Kapitel 1
The Intimate Journey: Sexuality Through Life's Transitions
Sex after cancer, divorce, childbirth, menopause-the very title of Iris Krasnow's groundbreaking work challenges our cultural assumptions about sexuality being reserved for the young and physically perfect. This book arrives at a pivotal cultural moment, as baby boomers refuse to fade quietly into sexless senior citizenship while younger generations navigate hookup culture and shifting relationship paradigms. Krasnow's research, spanning two years and 150 intimate interviews with women aged 20 to 90, reveals something revolutionary: sexual satisfaction often increases with age as women shed inhibitions and embrace authentic desire. Celebrities from Jane Fonda to Dr. Ruth have endorsed this perspective, with Fonda famously declaring at 75 that she's having "the best sex of my life." The book's cultural impact extends beyond its readership-it has sparked conversations in retirement communities, college campuses, and medical offices about the persistence of desire throughout life's transitions, challenging the pharmaceutical industry's narrow focus on physical function while emphasizing the brain as our most powerful sexual organ.
Kapitel 2
From Hookup Culture to Lasting Connection
Today's sexual landscape bears little resemblance to previous generations' experiences. What once required weeks of courtship now happens within minutes through text messages. Twenty-five-year-old attorney Karla explains, "I can send a text right now and in less than an hour be in bed with somebody I met once briefly, and may never see again." This isn't just the hookup generation-it's the "text-up generation," where digital messages initiate encounters and their cessation signals the end.
The speed and casualness of these interactions reflect broader cultural shifts. Media portrayals of sexuality have become increasingly explicit, making shows like "Sex and the City" seem quaint compared to HBO's graphic "Girls." Young adults display a nonchalance about nudity and sexual experimentation that reflects their generation's approach to physical intimacy.
Playwright Rachel Hirons challenges these glossy media portrayals through her work "A Guide to Second Date Sex," which presents the awkward reality rather than cinematic perfection. "Real sex is nerve-racking," she explains, arguing that media conditions us to view sex as performance rather than experience. Her generation approaches relationships differently-less about finding "the one" and more about finding whoever fits their current life stage. As the "instant-gratification generation," they discard relationships that don't work naturally.
Yet despite these shifts, young women today share similar confusion about casual sex as previous generations. Hank, a 25-year-old who's slept with about 25 women since college, describes his recent shift away from hookup culture. After years of "cheap pleasure" relationships with clear expiration dates, he's experiencing "self-loathing" and recognizes the "addiction cycle" of hookups provides no emotional nutrition. Now dating a woman whose mind he admires first, he's discovered that good sex requires interpersonal connection.
Though his parents' 30-year marriage began as a whirlwind romance, he now seeks something "more placid" but substantial-stability, companionship, loyalty and love. His evolution mirrors what research consistently shows: despite cultural shifts in how relationships begin, humans still fundamentally crave meaningful connection. The hookup culture, for many, becomes a phase rather than a lifestyle as they discover that physical intimacy without emotional connection ultimately feels hollow.
Kapitel 3
When Baby Makes Three: Navigating Postpartum Intimacy
The transition to parenthood creates seismic shifts in a couple's sexual relationship. The physical recovery from childbirth-whether vaginal delivery or C-section-requires weeks or months, but the emotional and psychological adjustments can take much longer. Between 15-20% of new mothers experience postpartum mood disorders, yet many suffer in silence, unprepared for the dramatic hormonal shifts.
Carmen Calvo experienced severe postpartum anxiety with her first child, having "recurring catastrophic fantasies" about harm coming to her baby. For her second birth, she tried placenta encapsulation-consuming her dried placenta in capsule form-which dramatically improved her recovery, leading her to become a Certified Placenta Encapsulation Specialist herself.
Beyond psychological challenges, new mothers often struggle with body image and feeling "touched out" from constant contact with a nursing infant. As psychologist Christine Hall explains after battling severe postpartum depression: "When you are nursing and holding a baby all day, the last thing you want is someone else touching you."
