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January 4, 2011
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Sexuality in Midlife and Beyond
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Get your copy of Sexuality in Midlife and Beyond

The physical transformations your body undergoes as you age have a major influence on your sexuality. 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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11 ways to help yourself to a better 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.

Such physical changes often mean that the intensity of youthful sex may give way to more subdued responses during middle and later life. But the emotional byproducts 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.

Treating sexual problems is easier now than ever before. Revolutionary medications and professional sex therapists are there if you need them. But you may be able to resolve minor sexual issues by making a few adjustments in your lovemaking style. Here are some things you can try at home.

  1. Educate yourself. Plenty of good self-help materials are available for every type of sexual issue. Browse the Internet or your local bookstore, pick out a few resources that apply to you, and use them to help you and your partner become better informed about the problem. If talking directly is too difficult, you and your partner can underline passages that you particularly like and show them to each other.
  2. Give yourself time. As you age, your sexual responses slow down. You and your partner can improve your chances of success by finding a quiet, comfortable, interruption-free setting for sex. Also, understand that the physical changes in your body mean that you’ll need more time to get aroused and reach orgasm. When you think about it, spending more time having sex isn’t a bad thing; working these physical necessities into your lovemaking routine can open up doors to a new kind of sexual experience.
  3. Use lubrication. Often, the vaginal dryness that begins in perimenopause can be easily corrected with lubricating liquids and gels. Use these freely to avoid painful sex — a problem that can snowball into flagging libido and growing relationship tensions. When lubricants no longer work, discuss other options with your doctor.
  4. Maintain physical affection. Even if you’re tired, tense, or upset about the problem, engaging in kissing and cuddling is essential for maintaining an emotional and physical bond.
  5. Practice touching. The sensate focus techniques that sex therapists use can help you re-establish physical intimacy without feeling pressured. Many self-help books and educational videos offer variations on these exercises. You may also want to ask your partner to touch you in a manner that he or she would like to be touched. This will give you a better sense of how much pressure, from gentle to firm, you should use.
  6. Try different positions. Developing a repertoire of different sexual positions not only adds interest to lovemaking, but can also help overcome problems. For example, the increased stimulation to the G-spot that occurs when a man enters his partner from behind can help the woman reach orgasm.
  7. Write down your fantasies. This exercise can help you explore possible activities you think might be a turn-on for you or your partner. Try thinking of an experience or a movie that aroused you and then share your memory with your partner. This is especially helpful for people with low desire.
  8. Do Kegel exercises. Both men and women can improve their sexual fitness by exercising their pelvic floor muscles. To do these exercises, tighten the muscle you would use if you were trying to stop urine in midstream. Hold the contraction for two or three seconds, then release. Repeat 10 times. Try to do five sets a day. These exercises can be done anywhere — while driving, sitting at your desk, or standing in a checkout line. At home, women may use vaginal weights to add muscle resistance. Talk to your doctor or a sex therapist about where to get these and how to use them.
  9. Try to relax. Do something soothing together before having sex, such as playing a game or going out for a nice dinner. Or try relaxation techniques such as deep breathing exercises or yoga.
  10. Use a vibrator. This device can help a woman learn about her own sexual response and allow her to show her partner what she likes.
  11. Don’t give up. If none of your efforts seem to work, don’t give up hope. Your doctor can often determine the cause of your sexual problem and may be able to identify effective treatments. He or she can also put you in touch with a sex therapist who can help you explore issues that may be standing in the way of a fulfilling sex life.

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The Aging Eye: Preventing and treating eye disease
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Get your copy of The Aging Eye: Preventing and treating eye disease

As we age, problems with eyesight become more common. Despite this, many people are not conscientious about caring for their eyes. Learn how to recognize the risk factors and symptoms of specific eye diseases—cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy—and what steps you can take to prevent or treat them before your vision deteriorates further.

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Will wearing glasses make my eyesight worse?

Q. I am starting to have trouble reading. But I have heard that wearing glasses to help me read will make my eyesight worse. Is that true?

A. This is a common question. Many people believe that glasses can make eyesight worse, but that’s more myth than reality.

Many of us start to have trouble reading in our mid-40s. The condition is called presbyopia (pronounced prez-bee-OH-pee-ah), and it is the natural loss of the focusing ability of the lens of the eye.

The lens is about the size of a shirt button. Because it can change shape, we are able to see objects that are close or far away. The closer the object, the more the lens has to “flex” to bring the object into focus. With age, though, the lens slowly grows larger and thicker. As it grows, the many tiny ligaments that connect the lens to the ciliary, or “focusing,” muscle in the eye become slack. When that happens, those ligaments (called zonules) cannot exert enough force on the lens to bend it into the position necessary to see close objects clearly. The lens also hardens and becomes less flexible, compounding the problem.

Exercising the ciliary muscles so they could pull harder on the lens would seem logical, but these muscles don’t get appreciably weaker with age. Even if eye exercises could strengthen the ciliary muscles, they wouldn’t have much effect.

There are two reasons people wrongly blame glasses for worsening presbyopic vision. First, the underlying condition worsens during the period when they start wearing reading glasses, so they associate the glasses with declining vision. Second, they get used to seeing near objects well when wearing reading glasses, so when they take them off, their vision seems to have gotten worse. They blame the reading glasses, when they’re really just experiencing the contrast between corrected and uncorrected vision.

People do learn to cope with bad eyesight. The brain learns how to interpret blurry images and make educated guesses. If glasses make it easier for you to see well, your brain may get out of practice doing the tricks it learned to do to cope with poor eyesight. But that’s not the same thing as glasses making your eyesight worse.

Whether glasses worsen presbyopia is a settled issue. They don’t. But it’s not as clear-cut when it comes to childhood myopia, or nearsightedness (a term that causes confusion: it means your sight is good for near things and bad for things in the distance). The National Eye Institute has reported that the prevalence of myopia has increased by 66% since 1980, and this increase has prompted many studies aimed at understanding the cause of myopia.

Myopia causes distant objects to be blurry because the eye grows too long, so the focal point of the lens ends up in front of the retina instead of directly on it. The condition usually develops in childhood and gradually worsens until eye growth slows down in early adulthood. Myopia is largely genetic, but the progression of the condition may be influenced by environmental factors such as the stress of focusing on near objects when reading. For some children, this stress on the focusing system may cause their eyes to grow, and hence their myopia increases at a much faster rate. Bifocals could reduce that stress, and a study published in Archives of Ophthalmology in January 2010 showed that children wearing them had a 58% slower rate of progression of myopia, compared with children who wore traditional glasses with regular lenses that corrected for nearsightedness. This study confirmed findings from an earlier one that showed a similar but more modest benefit from wearing bifocals. Meanwhile, some other studies have suggested that specially designed gas-permeable contact lenses may also slow myopic progression.

There isn’t enough evidence yet to recommend that children with myopia wear bifocals or special contact lenses. Myopia is a very complex condition, and as the results of more well-designed studies get reported, we may be able to figure out a way to alter the course of this increasingly common form of visual impairment.

— Stephen Taylor, O.D.
Ophthalmic Consultants of Boston