Added: Aleese Vaccaro - Date: 12.12.2021 13:10 - Views: 45333 - Clicks: 626
This article is a special guest post by geriatrician Dr. Like me, Dr. Didyk has a particular interest in informing and empowering older adults and families. Think about older adults and sex. What comes to mind? George Burns cracking wise about sex after 90 being like trying to shoot pool with a rope? A sweet old couple holding hands in their rocking chairs? This, of course, is largely due to pervasive ageism in society.
In my job as a consultant Geriatrician, I see older adults about a wide range of issues, including memory changes, falls, pain, depression, and medication adjustment. But what is often affected by all of those medical issues — yet rarely talked about — is sex. Geriatrics is a team sport, and one of the professionals on my team is Natalie Wilton, MSW, RSWa social worker who specializes in working with older adults with dementia.
I noticed that Natalie had a particularly skillful approach when working with responsive behaviours in dementia that had a sexual component, and I soon learned that Natalie is also a qualified sex therapist, with a special interest in older adults. I knew I had to interview her for my website, The Wrinkle. Clearly, more needs to be done to help ensure that older adults are supported in addressing this vital dimension of the human experience, and in getting the help they might need from their health providers. Many older women define sex as vaginal intercourse, which may amplify the decline in sexual activity if a male partner is less healthy or available.
The healthier the woman, the more likely she is to engage in sexual activity and although sexual desire may flag, the desire for intimacy does not. After menopause, the lack of estrogen production in females cause changes to the sexual organs, which can lead to challenges:. This might include shopping for a sex toy online may be preferable to a brick and mortar shop and lubricant readily available at most drug stores. For some women, medication can helpsuch as topical hormone therapy cream or vaginal suppositoryor systemic oral hormone therapy usually only if there are other symptoms of menopause such as hot flashes, due to risks and side effects.
Sex, after all, involves the mind along with the body. For many women, that means adjusting the perception that vaginal intercourse is the only way to have sex, trying different sexual activities, and maybe even using toys or devices to have pleasurable moments with their partner. Like in women, the aging male can take longer to become aroused, and can have a longer refractory period after an orgasm before being ready to begin a new sexual cycle. Erectile dysfunction is more common in older age, with up to two-thirds of men over 70 reporting ED.
This can be related to declining testosterone levels, and is also commonly influenced by many age-related conditions and the medications used to treat them. Along with medication adjustments and treatment of other physical health conditions, it also often helps for older men to rethink their approach to sex and intimacy. Intimacy is important to older men, who are more likely than their mature female counterparts to be in a partnered relationship.
To keep the connection strong, older adults may need to explore new techniques and devices to maintain a satisfying sex life. These could include toys, lubricants, visual material, or even a trip to the sex therapist. Preventing pregnancy is usually not a concern in later life. At my age? Some physical changes are normal and universal, but what about when there are unexpected health challenges in later life that can put a damper on sex?
Learn more about sex and caring for someone with a disability or illness here, in Part Two — Sex and The Caregiver. For instance:. There are many conditions with pain as a symptom, including osteoarthritis, injuries, neuropathic pain, or some stroke syndromes. Many pain syndromes are more active in the morning or nighttime — typical times for sexual activity, so making time for sex and intimacy in the middle of the day could be more enjoyable.
Positioning is very important when living with pain, and Natalie Wilton recommends rearranging pillows or looking into purchasing specialized foam wedges that can make sex more comfortable. Depending on the type of cancer and treatment plan, sex can change dramatically after a cancer diagnosis. Sex may not be able to continue in the physical way that was ly enjoyed and sexual pleasure sensations and orgasm may be very different. Some people lose interest in sex while being treated for cancer, but most want to continue or some type of sexual activity, especially if they are in a partnered relationship.
Many cancer centres have a social worker that can help address the communication strategies needed to renegotiate lovemaking in the setting of loss, or loss of function of a body part due to cancer.
Like with cancer treatment, there can be a fear of having sex after a heart attack or major cardiac procedure or surgery. In general, when a person is fit for exercise, they are also fit for vigorous sexual activity, so there may need to be an exploration of activities like massage, cuddling, or sharing sexual fantasies while recovering from a heart attack or surgery. Many cardiac medications can affect the ability to get an erection for men, and to achieve orgasm in both men and women, but stopping medications due to these side effects can lead to more symptoms and higher risk of recurrent events.
