Sexuality-and-Aging

How people experience and express their sexuality will change throughout their lives. Aging brings about natural changes, both physically and emotionally, which can affect our reproductive health, sexual intimacy and sexual response or arousal.

As we all approach later life, two of the things which brought us the greatest joy and took up most of our energies and time – our children and/or our careers – are no longer as prevalent in our every day life. This means that our personal relationships take on an increased importance. While the frequency or ability to perform sexually will generally decline modestly as seniors experience the normal, physiological changes that accompany aging, reports show that the majority of men and women between the ages of 50 and 80 are still enthusiastic about sex and intimacy.

Sex is a way to affirm the love of life. It is an expression of satisfaction gained from being in the present. It expresses the closeness of our deepest relationships and is an important measure of quality of life.

The Dating Game Revisited

Some seniors are single again after years with one intimate partner. Others have never hooked up with a long-term partner but haven’t been in the dating scene for a while. Still others are in the process of “coming out” and openly seeking a same-sex partner for the first time in their lives. Regardless of the circumstances, it can be nerve-wracking to be back in the dating scene later in life. You may be ready to date but you aren’t sure what the rules of the game are anymore.

The basic rules are the same –

  • Respect yourself
  • Respect your partner
  • Communicate
  • Use protection
  • Have fun

As a senior, you may no longer have to worry about unplanned pregnancy but everyone has to protect themselves from sexually transmitted infections (STIs). STIs have no age limits and if you are sexually active, you need to practice safer sex. The most important protection is to learn how to use a condom and lots of lubrication to negotiate safer sex with your partner.

Sex and sexuality are a natural part of life. Sex is good for your health!

Let go of old sexual habits. Focus on being sensual and enjoying all the ways you can feel sexy alone and with a partner. Be patient and go slow!  Explore different types of touch, sex toys and the different things that make you feel sexy and confident.

Bring up the subject of sex, share your fears or worries with your partner and clearly communicate what you like and don’t like.

You may have to plan sex more, but you can use this planned times to find the best time and place to ensure maximum comfort and pleasure!

Women’s Sexual Health

As women grow older they experience a hormonal transition that signals the shutting down of their reproductive cycles. This is menopause. In many ways it is similar to the transition they experienced in adolescence when things were just starting up. Everyone ages in slightly different ways. There are a number of common physical and emotional changes you may experience but then again…you may not.

Signs of aging

All women have different experiences – some women experience dramatic fluctuations in their hormone levels while others notice relatively little change. Here are some common physical signs of aging that a woman may experience:

  •     Urinary incontinence (when urine accidentally leaks)
  •     More frequent urination
  •     Decreased sexual desire and arousal
  •     Mood swings

In North America, sexuality is often associated with youth but in reality, many women find sexual joy and strength in their later years. They no longer worry about pregnancy and are comfortable communicating their sexual needs with a partner. Menopause can be a powerful time of self-discovery and liberation.

Menopause

Over a lifetime there are two significant milestones in your physical sexual development: puberty and menopause. The onset of menstruation means that a female is physically able to get pregnant. Menopause is the opposite transition.  Ovaries decrease the production of estrogens which signals the end of menstruation and ability to get pregnant. Technically, menopause signifies menstruation has ended for at least one whole year.

What is perimenopause?

Perimenopause refers to the time when a woman first starts experiencing signs of menopause until her menstrual period actually stops for a year. This transition can take several years.

How old will I be when menopause starts?

Most women go through menopause in their late 40s and early 50s. Starting at age 40 and even younger is considered normal too. Many women in their mid 30s may start to experience changes associated with perimenopause.

Will this ever end?

Menopause can last up to age 60 but, have no fear – most of these symptoms lessen and eventually go away.

What are the signs?

The perimenopausal transition is unique for all folks. You may experience relatively few signs of the change while others have them all..

