How Does Sexual Functioning Change As We Age?

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:

o decreased lubrication leading to vaginal dryness and pain
o atrophy or expansion of vaginal tissues
o decreased elevation of the uterus
o reduced muscle tension with few orgasmic contractions
o rapid decrease in arousal after orgasm
o reduced spread of sex flush
o 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:

o delayed and less firm penile and nipple erection
o longer excitement phase and longer interval until ejaculation
o decreased pre ejaulatory emissions
o diminished lifting of scrotum and testes
o more rapid return to pre arousal state
o shorter ejaculation time with reduced volume and fewer contractions
o shortened phase of impending orgasm and expulsion of semen
o 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

o 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.

o 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.

o 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.

o 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.

o 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.

What To Expect From Gay Counseling

If you’re considering counseling, you might be a little unclear about what you can expect. Your uncertainty is probably higher if you identify yourself as gay or lesbian. Read on if you’ve had trouble finding the right counselor or just have questions about getting started in therapy.

Trust And Acceptance From A Well-Chosen Counselor

If you choose a counselor carefully, you’ll find one with a high level of acceptance of the gay and lesbian population. Instead of seeming uncomfortable or avoiding challenging sexual topics, your counselor will be able to truly work with you. They’ll be aligned with you through any problem you face. Any questions or uncertainties will be addressed with respect and honesty.

This is the way it should be for all counseling experiences, but people seeking gay counseling often have greater challenges finding good support. When you feel respected and accepted from the start, you’ll have an easier time building trust with your counselor. With more trust, you’ll be more likely to open up with difficult issues and follow their recommendations. Take care in the first few sessions to be sure your counselor is a good fit for you.

Specific Understanding Of Gay and Lesbian Challenges

Whether you are coming to counseling as an individual or as a couple, you’ll want to find a therapist with training and experience working with the gay and lesbian population. They’ll simply have a better understanding about the stressors and mental health risks you may be facing. You may have faced bullying, depression, or even suicidal thoughts in your past.

Many people who identify as gay or lesbian have had struggles with their personal identity or have felt confused about their sexuality. Even if you need gay counseling for something like anxiety or bipolar disorder, your sexuality has likely played a part in your struggle. A counselor who really understands this can help you face your concerns with warmth and support. This expertise can be invaluable if you’ve often felt left out, confused, or stressed because of how you identify your sexuality.

Good Couples Counseling

No matter how sexuality plays a part, intimate relationships require a lot of effort from each partner. A couple is likely to face a lot of ups and downs both together and as individuals. These challenges can toss any relationship upside down from time to time. While gay couples do have some special concerns, they also just need good couples counseling at times.

Each partner in a relationship has their own personal history and their history as a couple. They may have job problems, family issues, questions about the future of the relationship, and many other stressors. A counselor can help each partner sort out the issues, understand how these have affected the relationship negatively, and help the partners open up to each other. If you feel like this is something that could help your relationship, know that there are very good counseling options for you.

Fighting the Pain of Sexual Abuse Through Counseling

As a young child, I was sexually abused by a family friend. This thoughtless, abusive act has forever changed my life. It has not just changed who I am but how I see things, how I view myself, how I make decisions and how I live my life. As a survivor of sexual abuse, I have struggled with self-esteem and anger issues, trusting others, accepting help from others, self-injurious behavior and a host of other issues which I can directly connect with my abuse as a child.

For many years, I have attended therapy and have cycled through a number of different therapists and counselors. It is not that each of my counselors or therapists was not good as what they did. On the contrary, each professional with whom I worked in regard to my experience played an important role in my healing process. Each one, in some way, affected me positively in my continuing recovery.

My journey through counseling is not yet over, in fact, it is just at its beginning stages. For many years, I have attended individual counseling. In individual counseling, I have learned to discuss my fears and other emotions, understand where my underlying issues originate and how to control my emotions and avoid potentially dangerous situations. I have also attended group counseling which offers a dynamic like no other I have found in any of my other therapy. In group therapy, I associated with and found friends in other survivors and created a kinship that cannot be created in any other way than to have experienced similar situations. I learned new coping skills from other survivors and gained a sense of empowerment from the strong group of survivors with whom I attended the group.

As I have, you too can heal from your sexual abuse experience(s) with the assistance of sexual abuse counseling. Through counseling, you will learn new ways to deal with your experience and learn to love yourself for who you are. You will learn that the abuse was not and is not your fault because it is not. You can gain a healthier self-esteem and self-understanding. If you have been sexually abused, counseling can help!