Seniors and Sexuality: Natural Changes Occurring With Aging (Part II)

David Yarian, Ph.D.

Most of us reading this are not twenty years old any more!

Our bodies are constantly changing - though many of us are in denial. Orthopedic medicine is one of the fastest-growing medical specialties, treating rotator cuff injuries, tennis elbow, injured backs, torn cartilage, blown ACLs - in aging baby boomers. We're not ready to give it up!

Your body changes as you age, and these changes can affect your sexual relationships.

Physical Changes Naturally Occurring With Aging

Testosterone regulates your sex drive whether you're a man or a woman. Most aging men and women produce enough testosterone to maintain their interest in sex, though patches and creams can provide an alternative source of the hormone to boost desire if needed.

Men and women experience different changes in their bodies as they age.

Women: Physical Changes that Affect Sexual Responsiveness

Most physical changes are linked to menopause and reduced estrogen levels. As you age, it takes longer for your vagina to swell and lubricate when you're sexually aroused. Your vagina also loses some elasticity. Together these can make intercourse less comfortable or even painful.

What to do:

  • Longer foreplay increases natural lubrication.

  • Use water-based lubricants, such as Astroglide, Probe, or Silk.

  • Estrogen creams or hormone replacement therapy can rejuvenate vaginal tissue.

  • Regular intercourse helps maintain lubrication and elasticity.

  • Do Kegel exercises to keep the pelvic floor muscles toned.

  • If you haven't had intercourse for a while, realize it takes time to stretch out - go slowly!

  • Minimize any pain or discomfort. Desire usually returns once any discomfort is relieved.

    Men: Physical Changes that Affect Sexual Responsiveness

As you age, it might take longer to achieve an erection; it may be less firm and it may not last as long. Aging also increases the time between possible ejaculations.

What to do:

  • Relax, stop worrying about it! Anxiety makes it worse.

  • Let go of performance expectations. American media is filled with messages implying that masculinity and virility is equated with youthful performance.

  • Kegel exercises are very helpful for men also, to tone the pelvic floor musculature.

  • Take longer with sexual activities. You may also need more direct physical stimulation.

  • Try different positions, for comfort and extra stimulation.

  • Focus on pleasurable sensations, rather than on hurrying towards orgasm and ejaculation.

  • Viagra, Cialis, or Levitra may help intensify erections.

  • Other medical devices, such as pumps, drugs, and implants have been developed. I would encourage a natural and relaxed exploration of sexual possibilities before submitting to an expensive and invasive medical procedure.

Psychological Changes Naturally Occurring With Aging

The aging process may have psychological and emotional effects - particularly as we live in a culture that glorifies youth and extols youthfulness as the epitome of physical beauty. (I would remind us all that this is market-driven: marketers learned long ago that younger people are more likely to spend disposable income, and are more susceptible to being influenced by advertising.)

  • We may be embarrassed or ashamed of our sexual needs as an older adult.

What to do: Get over it! Join the party. You deserve pleasure in your life, from birth until the day you die.

  • Changes in appearance affect how we feel about ourselves. Bodies no longer match the idealized body images we see in advertising and the media.

What to do: Realize that media has created the youthful ideal of beauty. Celebrate and love the body you have! Every wrinkle, stretch mark, gray hair, rounded contour, ache and pain is a mark of your ever-increasing maturity and wisdom! Bette Midler once said that if you are a woman and consider yourself unattractive -- visit another culture for a wake-up call. American stereotypes of physical attractiveness are insane dreams invented by marketers who are playing on our anxieties and insecurities in order to sell us more products.

  • Worrying about sexual performance may actually reduce the body's ability to perform sexually; men may experience erectile dysfunction, women an inability to lubricate.

What to do: Relax! Relax . . . Enjoy your partner. Look into his or her eyes. Breathe together. Cuddle, stroke, gently massage each other. Sexuality is about pleasure, playfulness, and spontaneity.

  • Depression may reduce energy, optimism, and desire.

What to do: Exercise, do pleasurable activites, get sun on your face every day. Talk with your doctor about an antidepressant medication. See a therapist. Talk with your friends. Write your feelings in a journal. Any positive action taken - even drinking a glass of water! - is a step towards moving out of depression.

Changes Due to Medications and Surgery

Chronic pain or surgery and illness that cause fatigue can make sexual activities more challenging or painful.

What to do: Talk about it. Slow down, focus on simple pleasurable activities. Experiment with different positions or activities to discover what is most pleasureful.

Some commonly used medications can interfere with sexual function. High blood pressure medications can reduce desire and impair erection in men and lubrication in women. Some antihistamines, antidepressants, and acid-blocking drugs can have side effects that affect sexual function.

What to do: Talk with your doctor about how to minimize these effects. It may be possible to substitute alternative medications that work as well as the original, but without affecting sexual function.

Read on for Part III -- Seniors and Sexuality: Improving Sex as You Age »

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