Here are some common signs that a woman may experience:

  • Menstrual irregularities (changes in your period) – The timing is irregular and the menstrual flow may be lighter or heavier than normal. You may notice the menstrual fluid is dark, thick and comes out in clots.
  • Hot flashes/night sweats – Hot flashes can be intense and sudden. If you see a woman in her 50s start to rip off her jacket in minus 20 degree weather she may be having a hot flash.
  • Itchy dry skin and dry eyes
  • Dizziness
  • Nausea
  • Changes in sexual desire and vaginal dryness
  • Increase of vaginal or urinary infections
  • Urinary incontinence (experiencing accidental leakage of urine)
  • Vaginal dryness
  • Sleep disturbances and insomnia
  • Headaches, aches and pains
  • Heightened sense of tension or stress
  • Depression and mood swings
  • Memory problems and inability to concentrate
  • Heart palpitations and anxiety attacks

Is there any help?

If any of these symptoms are affecting your quality of life, know that there are various forms of help available and it is up to you to choose which option might work best for you.

The first step is to explore natural methods of managing menopause such as herbs and supplements, changes to your diet, acupuncture and other stress reduction methods, such as yoga or meditation. For example, reducing your consumption of alcohol and caffeine can make a big difference, as does daily exercise.

Sex is painful. What can I do?

Waning hormones after age fifty cause thinning of vaginal tissues and can make sex painful. Use water or silicone based lubricant before and during sex to reduce the discomfort of vaginal dryness. Do not use cream, petroleum jelly or any other moisturizer that is oil-based. You can buy personal lubricant at the grocery or drug store. Talk to your doctor about lubricants or hormone treatments designed specifically for seniors.

How should I prepare for menopause?

Menopause is a completely natural and healthy part of life that all women experience. For some women it is a challenging period of difficult physical and emotional changes. For others, it is a time of personal growth and renewal. And for many women, it is both at the same time. They don’t call it “Menopausal Zest” for nothing!

Here are some suggestions to help you enjoy your menopausal years to their fullest:

  • Educate yourself about menopause by reading books, articles and information available online
  • Talk to friends and relatives who have already gone through menopause
  • Join a menopause or midlife support-group in your area
  • Enjoy a nutritious diet and exercise regularly
  • Practise meditation or another form of relaxation to maintain inner harmony and balance
  • Talk with your health care practitioner about any personal health concerns
  • Know that you have choices and can take charge of your own health

Men’s Sexual Health

Women are not the only ones who experience changes in sexual health as they age. As men grow older, their levels of testosterone (the male sexual hormone) naturally decline, causing changes in their sexual health, sexual function and emotions.

Signs of Aging

All men have different experiences – some men experience dramatic fluctuations in their hormone levels while others notice relatively little change. Here are some common physical signs of aging that a man may experience:

  • Less firm or less frequent erections
  • Increased ‘recovery time’ or time between erections
  • Decreased force of ejaculation
  • Urinary incontinence (when urine accidentally leaks)
  • Decreased sexual desire and arousal
  • Increased risk of prostate cancer

Until recently, there was little discussion about men’s sexual health and aging. Men were not encouraged to talk with one another about their experiences or to seek help with their sexual health changes. The underlying message was “It is not ‘manly’ to admit you are noticing a decline in your sexual prowess. Men should always be interested in sex and ready to go.” Thankfully this is changing as more men speak out about changes to their sexual functioning and new information and treatments become available for various sexual health issues, including erectile dysfunction (see erectile dysfunction) and prostate cancer.

Erectile Dysfunction

As men age, their ability to get erections is affected. An erection may take longer to attain, and may not be as firm as in their youth. You may find it difficult to get an erection at all. Causes can by physiological or psychological, but as men age, for many the physical causes become more common.

If you are having problems getting or sustaining an erection, talk to your doctor. There are many options to help you out such as sex toys, therapy and medication. One of the best things about growing older is that you have more time and flexibility to enjoy life without the stresses of career demands and/or family needs. Be spontaneous. Take advantage of your erection when you have one and enjoy!

What is erectile dysfunction (ED)?

Erectile Dysfunction (ED) is different from having a hard time getting it up or maintaining an erection because you drank too much, are tired, or feeling distracted by other concerns. The College of Family Physicians of Canada (2007) defines erectile dysfunction as “…when a man can’t get and keep an erection long enough to have sex on at least 50% of tries”. The Canadian Male Sexual Health Council defines ED as a problem that persists for more than three months. It is a common problem, affecting about one in every three men on a regular basis. It is more common in men over age 65 but it affects middle-aged and younger men as well.

