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Sexuality in Later Life



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Most older people want and are able to enjoy an active, satisfying sex life. Regular sexual activity helps maintain sexual ability. However, over time everyone may notice a slowing of response. This is part of the normal aging process.

Normal Physical Changes With Age
Women may notice changes in the shape and flexibility of the vagina. These changes may not cause a serious loss in the ability to enjoy sex. Most women will have a decrease in vaginal lubrication that affects sexual pleasure. A pharmacist can suggest over the counter vaginal lubricants.

Men often notice more distinct changes. It may take longer to get an erection or the erection may not be as firm or as large as in earlier years. The feeling that an ejaculation is about to happen may be shorter. The loss of erection after orgasm may be more rapid or it may take longer before an erection is again possible. Some men may find they need more manual stimulation.

As men get older, impotence seems to increase, especially in men with heart disease, hypertension, and diabetes. Impotence is the loss of ability to achieve and maintain an erection hard enough for sexual intercourse. Talk to your doctor. For many men impotence can be managed and perhaps even reversed.

Effects of Illness or Disability
Although illness or disability can affect sexuality, even the most serious conditions shouldn’t stop you from having a satisfying sex life.

Heart disease. Many people who have had a heart attack are afraid that having sex will cause another attack. The risk of this is very low. Follow your doctor’s advice. Most people can start having sex again 12 to 16 weeks after an attack.

Diabetes. Most men with diabetes do not have problems, but it is one of the few illnesses that can cause impotence. In most cases medical treatment can help.

Stroke. Sexual function is rarely damaged by a stroke and it is unlikely that sexual exertion will cause another stroke. Using different positions or medical devices can help make up for any weakness or paralysis.

Arthritis. Joint pain due to arthritis can limit sexual activity. Surgery and drugs may relieve this pain. In some cases drugs can decrease sexual desire. Exercise, rest, warm baths, and changing the position or timing of sexual activity can be helpful.

Most people worry about having any kind of surgery--it is especially troubling when the sex organs are involved. The good news is that most people do return to the kind of sex life they enjoyed before having surgery.

Hysterectomy is the surgical removal of the womb. Performed correctly, a hysterectomy does not hurt sexual functioning. If a hysterectomy seems to take away from your ability to enjoy sex, a counselor can be helpful. Men who feel their partners are “less feminine” after a hysterectomy can also be helped by counseling.

Mastectomy is the surgical removal of all or part of a woman’s breast. Although her body is as capable of sexual response as ever, a woman may lose her sexual desire or her sense of being desired. Sometimes it is useful to talk with other women who have had a mastectomy. Programs like the American Cancer Society’s (ACS) “Reach to Recovery” can be helpful for both women and men. Check your phone book for the local ACS listing.

Prostatectomy is the surgical removal of all or part of the prostate. Sometimes a prostatectomy needs to be done because of an enlarged prostate. This procedure rarely causes impotence. If a radical prostatectomy (removal of prostate gland) is needed, new surgical techniques can save the nerves going to the penis and an erection may still be possible. If your sexuality is important to you, talk to your doctor before surgery to make sure you will be able to lead a fully satisfying sex life.

Other issues
Alcohol. Too much alcohol can reduce potency in men and delay orgasm in women.

Medicines. Antidepressants, tranquilizers, and certain high blood pressure drugs can cause impotence. Some drugs can make it difficult for men to ejaculate. Some drugs reduce a woman’s sexual desire. Check with your doctor. She or he can often prescribe a drug without this side effect.

Masturbation. This sexual activity can help unmarried, widowed, or divorced people and those whose partners are ill or away.

AIDS. Anyone who is sexually active can be at risk for being infected with HIV, the virus that causes AIDS. Having safe sex is important for people at every age. Talk with your doctor about ways to protect yourself from AIDS and other sexually transmitted diseases. You are never too old to be at risk.

Emotional Concerns
Sexuality is often a delicate balance of emotional and physical issues. How we feel may affect what we are able to do. For example, men may fear impotence will become a more frequent problem as they age. But, if you are too worried about impotence, you can create enough stress to cause it. As a woman ages, she may become more anxious about her appearance. This emphasis on youthful physical beauty can interfere with a woman’s ability to enjoy sex.

Older couples may have the same problems that affect people of any age. But they may also have the added concerns of age, retirement and other lifestyle changes, and illness. These problems can cause sexual difficulties. Talk openly with your doctor or see a therapist. These health professionals can often help.



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