Urinary Incontinence in Women
Sexual relationships don't stop just because people get older. However, the aging process causes changes in the body that can affect the ability to perform or enjoy sexual activities. This slideshow will review some obstacles to sex that may occur as we get older, and how to overcome them for an enjoyable sex life, no matter what your age.
Sexual Changes in Women
As women age there may be sexual changes they notice. Some can be positive: post-menopause or following a hysterectomy many women enjoy sex more freely without the worry of unwanted pregnancy. But other women may notice changes in their appearance such as wrinkles or gray hair that make them feel less attractive, which can affect her sexual desire. In addition, physical changes can occur. As women age, hormones decrease causing the vaginal wall to thin, become drier, and more irritated. This can lead to painful sexual intercourse. Friction from intercourse may cause micro-tears in the vaginal wall, which can cause pain or bleeding. Prescription medications and over-the-counter lubricants can help. Talk to your doctor if this is a concern for you.
Sexual Changes in Men
Men will also start to notice changes in their bodies with age. It may take longer to get an erection, and the erections may not be as large or firm as they used to be. Men may need more foreplay for an erection to occur. Ejaculate amounts may be less. After ejaculation, loss of erection may happen more rapidly, or it can take longer to get another erection.
Erectile dysfunction (ED), or the loss of ability to get or maintain an erection can occur in up to 65% of men over age 65. Men who have heart disease, high blood pressure, or diabetes may contribute to impotence, either because of the disease itself or the medication used to treat it.
What Causes Sexual Problems as We Age?
There are several causes of sexual problems that occur with age. Illness, disability, and even medications used to treat medical conditions can affect sexual performance and enjoyment. However, most people can have a satisfying sex life even with medical issues. On the following slides we will discuss some of the more common causes of sexual dysfunction associated with aging and offer tips for solving those issues.
Sexual Problems as We Age - Arthritis
Arthritis causes joint pain that can make sexual intimacy uncomfortable. Exercise, rest, warm bath, and experimenting with different positions may alleviate this pain. If pain is severe, talk to your doctor as medications may help, or joint replacement surgery may be needed.
Sexual Problems as We Age – Chronic Pain
Other conditions that can cause chronic pain can interfere with sexual function as well. Bone and muscle conditions, shingles, poor blood circulation, or blood vessel conditions can lead to sleep problems, depression, isolation, and difficulty moving (mobility). All that can lead to difficulty with sexual relations between older people. Many of these issues can be treated – talk to your doctor if you experience chronic pain.
Sexual Problems as We Age – Diabetes
Diabetes is an illness that can cause erectile dysfunction (ED, also called impotence) and retrograde ejaculation in men, where the semen travels backwards into the bladder instead of out of the penis. Medical treatment can help.
In women, diabetes can cause sexual problems including vaginal dryness, painful intercourse, decreased libido, and lack of sexual response. Over-the-counter lubricants can sometimes help.
Men and women with diabetes should talk to their doctor if they experience any sexual symptoms due to their illness, as there are medications that may be helpful.
Sexual Problems as We Age – Heart Disease
Heart disease is another medical condition that can lead to sexual problems. Hardening and narrowing of the arteries (atherosclerosis) can impede blood flow, and high blood pressure (hypertension) also impairs blood flow, both of which can lead to problems with erections in men. Most people can eventually resume sexual activity following a heart attack about 3 to 6 weeks after their condition becomes stable again. Follow your doctor's advice regarding sexual activity after a heart attack.
Sexual Problems as We Age – Incontinence
Bladder dysfunction in men and women can affect sexual function. Common problems include overactive bladder, poor control of sphincter muscles, urine retention problems, and urinary tract infections (UTIs). Sexual activity can cause pressure on the bladder, which may cause incontinence, a problem that makes many avoid sex. These conditions can usually be treated.
Sexual Problems as We Age – Stroke
Stroke doesn't usually affect a person's ability to have sex, but it may cause problems with erections. If a stroke results in weakness or paralysis, different sexual positions or medical devices can make sexual intercourse possible.
What About Surgery and Drugs for Sexual Problems?
Surgery may cause stress and pain in the short-term. However, most people can resume their normal sexual activities after surgery, even after genital surgery. Talk to your doctor about when you can resume sexual activity following surgery.
Sexual Problems in Women as We Age - Hysterectomy
As women age some will need a hysterectomy, or surgery to remove the uterus. This does not interfere with sexual pleasure or orgasm. If a woman feels she can no longer enjoy sex after a hysterectomy, or a man feels his partner's femininity is affected, counseling can help.
