Sexuality in midlife and beyond
June 1, 2004 | 12:00am
Sex. The word can evoke a kaleidoscope of emotions. From love, excitement and tenderness to longing, anxiety and disappointment — the reactions are as varied as sexual experiences themselves. What’s more, an individual may encounter all these emotions and many others in the course of a sex life spanning several decades.
On the most mundane level, sex can be classified as just another hormone-driven bodily function or the means of reproduction and the perpetuation of the species. But to explain human sexuality as neatly as, say, growth patterns, grossly underestimates the complexity of the human sexual response. In addition to the biochemical forces at work, your experiences and expectations help shape your sexuality. Your understanding of yourself as a sexual being, your thoughts about what constitutes a satisfying sexual connection, and your relationship with your partner are key factors in your ability to develop and maintain a fulfilling sex life.
The physical transformations your body undergoes as you age also have a major influence on your sexuality. Declining hormone levels and changes in neurological and circulatory functioning frequently lead to sexual problems such as erectile dysfunction or vaginal pain. If you’ve experience some of these difficulties, you’re not alone. Fifty percent of men aged 50 and older report at least occasional erection problems. The figure rises to nearly 60 percent at age 60 and 70 percent at age 70. In addition, nearly all women contend with issues of vaginal dryness after they pass menopause.
Such physical changes often mean that the intensity of youthful sex gives way to more subdued responses during the middle and later life. This isn’t to say that the quality of the experience needs to suffer. On the contrary, the emotional by-products of maturity – increased confidence, better communication skills, and lessened inhibitions – can help create a richer, more nuanced, and ultimately satisfying sexual experience.
However, many people fail to realize the full potential of later-life sex. Misinformation about normal changes in sexual response coupled with misconceptions about what is "appropriate" sexual behavior for older people can deter many from even trying to maintain an active sex life. The result is that even small physical problems can put a permanent damper on an individual’s sexuality. Yet these obstacles don’t have to be insurmountable.
While midlife brings many changes for women, menopause is clearly a physical milestone. Menopause and the preceding months or years (known as perimenopause) are marked by hormone fluctuations, which can provoke a host of symptoms – from insomnia and irritability to dry skin and a thicker midriff. Many of these effects – vaginal changes and loss of libido, in particular – can wreak havoc on a woman’s sex life. Fortunately, women don’t have to be at the mercy of their hormones. Vaginal lubricants, lifestyle changes, hormone supplements, or the judicious use of herbal therapies may help alleviate many of these problems.
How about in men? Is there a male menopause? The answer is both yes and no. In the strictest sense, men don’t normally experience the precipitous drop in reproductive hormones that marks a woman’s midlife. Although testosterone – the hormone responsible for a man’s libido and fertility as well as his deep voice and facial hair – does taper off as man ages, the process happens gradually. After about age 25, the level of testosterone in the blood diminishes by an average of 1 percent each year. But this fact means little in itself because actual rates can fluctuate dramatically from person to person. It’s not uncommon for a man in his 70s to be able to father a child.
That said, men may notice changes in their sex lives after they reach their 50s. Erections may require more direct stimulation, the need to ejaculate is less urgent, and the rest period between ejaculations grows longer. However, none of these effects needs to interfere with a satisfying sex life, provided the man and his partner understand these changes and integrate them into their lovemaking.
Overall, the majority of men (66.8 percent) and women (56.7 percent) responding felt that a satisfying sex life was important to their quality of life. But an even higher percentage (91.9 percent of men and 87.1 percent of women) thought that a good relationship with their spouse or partner played a key role in their happiness.
Of individuals with partners, just over 60 percent in the youngest age bracket surveyed (45-59) had intercourse at least once a week. At age 75, the proportion dropped to one in four. Still, nearly three-quarters of respondents of all ages had intercourse once a month or more, provided they had partners. However, when the group was examined as a whole, only one out of five men and two out of five women had participated in any form of sexual touching or caressing over the last six months. Men tended to think about sex and feel sexual desire more frequently than women. And while rates of intercourse were similar for both sexes, more men than women reported engaging in sexual touching.
Treating sexual problems is easier now than before. Revolutionary new medications, for example, are there if you need them. But you may be able to resolve minor sexual issues by making a few adjustments in your lovemaking style. Here are some things you can try at home.
• Educate yourself. Bookstores have shelves full of good self-help materials for every type of sexual issue. Pick out a few that apply to you and use them to help you and your partner become better informed about the problem.
• Give yourself time. As you age, your sexual responses slow down. You and your partner can improve your chances of success by finding a quiet, comfortable, interruption-free setting for sex. Also, understand that the physical changes in your body mean that you’ll need more time to get aroused and get an orgasm. When you think about it, spending more time having sex isn’t a bad thing; working these physical necessities into your lovemaking routine can open up doors to a new kind of sexual experience.
• Use lubrication. Often, the vaginal dryness that begins in perimenopause can be easily corrected with lubricating liquids and gels. Use these freely to avoid painful sex – a problem that can snowball into flagging libido and growing relationship tensions. When lubricants no longer work, discuss other options with your doctor.
• Maintain physical affection. Even if you’re tired, tense, or upset about the problem, engaging in kissing and cuddling is essential for maintaining an emotional and physical bond.
• Try different positions. Developing a repertoire of different sexual positions not only adds interest to lovemaking but can also help to overcome certain physical and medical problems.
• Do Kegel exercises. Both men and women can improve their sexual fitness by exercising their pelvic floor muscles. To do these exercises, tighten the muscle you would use if you were trying to stop urine in midstream. Hold the contraction for two or three seconds, then release. Repeat 10 times. Try to do five sets a day.
• Try to relax. Do something soothing together before having sex, such as playing a game or going out for a nice dinner. Or try relaxation techniques such as deep breathing exercises or yoga.
• Don’t give up. If none of your efforts seem to work, don’t give up hope. Your doctor can often determine the cause of your sexual problem and may be able to treat it with medication. He or she can also put you in touch with a therapist or counselor who can help you explore issues that may be standing in the way of a fulfilling sex life.
The most important tool you have at your disposal is your attitude about sexuality. Armed with good information and a positive outlook, you should be able to maintain a healthy sex life for many years to come!
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