Spousal support proves crucial during this vulnerable period. Couples who navigate this transition successfully maintain open communication about their needs and expectations. Jordana, a mother of two young children, exemplifies prioritizing passion despite the chaos of early parenthood. Her rule? Never let a week pass without sex, as "the second you let a week go by, it becomes two weeks, then a month."
Self-confidence remains fundamental to reclaiming sexuality after childbirth. Feeling beautiful inside and out leads to passionate intimacy, which explains why many women report sex eventually becomes "better than ever" after the initial difficult transition period. The key lies in patience, communication, and creative approaches to intimacy-sometimes scheduling "Wednesday sex" or stealing moments while babies nap.
As children grow more independent, couples gradually rediscover their connection, often with a deeper appreciation for each other after weathering the challenges of early parenthood together. The most successful couples view parenthood not as the end of their romantic relationship but as another phase requiring adaptation and intentionality to maintain their bond.
Kapitel 4
Weathering Illness Together: Love Beyond Physical Limitations
When illness strikes, relationships face profound tests that reveal their true foundation. Julia Crowley, 32, endured her husband Rick's brain tumor and up to twenty seizures daily while raising two young children. Though their marriage had been strained before his diagnosis-with fertility treatments dampening her libido and increasing their arguments-Rick's hospitalization paradoxically rekindled their passion.
"When he got sick, that changed things quickly for me in terms of realizing how committed I was," Julia explains. Seeing her husband vulnerable with electrodes coming from his shaved head awakened a protective instinct and, surprisingly, sexual desire: "My desire for him had never been stronger."
Their intimacy flourished even during his illness. "We had more sex when he got home from the hospital than we had in years," she reveals. Now celebrating their eighth anniversary with Rick seizure-free for months, Julia reflects: "Usually you are older when you are forced to realize the true meaning of the marriage vows 'through sickness and through health.' I found out as a newlywed."
For military families, war injuries present unique challenges. Richaela and Derek's marriage strengthened after his leg amputation from an Afghanistan IED explosion. Their relationship improved once they moved into their first house as a married couple away from the hospital environment. Though Derek still struggles with PTSD-experiencing nightmares, anxiety in public places, and occasional angry outbursts-Richaela maintains perspective: "It's only a leg. I've seen far worse."
Indeed, over 1,500 Americans have lost limbs in Iraq or Afghanistan, with hundreds suffering multiple amputations. Another 1,500 warriors endure genital wounds-a primary fear among those being deployed. Fortunately, medical advances offer hope, with Dr. Anthony Atala's team at Wake Forest Institute for Regenerative Medicine making significant progress in regenerating human penises. Dr. Atala explains that this work is especially meaningful because it repairs "not just their physical health but also the patients' self-image and their relationships with their loved ones."
These stories reveal that illness, while challenging, often deepens intimacy as couples discover what truly matters. Physical limitations may require creative approaches to sexuality, but many couples report their emotional connection grows stronger through adversity. The most resilient relationships adapt to new realities while maintaining their fundamental connection-proving that true intimacy transcends physical perfection.
Kapitel 5
After Betrayal: Rebuilding Trust and Desire
The middle years of marriage often become vulnerable to infidelity as passion fades and routine sets in. When affairs happen, couples face an excruciating choice: walk away or rebuild from the ashes. Lisa Abrams, a judge whose husband's workplace affair became public scandal, chose the difficult path of reconciliation.
Her healing journey began with physical transformation: "As I became physically stronger, I became emotionally stronger." Through CrossFit training, she progressed to deadlifting 200 pounds and completing the challenging Tough Mudder course. Though she's wearing her wedding band again, she admits she's "still healing and will be my entire life."
Reading books about affairs, particularly Elizabeth Edwards', helped her reconnect intimately with her husband, along with his genuine remorse. Her fierce determination shows in her declaration: "No one else is getting my life!"
