by Dr. Joe Casciani

Aging and Sexuality

There’s an old adage, “Older adults make love less often, but mean it more.”  Sexuality in later life can remain constant, and even though there may be some challenges, seniors can continue to enjoy a physically end emotionally fulfilling sex life, at any age.  And, as the adage implies, sex can be better at 70 or 80, and though it may not be what it was like at 20 or 30, the fact that there are fewer stresses and family and work demands, an absence of unrealistic ideals and prejudices, less fear of unwanted pregnancy, and having more privacy allows people to enjoy sex as much as or more than when they were younger.

According to Health Canada, the benefits of maintaining sexual activity are well known but some are less well known:

• Sex burns fat and causes the brain to release endorphins, serving as natural pain killers and anxiety reducers;
• Prompts the release of substances that bolster the immune system and growth hormones that strengthen bones and muscles;
• Frequent sexual activity has been shown to slow the aging process and prevent wrinkles around the eyes;
• The physical exertion associated with sex is about the same as walking up two flights of stairs (and probably more pleasurable than what awaits two flights up!).

SOME OF THE COMMON EVENTS INTERFERING WITH SEXUAL ACTIVITY

Science has taught us that normal aging brings with it physical changes for both men and women.  An article from the National Institute on Aging describes changes for women to include a shortening and narrowing of the vagina, thinning of the vaginal walls, and less vaginal lubrication, collectively making some types of vaginal activity painful or less desirable.  For men, testosterone levels may decline and erectile dysfunction (ED) becomes more common, interfering with how long it takes to get and maintain an erection, or taking longer before another erection is possible.  See this website for a current list of recommended books about erectile dysfunction.

Other barriers that accompany the normal aging process include changes in body image with new questions about how “attractive” we are to our partner, performance anxiety and worry about sexual attention, major lifestyle changes such as retirement, and new concerns about illness, physical problems, and surgeries. Finally, we are never too old to worry about the risk of sexually transmitted diseases when engaging in sexual relations with another person who has other sexual partners; old age does not protect us from diseases like genital herpes, hepatitis B, or HIV.

PHYSICAL AND PSYCHOLOGICAL CHANGES IMPACTING SEXUAL ACTIVITY 

Many illnesses, disabilities, and medications can impact the older adult’s sex life. These include:

• diabetes – frequently causing ED in men or vaginal yeast infections in women;
• chronic pain – interfering with physical intimacy, while the pain medication itself can interfere with sexual function;
• heart disease – interfering with circulation, complicating physical arousal;
• heart attack – not necessarily interfering with enjoyment of an active sex life, the fear of sex triggering another heart attack is common though generally unfounded; discuss with your doctor;
• dementia – not impacting sexual performance, per se, but affecting judgement, appropriateness, and even recognizing his or her partner;
• incontinence – resulting in loss of bladder control during sex;
• stroke – often causing weakness or paralysis in different parts of the body;
• surgery (e.g., hysterectomy, mastectomy, or prostatectomy) – creating worry about future sex, a loss of interest, or feeling less desirable;
• medications – many prescription drugs used to treat high blood pressure, cancer, ulcers, anxiety and depression have side effects that impact sexual function and sexual desire;
• smoking and excess alcohol – though strictly lifestyle choices, both have a deleterious effect on sexual function.

KNOW WHEN TO SEEK HELP

Check with your physician or mental health professional about:

• switching medications with fewer side effects if your drug treatment limits your sexual enjoyment or functioning;
• cardiac rehabilitation programs to improve physical fitness;
• fear and worry about losing sexual interest and desire, low self-esteem, or about how attractive we are, or difficulty coping with new life stresses – age-related or not;
• suffering from erectile dysfunction and vaginal discomfort, and treatments that are now readily available.

ADAPTING – WHAT IT’S ALL ABOUT!

Each and every physical and psychological change that comes with advancing age requires new approaches to maximizing our enjoyment of sexual activity. Bodily changes in weight, skin and muscle tone require us to look beyond our own physical appearance and that of our partners, to feel just as comfortable in our aging body as we did in our young body, and to not let blame or judgement get in the way of enjoying a fulfilling sex life.

Feel free to be open with your partner about your sexual expectations and anxieties.  Discover new ways to be physically intimate if there are new obstacles.  If sexual intercourse is not possible, look for new ways to restore emotional and physical intimacy to a relationship.

Be willing to take more time to set the stage for romance and intimacy.  And, if you have lost your partner due to severe physical impairment or death, or through separation or divorce, start a new chapter and consider beginning another relationship, even exploring social dating sites (see a review of the best senior dating sites).  No one outgrows the need for intimacy and emotional closeness.  It we’re joining the Living to 100 Club, amore must be in the picture!

LIVING TO 100 CLUB RECOMMENDATIONS

There are literally hundreds of thousands of products and resources on the market to enhance the sexual experience – for all ages. Here are some curated books and products that may be of interest for the 50+ age group:

Mating in Captivity: Unlocking Erotic Intelligence – a best seller with a new take on intimacy and sex, the author is a NYC psychotherapist dedicated to improving human relationships.

Younger Next Year for Women: Live Strong, Fit and Sexy Until You’re 80 and Beyond – a guide for women about aging without fear or anxiety, with a premise on growing younger for the next five to ten years.

Younger Next Year for Men – a journaling program for becoming younger and healthier, bringing planning, record-keeping and motivation to the equation.

Naked at Our Age: Talking Out Loud About Senior Sex – the author describes herself as an advocate for ageless sexuality, and is described by others as the beautiful face of senior sex.

Kegel Fitness and Pelvic Resistance Program for Men – an 8-week DVD training course that provides a series of exercises to strengthen the pelvic-floor muscles shown to be associated with sexual performance and urinary health. Consult your physician before performing any exercise routine.

Premium Kegel Exercise Kit for Women – a best-selling 6-step training pelvic-floor program designed by board-certified OBGYN and Physical therapist.

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –