A woman sneaks from her room — well past midnight — and creeps a few doors down for her nightly romantic rendezvous with her lover.

No, this isn’t a story from some irresponsible summer camp or college dormitory. The setting was a nursing home.

And the story comes from Dr. Brad Thomas’ 30-year career as a family doctor in Seattle. Now health officer for Island County, Thomas reflects on those humorous experiences with his aging client base, but also the issues that come with getting older and maintaining a healthy and active sex life.

“I took care of this one family where I had three generations as patients and grandma was in the nursing home demented, but otherwise in really great shape,” Thomas said of the late night pleasure-seeker.

“She, every night at 2 a.m., would get out of her room, turn left, walk down two doors and hop in bed with Mr. Smith, who was very appreciative of the visit,” Thomas said. “The nursing staff and the associated families all knew about it, and it was okay with everyone. The problem was the night that she turned right and walked two doors down and got into bed with Mr. and Mrs. Jones.”

After the patient woke Mr. and Mrs. Jones, she had to be relocated to another facility, an example of how complications of advanced age can affect sexual relations in a unique way, Thomas said.

Dr. Chris Bibby, a primary care provider with WhidbeyHealth, said that while there are additional factors affecting the sex lives of senior citizens, most of these factors simply complicate sex, rather than hinder couples from experiencing intimacy.

“Both (aging) men and women slow down in their response,” Bibby said. “It’s not like you’re 20 anymore and someone bumps you the wrong way and you’ve got an erection. No, it takes a while to get an erection and to be excited. Same with a woman. Women tend to have vaginal dryness, tend to take longer to get lubricated.”

Bibby said that while these physical factors are at play, intimacy can go a long way in helping senior citizens experience sex in a positive manner.

“Intimacy starts not necessarily with sex,” Bibby said. “Intimacy: taking the time to appreciate each other, taking the time to spend time with each other, to cuddle with each other, to hold hands, to kiss, to do the things that we would consider intimacy. I think that’s first and foremost in any relationship, before you even get to the sex.”

Beyond remedies born from intimacy, conditions like erectile dysfunction and vaginal dryness used to hinder sex amongst seniors in a much larger way than they do today because of the advent of medications for such conditions, Bibby said.

Thomas noted that Viagra, in particular, changed the game for elderly men with erectile dysfunction, he said.

Although, some believe STDs are on the rise among seniors.

“With Viagra, there was a lot of interest in, ‘are we gonna unleash a torrent of STDs into nursing homes,’ and I think there has been some of that, but I don’t think it’s been a huge, huge problem,” Thomas said. “Especially not here.”

Recent health statistics support Thomas’ view.

Island County’s Assessment and Healthy Communities Director Laura Luginbill said in an email that she “did a quick run of the data on reported STDs among Island County residents age 65-plus years, and the numbers are so small as to be unrepeatable. Less than five every year.”

Thompson said the reports are so low “partly because (senior citizens) just don’t get tested and partly because they just don’t think about it.”

While STDs among senior citizens don’t appear to be an issue in Island County, there are several scenarios where they can be a health risk for an entire community, Thomas said, albeit a minor one.

“The other complication issue is if — especially in a retirement facility or nursing home or something — you’ve got one sexually functioning male and a lot of women,” Thomas said. “You’ve got a pool where potentially you could have a lot of exchange of STDs. But because it doesn’t impact fertility or pregnancy — there aren’t congenital birth defects in a 92-year-old that is going to have a kid — it has gone kind of undetected.”

The potentialities of these health risks among seniors have gone largely unnoticed by younger generations, perhaps because people want to avoid mental images, Thomas said.

“Who wants to think about their grandma having sex?” Thomas asked. “Even worse, who wants to think about their grandpa having sex? The STDs, if it makes them infertile? Too late. So it has kind of gone under the radar.”

So much so that Thomas said he didn’t think health professionals typically recommend screening for STDs among seniors because the comparable health risks are so much lower as compared to those of younger generations.

“Most of this stuff is self-limiting,” Thomas said of seniors. “If you get a herpes sore, it comes, it goes and may reoccur. But so what? If you get gonorrhea or chlamydia, it burns, it stings when you urinate for a while, and then it goes away. You are not gonna impair someone’s fertility or your own.”

But precautions are available for seniors who want them.

Bibby said safe sex is still the best way to go, regardless of age, when attempting to avoid the potential health risks of sex.

“Safe sex,” Bibby said. “It still applies, even if you’re 69 or 70. Know your partner’s history. If you have any questions, get tested beforehand. If you have any symptoms, get tested. Talk to each other before entering into a sexual relationship.”

Beyond STDs, Bibby said the only other potential health risk to having sex among seniors is if one has a heart condition that warrants caution with physical exertion in general.

“If you can walk up a flight of stairs without getting chest pain, then you’re okay to jump in bed, as far as I’m concerned,” Bibby said.

If STDs affect all ages similarly, factors like dementia, erectile dysfunction and vaginal dryness may affect seniors’ sexual experiences in ways unique from younger generations, Thomas said. Yet the unique sexual experiences of seniors do not have to be negative.

Both Thomas and Bibby agreed that sex is a wonderful aspect of life and is part of the joy of being human.

When caring for elderly couples, Thomas said, it isn’t unusual for one of the pair to be unable to have sex for some time before passing on. One widower in particular sticks with Thomas to this day, he said.

“There was specifically one old fellow, who — it was like somebody flipped a switch — he went from being 80 to being 50 because he found a new partner in his life,” Thomas said. “It was just amazingly transforming for the fellow. It was a great moment.”