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Sexuality
in Later Life
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 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)
National Institute
on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
1994
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