Not all affairs lead to reconciliation. Gina's pre-wedding affair with a coworker revealed fundamental incompatibility with her fiance. Despite proceeding with the marriage due to social pressure, it failed within a year. Years later, remarried with a child, she advises friends with pre-wedding doubts: "If there is any hesitation, don't do it."
Some affairs never become physical yet cause profound damage. Caroline, a 43-year-old stockbroker, remains obsessed with an ex-boyfriend from twelve years ago, requiring medication to manage her feelings. "This is my dirty little secret: I have never, ever had a connection like this with anyone else in my life," she confesses, describing their relationship as a "primal, emotional, sexual love" that still haunts her despite choosing stability over passion.
Those who've been unfaithful often carry their own burden. Kate, a 48-year-old woman, ended her two-year affair after realizing she was living "with a cheater's heart," unable to forgive herself despite never being caught. The guilt became its own punishment, affecting her self-image and relationship with her husband even though he remained unaware.
Couples who successfully rebuild after infidelity share common traits: the unfaithful partner demonstrates genuine remorse and transparency, while the betrayed partner eventually chooses to trust again without weaponizing the past. The process takes years rather than months, requiring both partners to examine the relationship dynamics that created vulnerability to infidelity. When successful, many couples report their relationship emerges stronger, with greater honesty and appreciation than before the betrayal.
Kapitel 6
Finding Freedom: Sexuality After Divorce
When marriages become unsalvageable, divorce becomes the path to wholeness despite its heartbreak. Jane Fonda left Ted Turner at age 62-a painful decision made because she "knew that I would die married and rich, but not whole." Now at 75, Fonda claims to be having the best sex of her life with boyfriend Richard Perry.
Women who successfully navigate post-divorce sexuality share common traits: they initiated their divorces, refused to live in "quiet desperation," and eventually reopened themselves to intimacy despite the trauma of ending their marriages.
Cathy Meyer rebuilt her life after her devastating divorce, earning a master's degree and establishing financial independence. Though she waited four and a half years before dating again, she eventually embraced casual relationships to rebuild her sexual confidence. When she finally found a meaningful connection with a man, the relationship lasted only a year before his death, but it taught her valuable lessons about healthy relationships.
Cathy now understands that sexless marriages aren't normal unless both partners agree to it, noting that in her divorce practice, lack of sexual intimacy is behind 99% of breakups. Despite her painful past, she's developed a deep appreciation for her sexuality and the power of orgasms as she's aged, finding that sex has actually improved with time.
Monica spent sixteen years in a marriage that looked perfect from the outside-a gorgeous power couple with a penthouse overlooking the Atlantic, extravagant parties, and exotic getaways. But beneath the glamour lay sexual incompatibility with her husband Bob, a handsome, sophisticated man eighteen years her senior who was a sex addict demanding intimacy on his terms.
After her cervical cancer diagnosis and subsequent hysterectomy, their marriage finally collapsed when Bob began an affair. Their divorce was bitter and financially draining, but it freed Monica to find her second great love-though that relationship ended after 9/11 when he chose to remain with his family.
Now in her fifties, Monica has evolved. Financially independent and successful in real estate, she seeks a relationship combining emotional depth with sexual chemistry, but refuses to sacrifice herself psychologically as she once did. She feels exhilarated by her self-discovery, comparing it to the freedom of her twenties.
Relationship therapist Marge Coffey advises divorced women re-entering the dating world to develop clear strategies before online dating, as expectations around sex have changed dramatically. She recommends women initiate conversations about sexual expectations early, discuss STD testing openly, and address potential performance anxiety by acknowledging their own nervousness first.
Coffey emphasizes that age shouldn't limit sexual enjoyment-she's counseled women in their late seventies seeking new relationships. The key is communication: women must articulate what they want and need sexually with new partners rather than expecting them to intuitively know. What women ultimately want, she concludes, is "fun sex, quality sex, and not to be a receptacle"-a partner concerned equally with their pleasure.
