Medically speaking, it's safer to be in love than out of it. The Rand Center for the Study of Aging tracked more than 4,000 men over 22 years and found that married men in their 50s, 60s and 70s have lower mortality rates than their single counterparts. Their research indicates this is due to a variety of factors, including emotional and physical support during illness and an atmosphere that encouraged healthy behaviors.
"Being in a romantic relationship does help one to live longer," agrees Dr. Barry Weckesser of The Heart & Vascular Center of Venice. He attributes that longevity to lowered blood pressure and stress- related hormone production.
"People who are in a long-term romantic relationship have a lower incidence of heart attack and strokes," he adds-so long as the relationship is a happy one. "Just the opposite is true for people in long-term relationships who are unhappy and stressed with their partner," he says. "The cardiovascular risk for this group is higher than if they were not in a relationship at all."
But our hearts are not the only things affected by love. Committing ourselves to another has physical consequences for the rest of our bodies as well. From contraception to childbirth to sexuality during the senior years, here's a round-up of health news and notes related to that thing called love.
Oral contraceptives remain the most reliable and simplest birth control method for women, but another form is making a surprising comeback. Years after the Dalcon Shield became the Ford Pinto of contraception, intrauterine devices have re-emerged as a popular method of birth control for women.
Dr. Joseph Corcoran, a board-certified obstetrician and gynecologist in Sarasota, says the two now available are as effective as tubal ligation. "They last five years and are reversible," he says. And they have other advantages: Corcoran says that European doctors prescribe one, the Mirena, to control extremely heavy and painful menstrual periods.
Corcoran says little is being researched in the way of male contraception. For men who know they want no children, he advocates vasectomy. "It's a scalpel-free, suture-free procedure, and recovery is measured in hours, not days."
Infertility affects at least two million couples every year in the United States. For many, in vitro fertilization (IVF) remains the best option for conceiving, but timing the procedure is vital to its success, says Corcoran.
Corcoran, who has treated hundreds of couples, says that infertility strikes all ages (he's treated a woman as young as 22). "In general, fertility rates are good for women up through their mid-30s," says Corcoran. But, he adds, "At 38, fertility rates decline precipitously." Once a woman gets to that age, she has only a five- to 10-percent chance of becoming pregnant using IVF. For that reason, most IVF programs insist that women aged 38 or older use donor eggs to increase their chances for success.
Although men can father children at any age, Corcoran says recent evidence suggests that many older men have breaks in the DNA chains of their sperm. Those breaks may increase the risk of miscarriage and defective genetic codes in infants.
The good news is that improvements to IVF have made it possible to predict how many embryos the procedure will create. This reduces the chance for multiple births beyond twins and increases infant survivability.
SEXUALLY TRANSMITTED DISEASE
Syphilis, chlamydia and gonorrhea remain the most common sexually transmitted diseases in Sarasota County.
Although gonorrhea has been declining (from a high of 498 cases in 1998 to just 290 last year), chlamydia rates reached 507 in 2001. Syphilis cases have also been growing, from a low of two cases in 1999, to 13 cases in 2001.
"There's no real answer for (the increase)," says Gary Erving, Health Services supervisor for the Sarasota County Department of Health. "Different diseases affect different age groups. Chlamydia generally affects mostly 15 to 24-year-olds, where the average age for syphilis is in the low 40s."
Even with the increases, Sarasota County ranks far below state levels in STDs. Duval County, for example, had nearly 10 times the reported cases of gonorrhea last year, Dade nearly nine times the cases of syphilis.
The treatment of choice is antibiotics, but as Erving points out, medication alone won't alleviate the problem. "We've had a cure for syphilis-penicillin-for 50 years, and every year we have more cases."
He says the county health department is fighting the problem with school outreach programs and excursions to area jails, bars, even local neighborhoods to test residents for these easily treatable diseases.
Nearly 3,000 babies are born every year in Sarasota County, but the closing of the Florida West Coast Birthing Center and the obstetrics unit at Doctors Hospital last year has left expectant mothers with few options for giving birth here. Sarasota has three licensed midwives and five licensed doulas, but the only hospital obstetrics unit left in the county belongs to Sarasota Memorial Hospital. Even so, with a $750,000 renovation of its labor and delivery area, it's a terrific place to enter the world. The hospital has a neonatal intensive care unit, lactation consultants and a maternal-infant staff available by phone 24 hours a day to answer questions from new mothers.
Under certain circumstances, it is reasonable to try to control the gender of future children, says Dr. Julio Pabon, a reproductive endocrinologist in Sarasota. "Most people doing this are trying to balance families with too many boys or girls," says Pabon. Others are trying to evade genetic disorders.
