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Sex in the second half of life

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Sexuality in Midlife and Beyond
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The physical transformations the body undergoes with age have a major influence on  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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Sexuality is not just for the young. Results from a University of Chicago survey published in 2007 suggested that over half of Americans remain sexually active well into their 70s. That said, sexual activity does subside with age. Biological factors tug in that direction, as do social arrangements: older people, especially women, often end up single when a spouse or partner dies. But researchers at Indiana University report that 20% to 30% of long-lived Americans are sexually active into their 80s.

Now suitable for study

It wasn't long ago that older people weren't included in studies of sexual behavior because they were seen as largely irrelevant to the topic: 59 was the upper age limit of a landmark study of American sexuality conducted in the early 1990s. However, the University of Chicago survey focused exclusively on older adults, including just over 3,000 Americans ages 57 to 85. The results lent some legitimacy to the subject of sexuality of older people. Here are some of the main points:

Sexual activity tapers off with age. Both surveys show a decline in sexual activity with age, although the drop-off isn't as steep as one might expect, and a significant minority (especially men) defies the trend. In the Indiana study, 35% of the men ages 80 and older reported that they had intercourse a few times or more in the past year. In the University of Chicago study, 38.5% of the men ages 75 to 85 reported having sexual activity with a partner in the previous year.

Older women are less sexually active than older men. Both studies show that older women — even the "young old," in their 60s — are less sexually active than men of the same age. The gender gap widens as people get older.

Partnered sex gets high marks. In the Indiana study, over three-quarters (78%) of the men ages 50 and over rated their most recent sexual experience with a partner as either extremely or "quite a bit" pleasurable. About two-thirds (68.2%) of the women in that age group rated their most recent experience with a partner that highly.

Yet, a sizable minority of the men (43%) and women (36%) in the Indiana study reported that their most recent partnered sexual activity was with someone other than a spouse or long-time partner. This category included casual or new acquaintances, friends, and "transactional" partners — people who engaged in sex in exchange for something, often but not always money.

Masturbation is common. Most men (63%) and almost half of women (47%) in the 50 and over age group reported masturbating in the past year, according to the Indiana survey. As with other sexual activities, the percentage declined with age.

Good health matters. The University of Chicago researchers found a strong association between good health and sexual activity, particularly among men. Diabetes seems to have a greater negative effect than either arthritis or high blood pressure on both genders, but especially on women. In the Indiana survey, a woman's evaluation of her last sexual experience did not vary with her self-reported health status.

Sexual problems are common. Half of those who participated in the University of Chicago study reported having at least one bothersome sexual problem. Among men, the problems included difficulty achieving and maintaining an erection (37%), lack of interest in sex (28%), anxiety about performance (27%), and inability to climax (20%). Among women, the common problems were lack of interest in sex (43%), difficulty with lubrication (39%), inability to climax (34%), lack of pleasure from sex (23%), and pain during sex (17%). In the Indiana survey, 30% of the women ages 50 and over said they experienced some level of pain during their most recent sexual experience with a partner.

Many men take something to improve sexual function. In the Indiana survey, 17% of men ages 50 and older took an erectile dysfunction drug in connection with their most recent sexual experience with a partner. In the University of Chicago study, 14% of the men and 1% of the women reported taking medications or supplements to improve sexual function during the past year.


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Hearing Loss: A guide to prevention and treatment
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Get your copy of Hearing Loss: A guide to prevention and treatment

If you think you might need a hearing checkup, you probably do. This Special Health Report contains in-depth information on the causes, diagnosis, and treatment of hearing loss. You'll learn how to prevent hearing loss and preserve the hearing you have now. You'll also learn about the latest advances in hearing aid technology and find out which kind of hearing device may be best for you.

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Help for feeling of fullness in the ears?

Q. I have a feeling of fullness in my ears that won't go away. I think it has been diagnosed as something called eustachian tube dysfunction. I have been to several otolaryngologists. Nothing has worked. Suggestions?

A. People with a persistent sensation of fullness in the ear should get it checked out by a physician. Occasionally, hearing loss can create such a feeling. Temporomandibular joint disorders (sometimes referred to as TMJ), which affect the joint that connects the jawbone to the skull, can also create the sensation. But a diagnosis of eustachian tube dysfunction does make sense.

The eustachian tube, which connects the middle ear to the nasal cavity, helps to equalize the air pressure on either side of the eardrum. If your eustachian tube is blocked or not working properly, there's less pressure on the inside of the eardrum than the outside, so the eardrum may cave in slightly, which causes that sensation of fullness. In serious cases, fluid accumulates behind the eardrum because pressure is so low that fluid from surrounding tissues and blood vessels gets pulled into the middle ear.

Some people try nasal sprays and over-the-counter antihistamines and decongestants for eustachian tube dysfunction, but there's no evidence that they are effective for this purpose.

Putting a tube in the eardrum equalizes pressure on the eardrum by connecting the middle ear to the ear canal. These tubes are used most often in children as a temporary measure to give the eustachian tubes time to develop.

Perhaps more often than we'd like to admit, doctors are faced with problems that can't be fixed. This may be one of those situations. I would think about trying biofeedback or some other kind of mind-body technique. The fullness sensation may not go away completely, but people can train their brains so that bothersome, even painful, symptoms are less troubling.

— Jo Shapiro, M.D.
Brigham and Women's Hospital, Boston