Sexuality Later
in Life
By: National
Institute on Aging
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.
Surgery. 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.
More Information
For a list of publications from the
National Institute on Aging (NIA) including an Age Page called AIDS, HIV,
and Older Adults, contact:
The National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
1-800-222-4225 (TTY)
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