Older people and sex
Stereotypes can be very powerful. One of the enduring stereotypes of the modern
age is that older people are not interested in sex and dont engage in
sexual relations. Sex between consenting adults is fine but not if they are
both above a certain age. Sex is for young healthy and attractive people. The
notion of grandparents doing it is revolting. Or so the stereotype goes.
The great danger with stereotypes is that people begin to accept them as being
true. We live in a society that idealises the thin athletic body of youth. Television
and various forms of advertising all promote the concept of the body beautiful.
Tall thin and leggy is in but the fuller figure is definitely out. It is not
just the vulnerable adolescent that can feel alienated in the modern world.
We know from our experience with young people that self-esteem and body image
are closely related and can be a source of deep unhappiness if the young person
perceives that they are very different from their peers. But self-esteem and
body image can also be very important for the older person as age related change
imposes its own challenges.
Older people look in the mirror too. They may fear being less attractive to
their partners as their hair recedes, the wrinkles increase and the varicose
veins start to get bigger. The person is also challenged by the physical changes
they observe in their partners. Some couples learn to accept these physical
changes and focus on wider aspects of their relationship and can continue to
enjoy physical intimacy to an advanced age. Others are less successful in making
this transition with great personal loss to themselves.
The menopause is an important time of change for most couples and it can be
a make or break time. It is a time of transition that is not just simply a question
of hormones. A successful transition through the menopause can ensure the continuation
of a satisfactory sexual relationship for many years to come. For some couples
the menopause can be a time of great sexual liberation as they are at last free
of the worry of pregnancy. It can also be the first time in years that the couple
have had the house to themselves without the fear of intrusion during lovemaking.
Some women may even experience an increase in sex drive because the oestrogen
levels begin to fall thereby allowing androgens to play a more powerful role
in physical arousal and sexual response. Readers may be surprised by that previous
comment since androgens are known to be male hormones however, both men and
women have certain amounts of both male and female sex hormones in their bodies.
It is the altered ratio of androgen to oestrogen in the menopausal female that
causes the sexual effect.
However, a decrease in sexual desire with advancing age is perhaps more common
in both men and women. Sexual response may also take longer. Men may begin to
experience erectile failure and this may cause considerable difficulties in
self-esteem especially if it is a new experience for the man. One of the most
positive spin offs from the recent availability of treatments for erectile failure
is that men are at last beginning to feel that they can now talk about this
difficulty to the doctor because something can be done about it.
I had an amusing experience when viagra first became available in Ireland.
A woman came to see me one day in order to get a supply of the drug for her
husband because the drug had not yet been launched in the country where she
now lived. The drug was on her shopping list of things to bring home with her
along with the Aran jumpers, the brown bread and the smoked salmon.
Some medications can affect
I digress! Women may experience soreness during intercourse because of thinning
and drying of the vaginal tissues. This happens as a result of the decrease
in oestrogen. These physical changes in the vagina may cause discomfort for
both partners and they may resort to the use of lubricants to compensate for
lack of vaginal moisture. If a couple do resort to using lubricants it is best
to use a water based item such as KY jelly rather than petroleum jelly, which
quickly loses its lubricating effect during intercourse. Prescription vaginal
creams containing oestrogen may be an even better option for the problem of
vaginal dryness and thinning.
There may also be issues concerning role change. This can be a particular problem
for women as they struggle with several competing roles all at once. The nest
is now empty but they may have to contend again with child minding as they care
for their grandchildren. Some women may also have to continue working outside
the home while still performing the traditional role of housewife. For some
women the juggling of these various roles may allow the role of sexual partner
to recede into the background.
Having negotiated their way through the menopause the couple may have to contend
with physical impairment. Arthritis can make sexual intercourse more difficult
but not impossible. People with cardiac or pulmonary disease may lack the actual
stamina to engage in intercourse. However, changes in sexual positions may allow
mutually satisfactory sexual relations to take place.
Some medications can affect sexual response. For example medication for high
blood pressure can cause erectile difficulty in the male so if that happens
discuss it with your GP. You dont have to accept such side effects as
part of lifes ongoing burden. Medication can be changed. Erectile failure
is not an essential element in controlling peoples blood pressure!
It is important for older people to continue to eat sensibly and take regular
exercise. A sedentary lifestyle accompanied by obesity, excessive alcohol consumption
and cigarette smoking can all result in a diminished or absent sexual response.
If you pay prudent attention to your health there is no reason why you cannot
enjoy good sex while having a medical card for the over seventies and a free
The desire for sex is a powerful, primitive and healthy drive within all of
us. Older people should ignore the stereotypes of today and seek help if they
are experiencing sexual difficulty. Sex is not just for the young. True sophisticates
might even say that it is wasted on them.
Dr Leonard Condren is the medical editor of irishhealth.com
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