Pabon is one of a handful of fertility specialists in Florida who are working with a program called MicroSort, a technique developed by the U.S. Department of Agriculture to screen for desired gender in livestock. Since its inception, MicroSort has led to the birth of more than 500 babies. It currently has an 88-percent success rate for producing girls and a 73-percent rate for boys.
MicroSort is still in clinical trials, but at least three couples have tried the technique at Pabon's Naples office. One couple succeeded in becoming pregnant with their choice (a girl); the other two were awaiting pregnancy results at press time.
Pabon is also excited about a technique he calls pre-implantation genetic diagnosis (PGD), where individual embryos can be sampled after a mere three days before they are implanted using IVF. "PGD has a much higher success rate for determining the sex of a child," says Pabon. His is the only clinic on the entire West Coast doing this procedure, which, unlike MicroSort, can be performed locally (couples using MicroSort must travel to the company's facility in Virginia).
Two years ago, AARP and Modern Maturity magazine commissioned a survey of attitudes toward sexuality of adults aged 45 and older. Sixty-seven percent of the men and 57 percent of the women aged 45-59 said they believed sex was a major component of quality of life. That number dropped sharply in those 75 and older.
Part of that decrease may be that seniors have few partners to play with late in life. Of those with partners, one of four aged 75 and older engaged in sex at least once a week.
"People think that at 50 you're over the hill. That's just bunk," says Beatty Cohan, a licensed psychotherapist in Sarasota who has authored books about sexuality. Cohan treated one couple in their 70s who claimed they hadn't had sex in 20 years. By the end of their treatment, they were enjoying it two and three times a week. "Age has nothing to do with it," she says. "There's no reason why people cannot have satisfying sex for their entire lives."
For many seniors, though, health issues inhibit sexual participation. Diabetes, hypertension, arthritis and prostate problems can all cause sexual dysfunction, as can the medications we use to treat them.
Cohan urges men who experience any type of erectile dysfunction to discuss the issue with their doctor to rule out disease. "And if you can't enjoy sex naturally, you still have options," insists Cohan. She points out that many men have been helped with penile implants and injections that stimulate erections.
When all else fails, remember that a healthy sex life does not have to include intercourse. "You can hug and kiss and caress," Cohan says. "There are many ways to enjoy our sexuality at any age."
A global study of some 30,000 adults aged 40 to 80 found that men become sexually dysfunctional at twice the rate as women. Not surprisingly, that study was funded by Pfizer, Inc., the pharmaceutical company that manufactures Viagra, the No. 1 prescribed medication for erectile dysfunction in America.
But Viagra doesn't work for everyone, and it has side effects. Some are minor-headache, facial flushing and upset stomach-but in some men, Viagra can cause heart attacks, hypertension, dramatic loss of blood pressure, and erections that last longer than four hours (yes, that is a bad thing).
For those who can't use Viagra, new drugs are on the way. Eli Lilly's Cialis works even faster than Viagra and promises 24-hour potency (compared to Viagra's four hours), and Bayer's Vardenafil seems to be especially effective for men whose erectile dysfunction stems from problems with diabetes. Both drugs should be available to U.S. consumers this year.
The most surprising aspect of these drugs is that they may serve women as well. Another study (again, funded by the makers of Viagra) indicates the drug might help women, but Cohan is skeptical of that claim. For women, she suggests having a complete hormonal work-up to rule out excessive estrogen levels and depleted testosterone levels. Either can diminish sexual desire.
If the spirit is willing, but the body objects, try exercise. A Harvard School of Public Medicine survey of nearly 2,000 men, aged 51 to 87, showed that the men who exercised vigorously for half an hour a day were about half as likely to have erectile dysfunction as men who didn't exercise at all.
Exercise improves blood circulation and balance. It also increases flexibility and releases endorphins that regulate energy levels, says Sarasota Pilates instructor Denise White. "You start to look better and feel better, and if you're more comfortable with yourself, you'll be more comfortable with your partner."
According to the Florida Department of Vital Statistics, nearly 3,000 couples took the wedding plunge in Sarasota last year. Nearly half that number split up.
Maybe if they'd sought help from one of the county's 59 marriage and family therapists, that number would be smaller. One of those therapists, Jamie Feheley, says the biggest mistake couples make is in failing to seek help early, when it can do the most good.
Besides, says Feheley, "Counseling doesn't always work." The most successful couples have shared value systems, and all the counseling in the world can't restore something that wasn't there to begin with. "How to raise the children, religion, politics are important," stresses Feheley, who teaches therapy methods to other professionals across the country. "Couples that conflict on such basic things as these are the ones who wind up in serious trouble."
Feheley encourages couples to seek some kind of counseling before they get married to establish whether they're compatible. It could also save them some bucks. In Florida, if the bride and groom take at least four hours of premarital counseling, they can get a $32.50 break on the $88.50 marriage license fee.