Kapitel 7
Embracing Authentic Desire: Women Who Choose Women
As societal acceptance grows, with several states now issuing same-sex marriage licenses and polls showing increasing support, more women are transitioning from heterosexual marriages to same-sex relationships in midlife. These transitions, while increasingly common, remain challenging in many communities where homosexuality is still viewed as illness or sin by nearly half the population.
Linda, a divorced mother who left her "overbearing" husband of fifteen years, shares her journey from heterosexual marriage to a fulfilling fourteen-year same-sex partnership with Louise. Though always attracted to women since childhood, Linda initially "followed the rules," marrying a successful older man and raising two daughters before acknowledging her true sexuality.
Her relationship with Louise began as friendship before deepening into romance. Linda describes their connection as "the most attracted I have ever been to anyone in my life," emphasizing the intimacy transcends physical aspects: "In Louise, I have a mother, lover, sister, and a girlfriend." Despite their differences-Linda being fashion-conscious while Louise is minimalist-they've created a blended family with three daughters.
Linda candidly discusses their sexual relationship, noting she feels "totally safe and free" with Louise compared to her marriage where "any time I got naked, he would climb on top of me." She's discovered greater sexual creativity, including using vibrators for the first time. At fifty-three, Linda identifies firmly as "a gay woman" rather than bisexual, feeling she's living as "a whole new person, and a whole person."
Carol, 51, takes a different approach, adamantly rejecting sexual identity labels despite being in a thirteen-year same-sex partnership after a fourteen-year marriage that produced two daughters. She and her female partner, who's eleven years younger, have a nine-year-old son together.
Carol admits missing sex with men but believes her attraction to women stems from "a deep desire for intimacy" rather than fixed sexual orientation. She suggests her marriage might have survived if her husband had been open to her exploring this aspect of herself rather than feeling threatened.
Their relationship involves shifted parenting roles-Carol feels like "the Dad" to their younger son while remaining "primary mom" to her older children. Though they share deep emotional intimacy as "best friends," their sexual relationship has faded into what's known as "lesbian bed death," where cuddling replaces sexual activity but the emotional connection remains strong.
Seventy-one-year-old Bon Kyle shares her journey from a thirty-three-year marriage to an eighteen-year partnership with Deb, whom she considers her true "soul mate." After moving out of her family home into a small apartment, Bon felt immediately at peace: "This is the real me." Their relationship blossomed quickly after a soccer game where Bon was struck by Deb's beauty.
These women's stories reveal that authentic sexuality often transcends conventional categories. Their journeys aren't about rejecting men but about embracing genuine desire and connection, sometimes discovered later in life after fulfilling societal expectations. What unites their experiences is the courage to pursue authentic relationships despite social pressure, and the discovery that true intimacy flourishes when we honor our deepest selves.
Kapitel 8
Reclaiming Femininity: Sexuality After Breast Cancer
Breast cancer survivors face unique challenges in reconfiguring their self-image and sexuality after mastectomies. While breasts have historically been viewed as "the crown jewels of femininity," these women discover their true womanliness extends far beyond physical appearance. Their stories share common threads: gratitude, resilience, and the realization that the mind, not the body, is a woman's most responsive sexual organ.
At 37, Sophia was diagnosed with Stage III breast cancer requiring mastectomy of her left breast. Rather than hiding her condition, she embraced a "warrior spirit"-having her children place temporary tattoos on her bald head and refusing to wear a wig. Her sex life improved during treatment as her husband was turned on by her strength.
After reconstruction, Sophia's breasts were asymmetrical, prompting additional surgery. Though she lost nipple sensitivity, she's developed a complex relationship with her scars: "Most of the time, I feel strong. I am proud that I am a woman with lots of scars... My scars make me feel tough and sexy, like a real survivor."
