How Does Sexual Functioning Change As We Age?

By Erica Goodstone, Ph.D.

Aging leads to changes in bodily appearance and organ functioning, lower levels of pituitary hormones, and a higher incidence of illness, injury, disease and chronic pain involving multiple prescriptions for pharmaceutical medications. These bodily changes, along with emotionally stressful life events, e.g., retirement, empty nest, loss of partner, or caring for elderly parents, may adversely affect sexual functioning.

Women

As women enter menopause, no longer ovulate, and their estrogen, progesterone and testosterone levels drop, many experience decreased desire for and arousal during sexual activity combined with less powerful orgasms or even inability to attain orgasm. Physiologic changes may include:

• decreased lubrication leading to vaginal dryness and pain

• atrophy or expansion of vaginal tissues

• decreased elevation of the uterus

• reduced muscle tension with few orgasmic contractions

• rapid decrease in arousal after orgasm

• reduced spread of sex flush

• decreased sexual desire and arousal

Men

As males age, decreased testosterone and testicular function, lowered sperm count, enlarged prostate, and reduced muscle tension often cause men to require greater stimulation to become aroused, have less frequent and more easily diminished arousal, decreased sensation, less powerful orgasms, and becoming tired or exhausted for some time after orgasm and ejaculation. Physiologic changes include:

• delayed and less firm penile and nipple erection

• longer excitement phase and longer interval until ejaculation

• decreased pre ejaulatory emissions

• diminished lifting of scrotum and testes

• more rapid return to pre arousal state

• shorter ejaculation time with reduced volume and fewer contractions

• shortened phase of impending orgasm and expulsion of semen

• more rapid loss of erection and longer refractory period

How Can Sexual Functioning and Enjoyment Continue Throughout Life?

As we age, there are some gradual declines in the response rate and reactions of many of our bodily organs and tissues. However, our bodies continue to respond to stimulation as long as we are breathing, our brain is functioning normally, and our heart is pumping.

Having a sexual problem is not unlike having any other type of physical or emotional problem. There is a cause, either physiological, psychological, or a combination of both.

Recommendations for Treatment to Overcome Sexual Problem

• Make an appointment with the appropriate medical doctor to have an evaluation of your physiology: hormone levels, blood vessels, blood flow, acute or chronic infections or other diseases. Depending on your gender and what the specific problem is, you may choose to see a gynecologist, urologist, endocrinologist, internist, gastroenterologist, oncologist, etc.

• Make an appointment with the appropriate psychotherapist (preferably someone who is also certified to provide sexual counseling or sex therapy) for evaluation of your psychological, emotional, mental and spiritual state. Depending on what you believe is the primary issue (your relationship, your family situation, your own self image or sexual concerns, your own religious or spiritual conflicts), you may choose to see a Marriage and Family Therapist, a Mental Health Counselor or Professional Counselor, a Social Worker, or a Psychologist.

• If your mental and emotional concerns are severely interfering with your ability to function in your everyday life, you probably should consult with a psychiatrist who can evaluate you and provide appropriate medications to alleviate your overwhelming symptoms. Then, you may be better able to gain insight and the capability of overcoming your problems if you also work with a psychotherapist.

• If you are courageous and really want to overcome a long term physical problem (such as a woman having vaginal pain or vaginnismus), you may choose to see a physical therapist who is trained to work with pelvic floor dysfunctions.

• Work with a body therapist, someone who is trained to alleviate neuromuscular tensions and other body dysfunctions. You may be surprised how many physical problems in distant parts of your body are related to your current sexual problem.

Dr. Erica Goodstone has helped thousands of men, women, couples, and groups to develop greater awareness of the issues in their relationships and their lives, to overcome and alleviate stressors and discords, and revitalize their relationships and their own mind-body-spirit connection. Dr. Goodstone can be contacted through her web sites at http://www.DrEricaWellness.com and http://www.SexualReawakening.com