Healthbeat

The secrets to maintaining a healthy sex life

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What to do about Erectile Dysfunction
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With all the ads on TV and in magazines heralding pills to treat erectile dysfunction (ED), it’s tempting to think that treatment for ED begins and ends with Viagra, Levitra, and Cialis. But it’s important to be aware that many men can ease, or even reverse, ED by making simple lifestyle changes — such as losing excess weight and quitting smoking — that also are likely to boost their overall health and reduce their chances of developing diabetes, cardiovascular disease, and metabolic syndrome. This report offers a comprehensive review of these treatments, as well as the causes of erectile dysfunction and how ED may be an early warning sign for other serious health problems.

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No men or women over the age of 50 would argue that their sex life is just the same as it was when they were 20. Maybe it's better. Maybe it's worse. But either way, it's bound to be different.

Just as the body changes with age, so does sexuality. This physical transformation usually includes declining hormone levels for both men and women, as well as changes in neurology and circulation. These shifts often lead to a variety of sexual problems such as erectile dysfunction or vaginal dryness. A wide array of medical treatments is now available to address these and other conditions.

Outward appearances also change with age, sometimes bringing a decline in self-confidence in the sexual arena. Nearly everyone experiences some of these changes. But they don't spell the end of a sex life for most older people.

Both physical and emotional issues can interfere with a good sex life. Sometimes they intertwine, causing breakdowns in communication and inhibitions that cause sexuality to sputter and stall. But these are not problems you must live with. Instead, treatments are available that can improve, if not cure, most physical problems.

What you can do

Self-help techniques and counseling can bring relief to relationship problems. By shifting your focus away from your perceived flaws to your attributes, you can boost your self-esteem and establish your own standards for attractiveness.

Think back on what it was that made you attractive in your younger years. Was it your soulful brown eyes, your crooked smile, or maybe your infectious laugh? Chances are, those qualities are still as appealing as ever. Also, try directing your attention to the experience of giving and receiving pleasure during sex. This can help you find the confidence to give yourself over to the experience. Great sex is often the outgrowth of a deep emotional connection — something that's not guaranteed by having a perfect body. A negative self-image isn't always rooted in your appearance.

Career setbacks or other disappointments can lead to feelings of failure and depression, both of which sap desire. For men, episodes of impotence can undercut confidence in their manhood.

No matter what its cause, a poor self-image can take a toll on your sex life. When performance anxiety develops as a result, it can spark a downward spiral of repeated sexual failure and diminishing self-esteem. Correcting this problem demands serious attention to its origin.

Many of the physical changes that come with age have noticeable effects on the sex organs and the sexual cycle. Thus, the careful lovemaking of a 70-something couple may bear little resemblance to the lusty pairings of 20-year-olds. This isn't necessarily a bad thing. Greater experience, fewer inhibitions, and a deeper understanding of your needs and those of your partner can more than compensate for the consequences of aging. The physical changes of aging can provide an impetus for developing a new and satisfying style of lovemaking.

Sexuality in later life

Middle-aged and older adults no longer accept such myths as "Sex is only for young people" and "Sex isn't important to older adults." A study conducted by AARP, "Sexuality at Midlife and Beyond," illustrates this. These are some of the findings:

  • Five out of six of the respondents disagreed with the statement that "Sex is only for younger people."
  • Six out of 10 people stated that sexual activity was a crucial part of a good relationship.

Only 10% of adults reported that they don't particularly enjoy sex, and just 12% agreed that they would be quite happy never having sex again.


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How to Quit Smoking
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Tobacco use may be the toughest unhealthy habit to break. But don’t get discouraged. You can quit. In fact, in the United States today, there are more ex-smokers than smokers. The information in this report can help you learn about common obstacles that arise when people try to quit, and the various techniques to overcome them.

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Is it better to stop smoking abruptly or gradually?

Q. I've tried to quit smoking three times. A friend suggested that instead of giving cigarettes up all at once, I should try to kick the habit gradually. Which method is best?

A. The traditional view has been that establishing a "quit day" to stop smoking helps increase the chance that people will actually be able to kick the habit. But a review by the international Cochrane Collaboration concluded that a more gradual approach is just as effective and may be more appealing to smokers who want to quit.

The authors reviewed 10 randomized controlled studies, involving 3,760 participants, comparing the outcomes of quitting abruptly or gradually. They found that abstinence rates were about the same regardless of whether people quit smoking abruptly or gradually, whether they used nicotine replacement therapy, and whether they tried to quit on their own or participated in a support group.

Unfortunately, the analysis further confirmed the sad reality that you are not alone — most people were unable to kick the habit after one try. Over all, 202 of 1,979 smokers (10.2%) who stopped smoking gradually remained abstinent at least six months later, compared with 192 of 1,781 smokers (10.7%) who quit smoking abruptly.

Still, smokers who want to quit have other options. Research on smoking cessation suggests that combining methods — such as using both a support group and nicotine replacement therapy — boosts the odds of quitting. In addition, the Cochrane review did not examine the impact of medications such as bupropion (Zyban), which can be used in combination with nicotine replacement therapy. Another option is varenicline (Chantix), which both imitates and blocks the effects of nicotine, reducing craving in some smokers. Whatever you do, keep trying. Many smokers make multiple attempts before succeeding.

— Michael Craig Miller, M.D.
Editor in Chief, Harvard Mental Health Letter