A mood disorder, or the medications used to treat one, can affect libido and sexual function. Serotonin reuptake inhibitors for example a commonly prescribed antidepressant can lead to delayed arousal and difficulty achieving orgasm. You can see from the above points, that sex and health issues are common, and can be addressed in different ways.
Shifting the focus from penis-vagina contact and orgasm to intimacy, pleasure and emotional closeness, can take the pressure off and reinforce the connection between partners. Sex therapists are professionals with additional training in sex therapy and may come from a background of social work, psychology, nursing, or medicine.
Most offer counselling and advice and work with individuals or couples. Therapy involves:. Sex therapists almost never provide sex surrogacy or have sexual contact with the client, although those services may be available from other professionals.
Some therapists, like Natalie Wilton, specialize in working with older adults, but many of the issues that come up are the same no matter the age group and can include:. Here are the links:. That must be a great unknown or a bias. Not sure which. Thanks for pointing that out, sue! This article is a good summary of how psychiatric medications and conditions can affect sexual function in women. I am 67 yrs, take sertraline and have no problem achieving orgasm while self-pleasuring.
Sex toys help. I read your post with great interest. I am an over-the-hill male, now turned 87 years, having had an open heart surgery in I have a heightened libido especially after the surgery and I enjoy sex now and then, in my own ways! I like it. Regular visits to the gym, watching tv shows and sports, and occasional indulgence in sexual mood are my pastime. Hi Jay and thanks for reading the article! As mentioned in the article. Thanks for sharing your experience! I hear people often say, including my physician, that I look much younger than my present age and that I should do whatever I have been doing all these years to keep up my physique.
My main mantra is gym and healthy vegetarian diet! Most of them are retired stage performers or shift workers. I recommend checking out Dr. I think meeting someone is the main problem for most of us old woman.
So, you are probably correct that finding a partner can be a barrier to sex in later life for older ladies. Thanks so much for sharing your perspective. However, I fear the radiation has permanently altered my vaginal tissue.
Up to that point my spouse and I of 36 years enjoyed an active sex life, but now intercourse is extremely painful. My medical professionals have prescribed topical hormone creams, vaginal stretchers and we have tried every lubricant on the market to no avail. I also take a low dose harmone replacement. My husband and I still have sexual drives and are otherwise healthy…but the pain…well…is a real pain.
Are there any other solutions out there? Huffman, et. Published in final edited form as: Gynecol Oncol. Published online Nov 7.
This might also be a good topic to discuss with a sex therapist. Part of continuing to enjoy your sex life might mean focusing on activities other than penetration for a while, so that you can continue to have the intimacy and pleasure you need, just in a different way. Thanks for sharing your experience, and know that you are not alone. The MonaLisa lazar treatment was the best fix for me.
Check online for gynecologists in your area who do this procedure.
The procedure you mention is laser therapy which has been used for the genito-urinary symptoms of menopause like vaginal dryness, irritation, vaginal laxity, and stress urinary incontinence — the kind of incontinence where urine is released with a cough, sneeze or with exercise.
As mentioned in the article, those symptoms can make vaginal intercourse painful. The laser therapy basically heats up the vaginal tissue and promotes collagen remodelling and increased lubrication. In doing some research into this therapy though, I found an opinion by the International Urogynecology Association that advises that we need more evidence using these devices before they can be widely recommended.
There have been 2 well-deed randomized controlled trials of the use of lasers to relieve genito-urinary symptoms and improve sexual function, involving a total of women. There did seem to be short-term improvement, compared to placebo treatments, and no major safety issues were identified. So it seems promising, but may be prudent to wait for more clinical evidence before investing too heavily in a course of laser treatment. When he got romantic before we married, I asked him to wait. He took an ED drug 5 or 6 times but tries waking me sometimes at 5am which was not what I imagined for our first time.
I have been in many relationships but never imagined my marriage would be the sexless one, especially spending so much time together during Covid. Please help. Thank you. Erectile dysfunction is complex, and may not just involve getting and maintaining an erection, so ED meds are not always the answer. If a man can get an erection in the early morning, then that may mean being flexible about the timing of intercourse. Going to bed earlier or planning for a nap later in the day to accommodate early morning sex could be a compromise. For many couples, taking the focus off of penis-vagina intercourse can relieve a lot of stress and be very pleasurable.Adult wants sex MT
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