The Right Coast

June 09, 2005
Sex in San Diego
By Tom Smith

The world wide conference of endocrinologists here in San Diego this year just ended. Some 8000 endocrinologists, or hormone doctors to the rest of us, converged on San Diego this week to discuss stuff most of us, including me, do not understand. It was a truly international event. Many came from Europe (including Euro-ladies, LWJ said cattily, "trying to look glamorous") and Asia, as well as here in Norteamerica. Lovely wife Jeanne said you could spot the endocrinologists all over San Diego, usually walking, she said, for endocrinologists are frugal, as MD's go. OB/Gyn's drive sports cars (not risk averse; look at their malpractice exposure); surgeons prefer Benz's or beamers (rich and want you to know it), but endocrinologists prefer aging Volvos and public transport.

I know, you want to know about the sex part. Bear with me here, because for some reason I have never been able to get my arms around the whole glandular thing, which is both complicated and not as interesting to me as say, electricity. Anyway, one of the most dramatic papers at the conference, according to LWJ, was given by a lady doc from Mass General or some similarly prestigious place, and argued that endocrinologists should just stop giving androgen therapy to post-menopausal women. (I apologize in a blanket manner for all phonetic spellings.) According to the presenter, there simply was not enough good data to support any reasonable conclusions about what the therapeutic results and side effects of such therapy are. This was a very controversial proposal to make, because androgen therapy is the major tool endorcrinologists have to treat reduced sex drive in post-menopausal women, and any other woman, for that matter. Apparently, some 40 percent of women complain of this condition, presumably even more for PM women. Discussion and some outrage, of a decorous endocrinological sort, ensued. The thing that seemed really interesting to me was the remark reported to me, made by one male doctor, who said something like, "look, post-menopausal women play different roles in today's society and our job is to help them fill that role." I would have had no idea what that meant, but apparently every MD there knew what he meant was, it is simply no longer the case that older women are content with not wanting to be sexually active, and it is doctors' job to help them out with that.

This led me to think about how very profound that changes have been in even the past dozen years or so regarding sexual behavior. You could almost call it a second sexual revolution, led by the same people who led the first. Both have a lot to do with medical technology. The Pill was one thing, Viagra is another. And now it seems there must be a lot of pressure on drug companies and doctors, to do something similar for women--come up with technology that will extend a satisfying sex life further into one's, ah, mature years.

I am as brainwashed as the next person to think of this the way Ely Lilly et al want me too. I watch the Cialis commercials and think, yes, I want to be good to go, or whatever the slogan is. Old people should be riding horses, shopping for antiques, walking on beaches, and having sex, just like the rest of us, except I can't really afford most of what they are doing on the commercials. But more objectively, one wonders about what effect, socially and economically, it will have to have so much time and energy invested in making sure the over 50 set is getting it on them. I wonder how much of this is driven by the priorities of an overly sexualized society, which is that way, I think, because sex is such good business. We already spend vastly more on keeping old people alive than we do on keeping children healthy, I would bet. It won't be long, before we are spending more on making sure 70 year olds can have great sex, than we are on health for kids. I'm not calling for some new government program or tax. That might be fine for Canada, where there is so much less sex anyway. But not here. All I'm saying now is, it's a strange world, and getting stranger. And yes, I plan to be entirely hypocritical in this respect. When the time comes, and may I live that long, I will be all over the best technology has to offer. Who am I stand in the way of history, and it's also the perfect way to end a nice day of antiquing.