Sex­ual Heal­ing

From our chang­ing bod­ies to ad­justed at­ti­tudes, un­der­stand­ing in­ti­macy as we age

ZOOMER Magazine - - CON­TENTS - By Lisa Ben­dall

Sex­ual Heal­ing Un­der­stand­ing our sex­ual selves as we age

ANY­ONE WHO HAS a few wrin­kles or grey hairs can at­test to it: body parts change as we age. All body parts. But while sex­ual func­tion in your 60s may not look the same as it did in your 30s, it doesn’t mean the cob­webs are clos­ing in. Nu­mer­ous stud­ies prove that in­ter­est in sex of­ten con­tin­ues into a ripe old age. So does ac­tiv­ity. An Amer­i­can study in the New Eng­land Jour­nal of Medicine found that a ma­jor­ity of se­niors age 65 to 74 are sex­u­ally ac­tive. In the U.K., the English Lon­gi­tu­di­nal Study of Age­ing (ELSA) re­ports that of non­s­in­gle women in their 80s, 41 per cent en­joyed a roll in the hay within the past year. We don’t have sim­i­lar re­search on Cana­di­ans at this age, but a Tro­jan sur­vey of 2,400 midlife Cana­di­ans found that the old­est group (55-59) got the same amount of plea­sure from sex as the youngest (40-44). Ad­vanc­ing age is not hold­ing any­one back.

But the older body is dif­fer­ent. And in or­der to stay sex­u­ally ac­tive later in life, adap­ta­tions might need to be made or treat­ments sought – or minds opened. “Mak­ing love is ex­press­ing your feel­ings for your part­ner in a phys­i­cal way. It could in­clude in­ter­course but it could in­clude other ac­tiv­i­ties,” says Dr. E. San­dra By­ers, pro­fes­sor and chair of the depart­ment of psy­chol­ogy at the Univer­sity of New Brunswick, who has re­searched sex­u­al­ity and aging. “You just need to find ways to plea­sure each other and feel good about it.” De­sire can also go down if the re­la­tion­ship is strained – some­thing that’s of­ten missed, says By­ers. “I see peo­ple who are look­ing for some kind of med­i­cal ex­pla­na­tion for a sex­ual prob­lem, but they’re fight­ing all the time. Who’s go­ing to feel de­sire for some­one you’re not get­ting along with?”

In­for­ma­tion is half the bat­tle, say ex­perts. “All the way through life, you should know what’s hap­pen­ing with your body and why,” says Roselle Paulsen, direc­tor of pro­grams at Sex­u­al­ity Ed­u­ca­tion Re­source Cen­tre (SERC) Man­i­toba. “It re­duces anx­i­ety and helps you feel

more com­fort­able with your­self.” Com­mu­ni­ca­tion in your re­la­tion­ship, she says, is also vi­tal. “Fig­ure out what you and your part­ner find erotic. Have those con­ver­sa­tions.”

Adds By­ers: “Peo­ple need to create new sex­ual scripts, new ways of mak­ing love that are mu­tu­ally plea­sur­able, that work for both part­ners.” Here’s what might lie ahead – and what you can do to make sure your sex life con­tin­ues to thrive as you age.

The Hor­mone Equa­tion

His Symp­toms The abil­ity to con­cen­trate and plan is al­tered by drop­ping testos­terone lev­els, says Dr. Jack Barkin, a Toronto urol­o­gist, and visual stim­uli may be less ef­fec­tive: “Look­ing at a sexy pic­ture may not stim­u­late a sex re­sponse any­more.” Sex­ual func­tion is also more strongly af­fected now by psy­cho­log­i­cal stress. And be­cause af­ter age 50 testos­terone lev­els de­cline by one per cent a year, this also causes de­creased de­sire, a re­duc­tion in mus­cle mass and an in­crease in body fat. Erec­tions take longer and are less rigid. (Ejac­u­la­tion may take longer, too, which can be fun.) Erec­tions may come and go sev­eral times dur­ing sex­ual ac­tiv­ity. The So­lu­tion Play along. “Penisin-vagina in­ter­course doesn’t have to be the be-all and end-all,” Paulsen says. “Sex can mean what­ever the cou­ple wants it to mean, as long as they’re both com­fort­able and will­ing.” For men who are hav­ing trou­ble get­ting erec­tions, pos­si­ble ther­a­pies in­clude PDE5 in­hibitors (Vi­a­gra and friends), in­jec­tions or vac­uum de­vices. Try talking to your fam­ily doc­tor or urol­o­gist. “Men still don’t want to talk about their prob­lems, even though we [doc­tors] can help them and they want help,” says Barkin. “We can’t re­verse the aging process but we can def­i­nitely pro­vide op­tions, whether they be med­i­cal, phys­i­cal or emo­tional, to help them have a sat­is­fy­ing sex­ual ac­tiv­ity.” Her Symp­toms Estro­gen pro­duc­tion drops off at menopause. Vag­i­nal tis­sues be­come thin­ner and more eas­ily ir­ri­tated and pro­duce less lu­bri­ca­tion. The vagina becomes less ex­pand­able. Although sex­ual de­sire is in­flu­enced by mul­ti­ple fac­tors, there’s also a nat­u­ral de­cline from aging and menopause, says Dr. Wendy Wolf­man, direc­tor of the Menopause Clinic at Mount Si­nai Hospi­tal in Toronto. (Drugs to ad­dress this are cur­rently in tri­als.) The So­lu­tion Make up the es-

