Patient education: Sex as you get older (The Basics)

How does sex change as you get older? — Sex can still be very satisfying as you get older, but it can change in a number of ways.

For example, you might:

●Have less interest in sex

●Have trouble reaching orgasm

●Have orgasms that are less intense or satisfying than they were when you were younger

●Have trouble getting aroused, for example:

•If you have a penis, you might need more stimulation to get or stay erect, or be unable to get erect.

•If you have a vagina, you might have trouble getting aroused or lubricated. You might also have pain or discomfort during sex. This can happen because the vagina can become dry, and the tissue can thin, after menopause.

What causes sex to change as you get older? — There are many things that can lead to decreased interest or ability to have sex as you age. These include:

●Lower hormones – As people age, their bodies makes less sex hormones. This is especially noticeable for people who have gone through menopause (when monthly periods stop). After menopause, levels of the hormone estrogen drop suddenly, especially for people who have had their ovaries removed. Low estrogen levels can eventually lead to vaginal dryness, irritation, and pain during sex.

●Other medical conditions – Medical conditions, such as diabetes, heart disease, obesity, high blood pressure, and chronic pain, can decrease a person's interest in or ability to have sex. Diabetes is a major cause of problems with erections, because it damages nerves and blood vessels.

●Past surgery or medical treatment – People who have had surgery or radiation therapy to treat prostate cancer often develop problems with erections. Certain treatments for an enlarged prostate can also cause problems with orgasm. Females who have had surgery to treat problems with their bladder or sex organs, or treatment for cancer, can also have problems with sex.

●Depression or anxiety – As people get older, they sometimes have problems with depression or anxiety. These conditions can also lead to problems with sex.

●Smoking – People who smoke cigarettes are more likely than those who don't smoke to have problems with sex.

●Medicines – Some of the medicines older people take to control diabetes, high blood pressure, heart disease, depression, and other conditions can have side effects that cause problems with sex.

●Relationship problems – Sometimes, partners have different ideas about sex and this can lead to problems.

Should I see my doctor or nurse? — If you are happy with the quality and amount of sex you have, and do not have pain during sex, then no, you do not need to see your doctor or nurse. But if you are not satisfied with your sex life, then it's a good idea to see your doctor or nurse. They might have treatments or solutions to suggest.

When you go, bring all of the medicines you take, including any non-prescription or herbal medicines. Also, be honest about what is going on. Talking about sex and relationships can feel embarrassing, but doctors and nurses are used to talking about it. They will be better able to help you if they understand exactly what is happening.

To help with your problem, your doctor might:

●Change your medicines – Sometimes, you can switch to a medicine that is less likely to cause problems. In other cases, your doctor might be able to lower your dose.

●Suggest hormones or medicines to improve sex – If you are having problems related to vaginal dryness, doctors often recommend "vaginal estrogen." This comes in creams, tablets, or a flexible ring that goes into the vagina.

●Suggest lubricants or devices that can improve sex or arousal

●Recommend that you speak to a counselor or therapist, either by yourself or with your partner

If you have problems in your relationship and you have been threatened, hurt, or afraid, call your doctor or nurse for help. You can also ask for help from your local hospital, groups that help with these kinds of problems, or a place of worship.

What if I had a heart attack or other major health crisis? — If you had a heart attack or other health crisis, the idea of having sex might scare you. Many people who had a heart attack or similar crisis can have sex safely afterward. Check with your doctor, and follow their instructions. You will probably need to wait some time after your health crisis is over before you have sex. And you might need to change what you do during sex. But chances are good that you will be able to have sex safely again.

Is there anything I can do on my own to improve my sex life? — Yes. Be open with your partner(s), and explain your feelings and concerns about sex and your relationship. Remember that sex does not only have to mean intercourse. You can explore different ways to find pleasure and be close with a partner.

Do not continue to have sex if it is painful. Also, encourage your partner to seek treatment for any physical or sexual problems they might have.

If you have a condition that causes pain or stiffness, such as arthritis, try to plan sex at a time when you are feeling your best and your pain medicines are most effective. If you are less flexible than you used to be, try different positions or activities, or ask your partner if they can help.

More on this topic

Patient education: Sex problems in males (The Basics)
Patient education: Sex problems in females (The Basics)
Patient education: Medicines for depression (The Basics)

Patient education: Sexual problems in males (Beyond the Basics)
Patient education: Sexual problems in females (Beyond the Basics)
Patient education: Heart attack (Beyond the Basics)