Sexuality in Midlife and Beyond

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• An excerpt from this report

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Sexual Problems

Advancing years leave their mark on the body, mind, and emotions. Some of these changes are for the better, while others are less desirable. Sex is no exception. Many of the physical changes that come with age have noticeable effects on sexuality. Concerns related to sex and aging can include slower arousal, softer erections for men, reduced vaginal lubrication for women, and less intense orgasms. Medications and health conditions — such as diabetes, high blood pressure, heart disease, and arthritis — can also create sexual difficulties. But you can overcome these challenges and enjoy a better sex life. This report details the treatments, medications, and self-help techniques that can resolve common sexual problems.

Prepared by the editors of Harvard Health Publications in consultation with Alan Altman, M.D., Assistant Clinical Professor of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School and Suki Hanfling, MSW, LICSW, AASECT Certified Sex Therapist, Founder and Director of The Institute for Sexuality and Intimacy in Belmont, Mass. (updated: 2007)

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Here's an Excerpt from this Sexual Dysfunction Special Health Report

Sex. The word can evoke a kaleidoscope of emotions. From love, excitement, and tenderness to longing, anxiety, and disappointment—the reactions are as varied as sexual experiences themselves. What’s more, many people will encounter all these emotions and many others in the course of a sex life spanning several decades.

On one level, sex is just another hormone-driven bodily function designed to perpetuate the species. Of course, that narrow view grossly underestimates the complexity of the human sexual response. In addition to the biochemical forces at work, your experiences and expectations help shape your sexuality. Your understanding of yourself as a sexual being, your thoughts about what constitutes a satisfying sexual connection, and your relationship with your partner are key factors in your ability to develop and maintain a fulfilling sex life.

The physical transformations your body undergoes as you age also have a major influence on your sexuality. Declining hormone levels and changes in neurological and circulatory functioning may lead to sexual problems such as erectile dysfunction or vaginal pain. Half of men ages 50 and older report at least occasional erection problems. The figure rises to nearly 60% at age 60 and almost 70% at age 70. In addition, many women contend with issues of vaginal dryness and a lagging libido after they pass menopause (when the ovaries stop producing estrogen). 

Such physical changes often mean that the intensity of youthful sex gives way to more subdued responses during middle and later life. But the emotional by-products of maturity—increased confidence, better communication skills, and lessened inhibitions—can help create a richer, more nuanced, and ultimately satisfying sexual experience. However, many people fail to realize the full potential of later-life sex. By understanding the crucial physical and emotional elements that underlie satisfying sex, you can better navigate problems if they arise. This report will take you through the stages of sexual response and explain how aging affects each. You’ll also learn how chronic illnesses, common medications, and emotional issues can influence your sexual capabilities. Finally, you’ll find a detailed discussion of various medical treatments, counseling, and self-help techniques to address the most common types of sexual problems.

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