tro­gen you’ve lost. “It can re­store some of the mois­ture and elas­tic­ity,” says Wolf­man. “Since the vagina is exquisitely sen­si­tive to estro­gen, it will respond to safe, lo­cal low-dose estro­gen ther­apy via a low­dose tablet, cream or ring – or when sys­temic es­tro­gens via pills, gels or patches are used.” Help your skin by wear­ing breath­able cot­ton un­der­wear (go com­mando at night) and wash both your undies and your lady parts with mild, fra­grance-free soap. Vag­i­nal gels con­tain­ing hyal- uronic acid can help with dry­ness. Some women use co­conut oil or even Crisco short­en­ing. For sex, learn to love lube. (Lubri­cant will also pro­tect your con­dom from break­ing – you are us­ing con­doms to pre­vent STIs, right?)

Fix the Plumb­ing

His Symp­toms The prostate en­larges with age, ob­struct­ing urine flow in 65 per cent of men over 50. Symp­toms like fre­quency, urgency, in­con­ti­nence and in­fec­tions can in­ter­fere with sex and self-con­fi­dence. Prostate en­large­ment and erec­tile dys­func­tion also ap­pear to be in­ter­linked, so if ED becomes an is­sue have it checked ASAP. The So­lu­tion Treat the prostate symp­toms. “Of­ten, if we can im­prove the void­ing func­tion with med­i­ca­tion, we can also im­prove the erec­tions.” says Barkin. Her Symp­toms Women, too, may have some uri­nary in­con­ti­nence as they age, of­ten re­lated to weak­ened blad­der or pelvic floor mus­cles, some­times caused by preg­nancy, child­birth and menopause – and for both men and women, a lack of phys­i­cal ac­tiv­ity, obe­sity or, well, just plain aging can be the cul­prit. Like men, women may worry about leak­age at the wrong time or that the skin car­ries an odour. “It can af­fect your de­sire,” notes Wolf­man. Plus your skin can get sore if you’re wash­ing too fre­quently or wear­ing ab­sorbent pads all day long. The So­lu­tion There are also prod­ucts you can in­sert vagi­nally, like Uresta and Poise Im­pressa, that block urine leak­age, but may de­flate spon­tane­ity. Both must be re­moved be­fore in­ter­course. Depend­ing on the cause, phys­io­ther­apy to strengthen your pelvic floor might help, but it’s im­por­tant to pin­point with your health-care pro what’s caus­ing it be­fore treat­ment.


FOR PEO­PLE WHO YEARN to trade in their pri­vate parts for newer mod­els, is surgery an op­tion? When it comes to sur­gi­cally treat­ing age-re­lated changes in a bid to im­prove your sex life, per­haps not. Some cos­metic sur­geons of­fer vagino­plas­ties, also known as “vagina tight­en­ing” for women who feel their slack­ened vagi­nas are in­ter­fer­ing with their sex­ual func­tion. That said, med­i­cal so­ci­eties are cau­tious and con­cerned and cite a lack of long-term re­search on safety and ef­fi­cacy. Like all surg­eries, there can be se­ri­ous risks to th­ese surg­eries and, with­out clear ev­i­dence of ben­e­fits, the med­i­cal ex­perts don’t rec­om­mend them. In fact, the So­ci­ety of Ob­ste­tri­cians and Gy­nae­col­o­gists of Canada cau­tions that there’s lit­tle ev­i­dence to show that hav­ing an op­er­a­tion on your vagina will ac­tu­ally en­hance your plea­sure – or your self-es­teem.

Sim­i­larly, older men who no­tice a bit of shrink­age be­cause of in­creased ab­dom­i­nal fat or lack of blood flow should steer clear of so-called en­hance­ment pro­ce­dures. Th­ese surg­eries very of­ten do more harm than good, says urol­o­gist Jack Barkin, and the Sex­ual Medicine So­ci­ety of North Amer­ica con­sid­ers them “ex­per­i­men­tal.” Some Cana­dian clin­ics even of­fer fat in­jec­tions to in­crease size, but this car­ries se­ri­ous risks as well, in­clud­ing in­fec­tion and scar­ring. “There is no way to make a pe­nis longer than what it is,” Barkin adds. In other words, gents, it’s not the size – it’s how you use it that counts.

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