Overcoming sexual problems in old age

Overcoming sexual problems in old age

As people age, many also want to maintain satisfying, active physical and sexual relationships. Unfortunately, the ageing process also may cause some undesirable changes in the body. But experts are of the view that many things can be done to overcome sexual problems at the on set of old age,

Talking about sexuality, people think it is only for the young. Interestingly, anybody who cares to listen would understand that elderly people also want to be close to others and maintain satisfying, active physical and sexual relationships.

In bringing a smile to the face of an elderly man, ask about his sexual relationship or tell him he looks younger than his age. In offending the woman, tell her the husband is to take a new wife. This is how serious sexual relationship is, irrespective of age or gender.

Unfortunately, the ageing process could cause some undesirable changes in bodies, becoming obstacles to a healthy and enjoyable sexual relationship with another person. Some for medical and health reasons also experience a lowered libido and would not hide it when talking to their physician.

“Whatever you might want to do for them, the men will want to know whether it will affect their libido. For the women, there is no problem with a lowered libido,” Dr Olufemi Olowookere, a family physician, Tony Anenih Geriatric Centre, University College Hospital (UCH), Ibadan, said.

Some women find sex more enjoyable as they age. After menopause, they may no longer fear an unwanted pregnancy, and may feel freer to enjoy sex. However, Dr Olowookere said “a lot of the time, many tend to experience a reduced libido because of vaginal dryness arising from hormonal imbalances. This makes them want to avoid completely having sexual intercourse.”

Impotence or erectile dysfunction as men age also becomes common. Erectile dysfunction is the loss of the ability to have and keep an erection hard enough for sexual intercourse. Researchers indicated that by age 65, between 15 and 25 per cent of men have this problem at least one out of every four times they have sex.

Illness, disability, or the drugs taken to treat a health problem can affect having a healthy and satisfying sex life. “Some men are hypertensive and are taking medications. Some of the anti-hypertensive drugs have been recognised to affect a man’s libido. So if the medication is substituted with another, the problem resolves,” he said.

Drugs that can cause sexual problems also include antihistamines, antidepressants, tranquilizers or sleeping pills, appetite suppressants, diabetes drugs, and some ulcer drugs. Some medications can lead to impotence or make it difficult for a man to ejaculate. In addition, some drugs can reduce a woman’s sexual desire.

Low back pain and bladder dysfunction are also reasons for unsatisfactory sex life. Dr Olowookere said: “Some men have very terrible back pain due to lumbar spongyilosis, which they say affect their sex ability. Also, where the man has a heart problem, it could affect the number of times he might engage is a sexual relationship. But we encourage men with heart problems and hypertension to be careful.”

Narrowing and hardening of the arteries (atherosclerosis) can alter blood vessels thus disallowing blood from flowing. This can lead to problems with erections in men, as well as high blood pressure (hypertension).

Loss of bladder control or leaking of urine is more common with ageing, especially in women. Stress (urinary) incontinence happens during exercise, coughing, sneezing, or lifting, for example. Due to the extra pressure on the abdomen during sex, incontinence might cause some people to avoid sex.

In addition, joint pain due to arthritis can make sexual contact uncomfortable. Also the discomfort of arthritis, a pain that continues for more than a month or occurs on and off over time, can cause much discomfort, leading to sleep problems, depression, isolation, and difficulty moving. These chronic pain conditions can interfere with intimacy between older people.

Many men with diabetes, where the blood sugar is left uncontrolled, can develop impotence and retrograde ejaculation. Likewise, too much alcohol can cause erection problems in men and delay orgasm in women.

Similarly, the ability to have sex is rarely damaged by a stroke, but problems with erections are possible. It is unlikely, however, that having sex will cause another stroke.

Meanwhile, Dr Olowookere said where there is no problem, ageing should not be a barrier to having sex. In fact many elderly men still have sex. “It is only in Africa parlance that when a woman is growing old, the man says he wants to develop a sexual relationship with a younger woman and this, they will back up with different explanations,” he added.

But an elderly man may find it takes a longer time to get an erection. His erection may not be as firm, as large, or as hard as it used to be. The amount of ejaculated semen may be smaller. The loss of erection after orgasm may happen more quickly, or it may take longer before an erection is again possible.

Nonetheless, Dr Olowookere emphasised on faithfulness to their partners, because of the possibility of sexually transmitted infections such as syphilis, gonorrhoea, Chlamydia infection, genital herpes, HIV and hepatitis. There is also an increased risk of elderly couples that are sexually active developing urinary tract infections. Urinary tract infection occurs because of retention of traces of urine in the bladder, which increases the tendency for these infections.

Can emotions and cultural beliefs play a part in sexual satisfaction? Sexuality is often a delicate balance of emotional and physical issues. For example, some women believe that once they are old, they should abstain from sex and get involved with the care of their grandchildren. Some worry about how their looks had changed, thinking they are no longer attractive to their partners.

“If a man is having issues concerning age, illness, retirement, and other lifestyle changes, these worries can cause sexual difficulties. But sex should have no negative implications,” he said.

Dr Olowookere advised that when individuals have a problem that affects their sex life, they should talk to their doctor, who will be able to suggest a treatment depending on the type of problem and its cause.

For example, the most common sexual difficulty of older women is dyspareunia, painful intercourse caused by poor vaginal lubrication (vaginal dryness). Over-the-counter, water-based vaginal lubricants could be of use to correct the problem.

For men, if impotence is the problem, it can often be managed and perhaps even reversed using medications. Other available treatments include vacuum devices, self-injection of a drug, or penile implants.

Also following a healthy lifestyle- exercise, eating healthy food, drinking plenty of fluids like water or juices, cessation of smoke, stress management and avoiding alcohol- can also help maintain a healthy and sexual lifestyle.