Sexual Problems as We Age - Mastectomy
As women age breast cancer incidence increases and in some cases, a mastectomy to remove all or part of the breast is needed. While a sexual response is still intact, a woman may lose her desire or feeling of being desirable following the surgery. Support groups can help, as can programs like the American Cancer Society's "Reach to Recovery." Breast reconstruction can also be performed.
While less common, men can also develop breast cancer, and the disease makes their bodies produce more female hormones which can lower a man's sex drive.
Sexual Problems as We Age - Prostatectomy
Certain health conditions that men can develop as they age include BPH (benign prostatic hyperplasia), acute urinary retention, urinary tract infection, hemorrhage or recurrent hematuria, bladder outlet obstruction, or renal insufficiency. These conditions may require surgery to remove all or part of the man's prostate (prostatectomy). Following the procedure, men may develop urinary incontinence or erectile dysfunction (ED, also called impotence). If total removal of the prostate gland is required (radical prostatectomy), talk to your surgeon about options to save the nerves that go to the penis so an erection will still be possible following the procedure.
Sexual Problems as We Age – Medications or Alcohol
A common cause of sexual problems can also be side effects of medications such as blood pressure medications, antihistamines, antidepressants, tranquilizers, appetite suppressants, diabetes drugs, and ulcer drugs. Other drugs can lead to erectile dysfunction (ED, or impotence) or cause difficulty ejaculating in men, and some drugs can cause loss of sexual desire in women. Talk to your doctor if you experience side effects from medications you are taking. Your doctor may be able to prescribe a different drug.
Alcohol in excess can cause erectile problems in men and delayed orgasm in women.
Safe Sex and Pregnancy
Even though older women may be approaching menopause and have irregular periods, pregnancy is still possible. Until a doctor says a woman is post-menopausal (no period for 12 consecutive month) pregnancy is still possible.
Safe Sex and STDs
Sexually transmitted diseases (STDs) are possible at any age. While young people are at highest risk, sexually active older people may still contract STDs including diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, hepatitis C, genital warts, HIV, chancroids, ectoparasitic infections, AIDS, LVG (lymphogranuloma venereum), HPV, urethritis, crabs, pubic lice, and trichomoniasis. Practice safe sex to reduce your risk of STDs.
Safe Sex and HIV/AIDS
The number of older people who are diagnosed with HIV/AIDS is increasing. People over age 55 account for nearly 20% of people living with HIV/AIDS in the U.S., according to the Centers for Disease Control (CDC). Those at risk include those with more than one sexual partner, people who are recently divorced, widowed, and are having unprotected sex. Always use a latex condom during sex to protect yourself from HIV/AIDS and other sexually transmitted diseases (STDs).
Can Emotions Play a Part in Sexual Satisfaction?
Sexuality is often tied into both our physical and psychological well-being. Men may fear that erectile dysfunction (ED) will be a problem, and that worry in itself can trigger episodes of impotence. Women may become concerned their looks make them less desirable to their partner, and can affect her enjoyment of sex. In addition to normal daily stressors, older people may be concerned about aging, illness, retirement, and other life changes, which can affect performance sexually. Talk with a doctor or counselor about your concerns, as help is available.
Senior and Single
If you are senior and single you may find it more difficult to find a partner with whom to share intimacy. Women live longer than men, and outnumber men as we get older. Meet new people by participating in social activities you enjoy and where other seniors will be present. Look for local senior centers, adult education classes, or county recreation activities.
Talk To Your Health Care Practitioner
If your sex life is not what it used to be, talk to your doctor. Depending on the cause, there may be a treatment. For older women, the most common problem is women is dyspareunia, which is painful intercourse caused by poor vaginal lubrication (vaginal dryness). This may be treated with over-the-counter lubricants, or estrogen. For men, erectile dysfunction (ED) is a common concern and there are a number of prescription medications that can help. Maintain open communication with your doctor and let him or her know your concerns.
What Can I Do To Have An Active Sex Life As I Age?
It's possible to have a healthy, active sex life as you get older. A key component of that is to maintain a healthy, active body. Exercise, reduce stress, eat a balanced and nutritious diet, drink lots of water and juice, and don't smoke or drink. See your doctor for checkups regularly. If you care for your body, you can maintain a healthy sex life as you age.