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Sexual worries Sex and ageing On the other hand, for many older people, sex assumes less importance than it did during their younger years.
Common problems for women as they get older Tenderness of the clitoris, so that friction easily makes it sore, is another common problem. Symptoms of cystitis. Bruising of the urethra (the opening through which urination occurs) during sex is more likely in older women because their skin tissue is thinner. This can lead to a burning sensation when urine is passed after sex, and the woman may also feel she needs to pass small amounts of urine frequently. This is known as ‘urethral syndrome’. Although it feels like cystitis, it is not caused by an infection. Less desire for sex occurs in some women after the menopause. In all premenopausal women, the ovary secretes ‘female’ hormone (oestrogen), and also a small amount of ‘male’ hormone (androgen). The androgen is important for sexual desire (libido). After the menopause, the levels of both types of hormone fall. The fall in androgen level may be one reason why some women feel less desire for sex in later life. Loss of self-esteem may also lead to less desire for sex. If you feel despair over lost youth and slimness, and believe that some of your sexual attractiveness has gone, it may be hard to respond to a partner. Worries about your partner. You may also worry that your partner is not really up to it, particularly if he has angina or has had a heart attack – some women are terrified that their partner will die during sex and this, unsurprisingly, puts them off. Common problems for men as they get older
This slowing down is a long way from impotence, but it can cause panic. You may fear that you are going into a speedy sexual decline and will soon be unable to perform at all. Some men take any slight reduction in their body's response – however marginal, and whatever its cause – as the first sign of the onset of impotence. In fact, almost any illness will interfere with sexuality for a while, but the danger is that this ‘performance anxiety’ will take over, so the fear becomes a self-fulfilling prophecy. With increasing age, men are more likely to be taking drugs for high blood pressure (hypertension); many of these can cause problems with erections. You are also more likely to have a condition, such as diabetes, which can affect erection and ejaculation. Some men also have a fixed idea that sex means vigorous, thrusting intercourse with the man on top (the ‘missionary position’). But as a man gets older, he may find this more and more difficult, or a heart condition may make him frightened to try. So he may start to regard himself as a sexual failure and give up, instead of experimenting with new positions and new ways of gaining satisfaction. Common problems for men and women as they get older Emotional ‘baggage’. A relationship that has been poor for years may become worse as the older couple find themselves spending more time together. Finding a partner. Older people are often on their own, and finding a partner may be difficult. How you can help yourself Share your expectations.If one partner has needs or expectations that are not being met by the other, sort the problem out rather than let resentment, anger or guilt take over. Counselling (these are listed in the useful contacts can be very helpful in this situation. Try to avoid becoming 'performance conscious'.Do not interpret natural sexual ‘slowing down’ as being near to impotence. In fact, the natural slowing down of your sexual responses may make you more in tune with your partner’s needs, because it may mean that stroking and cuddling become more important. Sort out relationship problems.You may feel that your relationship with your partner has been unsatisfactory for so many years that it is pointless to try to do anything about it. In fact, it is never too late to try to improve things, particularly as you and your partner may have many years ahead in which you will be increasingly in each other’s company. Ignore setbacks.If you have a sexual setback, do not assume it is the ‘beginning of the end’ of your sex life. It is natural for an illness, or a period of depression, to make you lose the desire for sex, the ability to perform sexually or the ability to respond to your partner. When you or your partner feel better, your sex life will improve again. If it does not, talk to your doctor as there may be a simple explanation (for example, you may have been put on some medication that is affecting your sexuality). If you are worried that sex could damage your heart, or that you or your partner might have a heart attack during sex, talk to your doctor. If you have had a heart attack or heart surgery the hospital should have given you advice about when to resume your sex life. If impotence is the problem, see your doctor. Do not accept impotence as being just a normal part of growing old. If you can not get an erection that is sufficient for intercourse, discuss it with your doctor, no matter how old you are. There may be a reason that can be put right and there are various methods of improving erections (look at the section on impotence). Viagra is as safe in elderly men as it is in younger men. A study of Viagra in the over-65s reported a 69% improvement (Journal of Gerontology 2001;56:M113–M119). Use lubricants.Whatever a woman’s age, sex should not be painful. If it is, it is important to find out why. If a dry vagina is making sex uncomfortable, special lubricants or hormone treatment will help (even if it is many years since the menopause). Apply the lubricant generously over and around the clitoris and urethra, as well as the vagina, to relieve clitoral soreness and prevent urethral syndrome. Similarly, if you are using a hormone cream, apply a small amount to the clitoris and around the urethra. For more information, look at the section on vaginal dryness. Try more foreplay.Remember that older women need more foreplay to become aroused. Inserting the penis before the woman is fully lubricated (perhaps because the man secretly worries that he will lose his erection) will cause discomfort or even pain. New partners.If you have a new partner, be aware that you need to practise safe sex to avoid the risk of sexually transmitted infection, whatever your age. In the past 5 years in the UK, the numbers of people with chlamydia, gonorrhoea and syphilis have increased three-fold in the over-65s.
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