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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