Sexual health – Sex after 50

What aspects of sex are likely to change as you and your partner get older? How can you both adapt to those changes? Janice Swanson, doctor of psychology, a licensed psychologist and a specialist in human sexuality at Mayo Clinic in Rochester, Minn., has some answers.

The changes your body goes through as you age impact your whole sexual experience — not just your sexual function. When confronted with the normal changes of aging, you may feel as ill-prepared and awkward about sex as you did during your first sexual experiences as an adolescent.

Not much has been written about this complex transition, but that’s changing. People are living longer than they ever have before, and many have the expectation of being sexually active for the majority of their years.

Most important, communicate with your partner. It sounds simple, but it can’t happen unless you actually set aside time to be sensual and sexual together.

When you’re spending intimate time with your partner, verbalize your thoughts about lovemaking. Tell your partner what you want from him or her. Be honest about what you’re experiencing physically and emotionally as your body undergoes the inevitable changes of aging.

More generally, it never hurts to do some reading. Learn about sex during the second half of life. Often, books include helpful exercises and suggestions — such as sensual massage, different types of foreplay and sexual variety — that can help you.

For men, testosterone plays a critical role in the sexual experience. Men’s testosterone levels are highest in their late teens. After that, they gradually fall throughout the lifespan. By the time men reach age 60 to 65, most will notice a difference in their sexual response. The penis may take longer to become erect, and erections may not be as firm. It may also take longer to achieve full arousal and to have orgasmic and ejaculatory experiences.

Another significant change is in the actual chemistry of an erection. A chemical the body produces to help sustain engorgement of the penis has a shorter duration of activity as men get older. Drugs such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) have been introduced to help with the general functioning of that biochemistry.

As women approach menopause, they experience a hormonal transition very similar to the one they reached in adolescence — except that now, instead of starting up, their cycles are shutting down. The amount of estrogen their bodies produce declines. As a result, many women feel noticeably less receptive to their partners’ sexual overtures. They also may miss that midcycle spark of interest that reproductive biology gave them. And because estrogen affects the brain, women may experience emotional changes as well.

Any condition that affects general health and well-being is also going to affect sexual function. Illnesses that involve the cardiovascular system, high blood pressure, diabetes, hormonal problems, depression or anxiety — and the medications used to treat these conditions — could pose a potential problem for your sexual health.

Your blood pressure, for instance, could affect your ability to become aroused, as could the medication you take to treat high blood pressure. For a man, this might mean difficulty in getting an erection. For a woman, it might affect how her clitoris engorges.

What people often don’t think about is the emotional effects of having an ailment. After a heart attack, for instance, you could become depressed because the experience drove home the fact of your mortality. One of the symptoms of depression is the loss of pleasure or sexual interest. So even though the heart attack itself may have no direct effect on your sexual functioning, your emotions may disrupt it.