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Sexuality Later in
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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