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.

Premarital Counseling: Ten Ways to Increase Sexual Intimacy Through Couples Counseling

So many couples don’t discuss important aspects of marriage until AFTER they’re married. Will you have children? Will both of you work, or just one of you? Where will you live? Who will be in charge of which chores? How much personal time will you give each other? How do you both see finances in marriage?

Talk about the ten B’s, and build a healthy marriage that lasts many, many years. Avoid the misunderstanding and misconception caused by putting off the B’s! I will provide you both a safe place, a plan, and guidance to talk about the following aspects of marriage intimacy.

Business. What are your career prospects and attitudes about work? How do you envision your life together? What are your most important goals? How do you see your work life together?

Baby. How do you feel about having a child, or not? Would either of you like more than one? How do you want to raise the child? Have you talked about discipline?

Bottle. Concerning alcohol and drugs, I am surprised how many couples aren’t aware of their partner’s habits and tendencies. In premarital couples counseling we can safely discuss your values and behaviors with alcohol and drugs.

Bedroom. What are your expectations and preferences sexually? What attitudes and values do you hold? What about infidelity?

Bank. Money and financial issues are one of the biggest causes of divorce. I will provide you with constructive ways to talk about responsibilities, budgeting, and financial history aspects of relationship. Do you want the freedom to buy items without your partner’s approval? How do you want to handle debt, and the money that is earned?

Beliefs. Compatibility and personality differences can be turned in to strengths. How do your values, religion, and politics impact your relationship?

Broom. Explore home issues before unspoken habits trip you up. What kind and how big of home do you want to live in? Who’s in charge of what chores? How clean and tidy do you keep house?

Blemishes. What are the imperfections or baggage that you’d rather talk about now? No one is perfect, and we all have baggage. Do each of your parents want to see you a little, or quite a bit? This is good to discuss to prevent blemishes related to extended family.

Body. Are there any body issues that you want to discuss? What happens if and when one of you gets ill?

Belly. What are your food preferences? I’m surprised how many clients have food arguments about the different ways they like to eat and exercise. Do you get in to your N.O.C.T.: NO ONE CAN TELL me what to do – over food?

In premarital counseling, talk about the ten B’s to help you explore the need to be yourself, and the need for connection, so that you can develop a more mature sense of your self, and a more mature connection in your marriage. You can prevent the power struggles so common for all of us while growing your sense of self and building a foundation for adult sexual intimacy. I will provide you with communication skills to enhance your marriage, plus offer you conflict resolution skills for those difficult moments. Imagine the depth of your vows to one another as you learn through couples counseling how to grow who you are individually, and how to grow the emotional intimacy between you. Then can avoid the intimacy problems in your healthy marriage together, and include more sexual intimacy between you!

I originally learned about the ten B’s in my five year, Integrative Body Psychotherapy training, 1990-1995, and I’ve adapted them a bit for this article. Why not see for your selves how talking with a trained third party can enhance your premarital, and marital, lives!

Women and Sexual Libido Issues

Libido simply means sex drive. A woman’s desire for sex can vary individually. When a woman is in a new relationship she will experience what is commonly called “the honeymoon phase” where sex is abundant whilst over a period a woman’s sex drive will decrease. The frequency of sexual activity ranges from daily to not happening at all. If you are concerned about the decrease in your sexual libido, you might need to seek professional help.

What causes female sexual dysfunction?

Female sexual dysfunction is caused by changes in the sexual desire of women. Menopause is common to induce a decline in a woman’s desire for sex. This is primarily due to a hormonal imbalance. Dyspareunia can cause pain during sexual activity with women. Women who have given birth can experience a decline in their sexual libidos due to hormonal changes especially with the increase of prolactin which is responsible for decreasing female’s libido.

Infections

Infections can also be contributing factors to female sexual dysfunction. Women do experience issues with achieving orgasm and the underlying factors which cause this can stem from both medical and psychological reasons. Infections such as thrush or yeast infections can take any woman’s desire for sex away in an instant.

Diagnosis methods

There are different diagnosis methods which can be utilized in diagnosing women with low libidos. Doctors can perform physical examinations which consist of family histories as well as checking the overall health of the female who is experiencing a low libido. Blood and urine tests are utilized with diagnosing methods as well as hormone tests.

Treatments

Reduced libidos are treated with various styles. Treatments can include seeking any underlying medical problems which the patient might have. Hormone replacement therapy which typically adjusts the balance of hormones in a female’s body. Anti-depressants and stress management have proved to work with females suffering from low sexual libidos. Counseling aids as well with the emotional factors involved with females suffering from sexual issues.

Counseling

Many counseling options are available for women if first they become accepting of the problem. Counseling can aid women with learning new communication skills which will in return aid them in their relationships with their sexual partners. Underlying issues can be addressed through therapy as well as education on different sexual techniques and fantasies and desires.

Some women are reluctant to seek counseling to aid them with their low sexual libido issue however, it is of the utmost importance that if emotional or psychological factors are the problem for their low libido’s they must seek counseling to realize what these issues are.

Where should women seek help for low sexual libidos?

Where can women seek help for their low sexual libidos? Their first place to check should always be with their family doctor. A woman’s family doctor can provide referrals to sex therapists or psychologist. Urologists can aid women as well if there are some underlying medical problems which are affecting a woman’s desire to have sex.

Things every woman should remember

Some things which women need to know about low sexual libidos is that the desire for sexual activity varies individually. Some of the many factors which can affect low sexual libidos in women can be stress, feeling rushed, not being compatible with your sexual partner and any types of drugs which you might currently be taking. Illegal drug usage as well as alcohol abuse can cause a low sexual libido in women. If you are currently taking prescribed medications, you should check to see what the side effects are. If one of the side effects is a decrease in your sex drive, discuss with your medical doctor an alternative to the medication which you are currently taking.