Her one regret was maintaining a facade of strength: "I created the problem because in my efforts to be strong... I let my husband assume I was invincible." Despite side effects from Tamoxifen including hair thinning, fatigue and depression, she found splitting the dose made a significant difference. Though she prefers having sex with her shirt on, her husband insists she's "more beautiful than ever"-she's still working toward embracing her new body as much as he does.
Heather chose prophylactic double mastectomy at 32 after two aunts had breast cancer and her mother was diagnosed with Stage Four. With three young children and a family history of breast cancer, she couldn't bear the emotional or financial burden of bi-annual MRIs for monitoring.
Three years post-surgery, Heather is thrilled with her results: "They look fantastic and feel very soft." Her cancer risk dropped from nearly 50% to just 2%. Though initially nervous about intimacy, she guided her husband's hands to show him it was okay to touch her. "For me, unless someone brings up my surgery, I pretty much forget about them. I just see them as great boobs that are now a part of me... I don't look at my breasts the same anymore. I used to see vanity, and now I see my future."
Dr. Lorraine Tafra explains how modern breast cancer treatment has evolved through detailed tumor biology analysis, allowing more personalized approaches. Surgical techniques have advanced significantly, with immediate reconstruction now common rather than delayed procedures. Nipple-sparing mastectomies (like Angelina Jolie had) are increasingly performed when disease isn't present in the nipple area.
Vinnie Myers, known as "the nipple guy," is a world-renowned tattoo artist who specializes in creating realistic nipple tattoos for breast cancer survivors. Working from his Maryland studio, he helps women complete their reconstruction journey with custom-designed nipples in various colors and shapes. His emotional connection with clients runs deep, hearing heartbreaking stories of husbands abandoning wives after diagnosis. One woman told him her husband "has not looked at me since I was diagnosed." Vinnie reassures them: "You will have another life! You're going to look great."
These survivors demonstrate that femininity and sexuality remain vibrant after breast cancer. Though the journey involves grief and adjustment, many women discover newfound appreciation for their bodies' resilience and develop deeper intimacy with partners who love them completely.
Kapitel 9
The Change That Changes Everything: Navigating Menopause
Menopause affects each woman uniquely, with stark variations in sexual desire and physical responses. Some women experience dramatically diminished libido while others discover newfound sexual freedom once pregnancy concerns disappear. The most successful transitions occur when women have flexible, supportive partners to whom they remain attracted.
Lucille, divorced at 45 after a 15-year marriage to a substance-abusing husband, met Johnny, an African American former NBA player 15 years her junior. Ten years into their relationship, she describes their connection as "very solid" with "fantastic" sex. At 53, Lucille began testosterone cream and progesterone therapy, which dramatically enhanced her already active libido and physical strength.
After a hysterectomy at 39 that threw her into early menopause, Joanne discovered her sexuality actually flourished. At 65, she reflects on her 20-year relationship with Richard, who died a year ago at 74, describing him as "the hottest romance I've ever had." Despite stopping hormone therapy at 60, her desire never diminished. Now widowed but undaunted, Joanne remains sexually confident: "My appetite at sixty-five is stronger than ever. Don't listen to anyone who tells you that after menopause your sex life will be horrible."
Lynn represents a different experience-she has peacefully accepted the end of her sexual relationship with her husband Ron. After sixteen passionate years together-starting with "hot, hot, hot" sex up to five times daily for their first five years-menopause four years ago dramatically changed their physical relationship.
"My vagina has shriveled up, and sex is painful," Lynn explains. Without previous vaginal deliveries, her tissues lack elasticity, making intercourse excruciating despite trying lubricants and dilators. Simultaneously, her libido disappeared completely-"I want to want to, but I just don't."
Fortunately, Ron's testosterone levels have also decreased, creating a synchronicity in their diminished desires. Their last successful intercourse was New Year's Eve 2011, but Lynn insists their relationship is "more intimate" now: "This is a man I am more madly in love with than when we were having sex five times a day."
