Sexuality in Later Life

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Dr. Chris Steidle - Northeast Indiana Urology

Sexuality in Later Life

Courtesy of the NATIONAL INSTITUTE ON AGING

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 should not 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.


SurgeryProstatectomy 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 used to treat prostate cancer,

new surgical techniques may be able to 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:


NIA Information Center

P.O. Box 8057

Gaithersburg, MD 20898-8057

1-800-222-2225

1-800-222-4225 (TTY)


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