Sexual Health Through Education
Midlife is a time of many changes to a person’s body and physical abilities, their relationships, and possibly life values and goals. Many people who are currently “middle-aged” are part of a generation that challenged long-held theories on issues, and mid-life sexuality is no exception.
Challenging the belief that interest in sex disappears somewhere in late middle age has given way to an equally mistaken view that ‘change’ in the sexual part of a person’s life is automatically an indication of dysfunction. Interest in a sexual relationship doesn’t ever have to end, but there will definitely be changes to deal with and many of these changes are a normal part of human sexual development.
The sexual changes associated with aging are often described in terms of decline rather than simply as natural changes.
For example, testosterone is present in both the male and female sexual system. Although testosterone levels gradually decrease with age, most people’s bodies will continue to produce enough testosterone to remain interested in sex without using hormone replacement. (It would seem that the medical and pharmaceutical industries, however, would have us believe otherwise.) While both men and women may notice that some physical aspects of sexual response change or diminish, they may, in fact, feel more emotionally connected to their partner than ever before.
Many of the physiological changes women experience can be associated with menopause. For example, less estrogen production causes thinning of the vaginal walls and possible dryness that can result in discomfort during intercourse. Some sexual changes are similar to other physical changes of aging e.g. it takes longer for sexual arousal to produce the lubrication that makes intercourse more comfortable. This is normal and many couples enjoy the slower lovemaking that helps produce enough lubrication for comfort.
If a woman has ongoing problems with dryness during sex, her mood and interest in sex will certainly be affected. She needs to talk to her partner about this so that they can deal with the situation together. In addition to slowing things down, using a lubricant can also help deal with this problem. Water-based lubricants can be found at the grocery store or pharmacy near the condoms or feminine hygiene products. Extra lubrication is especially important if a couple is using condoms – for comfort and to reduce the possibility of the condom breaking. If vaginal dryness is a problem at other times, as well, regular use of a moisturizer like Replens can be helpful. Some women will need to use an estrogen cream or gel, but these will have to be prescribed by a doctor. It is also worth mentioning that there is some evidence that regular sexual activity and orgasm help preserve a woman’s sexual functioning, especially the ability of the vagina to lubricate.
As a man ages, it usually takes longer to achieve an erection and it may not be as firm as when he was younger. The erection may “come and go” several times during lovemaking. This is normal—not an indication of erectile dysfunction. If a man is having difficulty getting or keeping an erection and there is no medical reason, it is important for him and his partner to talk about the situation and their feelings. Additional direct stimulation through touch or oral sex may be all that is needed. A man may also notice that, after ejaculation, it takes more time for him to be able to have another erection. This is also normal—just a natural part of the general slowing down of the body as it ages.
Sometimes sexual difficulties are the result of other relationship problems that need to be resolved. Lifestyle factors can also be at fault. Stress, lack of exercise, poor eating habits, cigarette smoking and alcohol/drug use all take a greater toll on a person’s sexual responsiveness as s/he gets older. Sometimes the solution is simply taking more time for sex with less of a focus on intercourse. Make the time to enjoy the physical sensations of other types of touching, for example a loving massage.
There are books and Internet sites written specifically for midlife and older couples who want to continue to enjoy their sexual relationships. A couple may need to be willing to try new things but neither partner should feel pressured to do something that makes them feel uncomfortable. However, couples often find that talking and being open to new ideas actually increases the intimacy in their relationship.
It is true that some medical problems can interfere with sexual response. Chronic pain, surgery or illness that causes fatigue can make sexual activities more challenging or painful. Some commonly used medications can interfere with sexual functioning, as well. If a man or woman is taking medication or they are concerned that sexual changes are the result of a medical problem, they should visit their doctor. Often the doctor can change the medication to one that has fewer or no sexual side effects.
Doctors, themselves, sometimes feel uncomfortable asking a patient about their sexual relationship. If this is the case, it is important to introduce the topic yourself by asking questions and being specific about any concerns you have.
People who are not able to talk about their concerns with their partner or a health professional may begin to feel anxious and negative about their sexual relationship. A person’s ability to have and enjoy sex during midlife and beyond depends on their mind as much as their body, so a sense of humour and a willingness to adapt to change are also helpful.
It is true that, for most people, “sex” is not the same at 50 as it was at 25. That doesn’t mean however, that it can’t be as fulfilling or enjoyable. After all, the need for intimacy is ageless.
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