Daily Breeze (Torrance)

Maintain your sexual health in your later years

- By Drs. Jocelyn Craig and Jennifer Liu Correspond­ents Dr. Jocelyn Craig is the medical director of the Pelvic Health Program at MemorialCa­re Long Beach Medical Center. Dr. Jennifer Liu is the chief of urology at the hospital.

Continuing to want to be close to someone doesn’t change just because you are getting older. It is normal to still want to have an active, satisfying sex life as you age. You just may need to adapt sexual activity to accommodat­e physical, health and other changes.

These changes can vary for men and women, and, at times, it can impact both partners. It’s important to not be embarrasse­d to address any sexual change concerns with your partner and/or physician.

Women’s sexual health

One in two women older than 50 are affected by sexual issues, according to the Sexual Advice Associatio­n. Many of these changes come from menopause. The further you are in your menopause journey, the more your estrogen levels deplete. That depletion may cause you to feel moody, tired and irritable, and experience hot flashes.

Menopause can also change a woman’s sex drive. While some report an increase in sex drive, it is more common for women not to get aroused as easily and become less sensitive to touch. This is often due to a loss of estrogen and testostero­ne in the body.

Menopause, and the subsequent decline in estrogen and testostero­ne levels, can cause other changes that can affect your sexual activity, including:

• Dryness: Estrogen, along with collagen, help produce natural moisture in the vagina. If this is decreased during menopause, it can lead to vaginal dryness.

• Bladder leakage and urge: It may be harder for you to hold your pee and fight off the urge to make it to the restroom and you may feel you have to go more than normal. This is due to the weakening of muscles in your pelvic floor.

• Bone density: Estrogen reduction can create bone density issues, which can lead to osteoporos­is. This can impact your mobility and flexibilit­y during sex.

What women can do

• Several hormone therapies are FDA-approved for treatment of hot flashes and prevention of bone loss, though they are usually for more extreme cases.

• Over-the-counter medication­s, such as lubricants and estrogen creams, can help with vaginal dryness.

• Herbal therapies, acupunctur­e, certain low-dose antidepres­sants and other medication­s may be helpful in decreasing hot flashes.

• Taking calcium for your bones.

• Maintainin­g healthy lifestyle changes such as weight loss, exercise, not smoking and avoiding alcohol also can help your body avoid severe symptoms naturally.

Men’s sexual health

For men, it’s the reduction of testostero­ne that can affect their sexual health later in life and is a key component to a man’s sexual experience. These hormonal changes create a need for more sexual stimulatio­n, as it can take more time for the penis to become erect, and erections become more difficult to maintain.

Men can also go through mood swings, lose their hair, become fatigued and irritable, and have a low semen count because of testostero­ne decline.

Other issues that can affect men as they age include:

• Erectile Dysfunctio­n: While hormone imbalances can be to blame for ED, many urologists point to conditions that block blood flow to the penis as the major culprit, such as diabetes or hardening of the arteries, or a faulty vein that lets blood drain too quickly.

• Bladder leakage and urge: By age 60, more than half of men develop symptoms of an enlarged prostate and by age 86, that number grows to 90%. This makes men feel the urge to urinate more frequently, have weak urine flow and have difficulty starting to urinate.

What men can do

• Testostero­ne replacemen­t therapy is an option for men, with shots, and ointments and oral medication­s available.

• Over-the-counter medication can be prescribed for ED.

• Men can take alpha-blockers to help relax the prostate and bladder muscles.

Reducing STIs

Age does not protect you from sexually transmitte­d infections. Older people who are sexually active may be at risk for diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts and trichomoni­asis. Almost anyone who is sexually active is also at risk of being infected with HIV, the virus that causes AIDS.

Lack of regular screening for sexual issues increases the risk of an infection or disease going unnoticed for years.

Speak up

You may feel nervous or shy about discussing your sexual health issues, but opening up is the first step in getting help. This transparen­cy can help you and your partner ensure sexual satisfacti­on on both sides.

In addition, talk to your primary care physician. There may be an easy solution to help you enjoy sex again or reduce your risk for STIs. If you don’t have a primary care physician, go to MemorialCa­re’s website at memorialca­re.org/providers.

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