What causes erectile dysfunction?

A lot of males are embarrassed to talk about ED because they assume it is some kind of sexual inadequacy on their part but this is not true. It can be your body or mind’s way of indicating there is an issue that needs addressing. There are a number of physical causes and medications that can cause ED.

Physical causes usually stem from damage to the blood vessels that carry blood to the penis or to the nerves that carry signals of arousal from the brain to the blood vessels themselves. For example, ED can be caused by a stroke, diabetes, hardening of the arteries, smoking, Parkinson’s disease, alcoholism, Multiple Sclerosis (MS), liver or kidney failure, brain or spinal-cord injuries, Hypogonadism, or radiation to the testicles (treatment for prostate cancer).

However, ED is not just a physical health problem. The mind-body connection is strong, and how a man feels or what he thinks has direct impact on what his body does. Mental causes of ED include stress, anxiety, depression and grief. For example, a man who has experienced ED once may begin to worry that it will happen again. The anxiety he feels becomes a self-fulfilling prophecy because he cannot relax and his body responds by shutting down.

If this is happening, remove the goal of penetration altogether from your next several sexual encounters. Once your mind learns not to anticipate it, it will stop letting you get so anxious.

Try to maintain perspective. It’s perfectly normal and okay for your sexual drive to slow as you age. Try not to put too much pressure on yourself to be sexual in the exact same ways you were when you were younger. Look at this as an opportunity to rediscover your sexual self as an adult.

Is there help?

Yes – there is something you can do about ED. One thing you can do is practise relaxation techniques to ease your mind and remind yourself that you are not alone. Boost up the foreplay with your partner and take the focus off penetration. You don’t have to “perform” in order to have a sexually satisfying relationship.

Other treatments depend on what the cause is. Your doctor can run some tests and may recommend hormone shots or medication such as Viagra, Levitra or Cialis. It is important, however, that you consult a physician before taking medications to stimulate arousal so that you fully understand the risks and benefits of various options. In July of 2005, Health Canada issued a health warning to men who take Viagra, Levitra or Cialis about risks of vision loss or impairment caused by blockages to the optic nerve. Any man who notices sudden vision loss or vision-related problems while taking these drugs needs to seek immediate medical treatment.

Prostate Cancer

Prostate cancer is the most common form of Cancer diagnosed in Canadian men. The risk of developing it increases with age 1, but if diagnosed early it can usually be cured and managed more easily.

What is the prostate?

The prostate is a gland that sits close to the rectum just below the bladder. It makes whitish fluid that mixes with sperm from the testicles to make semen and it helps to control urine flow.2

What causes prostate cancer?

There is no one single cause of prostate cancer but there are risk factors including age, family history, racial ancestry and possibly diet3. The risks increase as you age. Some prostate cancers grow very slowly and you may have it for some time without noticing any health problems. All men over the age of 50 should be tested. A man may want to start earlier if he has had other risk factors such as a family history of cancer.

What is involved in testing for prostate cancer?

Prostate cancer can be managed and even cured if detected early so it is important to talk with your health care provider about having a prostate screening test. There are two basic tests that can help to detect prostate cancer early on: DRE and PSA.

During your annual physical check-up, you may receive or ask for a digital rectal examination (DRE). The doctor inserts his or her gloved finger into the rectum to feel the prostate gland. Click here for more information. This may feel a bit uncomfortable but it may help to remember that most doctors have done this hundreds of times.

Women’s Health

Courses, phone counselling and a lending library are available at Alberta Health and Wellness . Visit the website or call HealthLink at 403-943-LINK (5465) in Calgary, Toll-Free 1-866-408-LINK (5465).

For additional information about perimenopause/menopause, visit the following websites:

 

Men’s Health

Courses, phone counselling and a lending library are available at the Alberta Health and Wellness . Visit the website or call HealthLink at 403-943-LINK (5465) in Calgary, Toll-Free 1-866-408-LINK (5465).

 

Considerations for Trans Folks:

Transwomen patients on feminizing hormone therapy:

Mammograms are recommended for transwomen who have been using estrogen for at least 30 years AND are at least 50 years of age, unless there is a strong family history of early breast or ovarian cancer.  http://transhealth.ucsf.edu/trans?page=protocol-aging