Dr. Andrew Goldstein, director of The Centers for Vulvovaginal Disorders, specializes in treating sexual pain in women. About 20% of his patients suffer from treatable skin diseases like lichen sclerosus and lichen planus that cause sexual discomfort. Another common cause is prolonged birth control pill usage, which can lead to vaginal dryness-a side effect many gynecologists fail to mention when prescribing.
Deborah Nichols, a women's health nurse practitioner, focuses on helping women understand how libido changes with age. She explains that many older women lose familiar arousal sensations but can learn to rethink desire as originating more from the brain than the vulva. A significant portion of her practice involves diagnosing and treating pelvic pain that other providers misattribute to insufficient foreplay or vaginal dryness.
These varied experiences reveal that menopause, while challenging, doesn't necessarily diminish sexuality. With proper medical support, open communication with partners, and willingness to adapt, many women discover this transition opens doors to new forms of intimacy and self-discovery.
Kapitel 10
Golden Years, Silver Foxes: Sexuality in Later Life
At seventy-plus, today's seniors are redefining aging sexuality. Unlike previous generations who quietly accepted diminished intimacy, these vibrant elders embrace what Dr. Melanie Davis calls "outercourse"-non-penetrative activities like mutual masturbation, body rubbing, and sex toys that accommodate physical changes while maintaining connection.
Sylvia, at eighty-eight, has no interest in dating after her husband's death, but pleasures herself regularly: "I do a lot of masturbation... I give myself orgasms two to three times a week." Patricia, eighty, found new love a year after her husband's death: "Finding love in my eighties is like opening another world I never knew could exist."
Shirley, seventy-two, radiates in her orange pantsuit and matching lipstick, whispering: "I'm having the best sex I've ever had in my life." Her journey spans from a sexually repressed 1950s marriage at eighteen to discovering sexual freedom in the 1970s through open marriage. She eventually left her first husband for her "Omar Sharif" with whom she's now been married for twenty-four years. They maintain their passion with weekly scheduled lovemaking sessions, Tantric practices that focus on intimacy over intercourse, and creative use of sex toys. "After seventy," she says, "there comes a sweetness about making love, touching becomes more important, and intercourse becomes less important."
Dr. Marilyn Charwat, a seventy-nine-year-old sex therapist, advocates for regular orgasms-"at least three times a week"-to maintain vaginal health and overall vitality. "Sex at every age can be gratifying if you have an open and loving partner and you are open and loving about yourself," she insists.
Dorothy, seventy-three, started an affair after placing her husband with early Alzheimer's in a care facility. She reconnected with a seventy-five-year-old man from her hometown at a funeral after fifty years apart. "I have never been this comfortable with a man. I have never been this comfortable with sex," she confesses. Despite needing Viagra, her lover is "a fabulous lover, adventurous" who makes up for erectile issues in other ways.
Dr. Ruth Westheimer, the iconic psychosexual therapist now eighty-five, advises: "If you need the love, the companionship and, yes, the sexual gratification of a relationship, then by all means seek one out." She emphasizes that older people should understand how arousal changes with age, take their time with sex, and not compare current experiences with youthful ones. "Snuggling is so nice because it feels good and doesn't have to involve intercourse," she says.
The rise in retirement romances has brought a concerning increase in STDs among seniors. From 2005-2009, cases of syphilis and chlamydia among those fifty-five and older increased 43 percent according to CDC data. Many seniors dating after losing spouses lack the sex education their grandchildren received.
Ellen Barnard co-owns A Woman's Touch, offering sexual health counseling and adult toys. She emphasizes adaptability as the key to intimacy with aging, noting that lifestyle choices significantly impact sexual function: "The women I talk to who do really well after cancer and who glide through menopause into their older years are the ones who eat well... exercise every day... keep their stress levels down."
The chapter closes with Helen, 85, and Gus, 89, married for fifty-five years. Despite Gus's early Alzheimer's, they maintain intimacy through singing old show tunes together and regular cuddles-a simple yet profound testament to enduring connection.
