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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 shouldnt 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 doctors 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 womans 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
Societys (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 womans
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 womans
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)

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