Changes in the Body

There are many changes that happen in our bodies as we age, and some of these changes can modify sexual experience in later years. Both women and men experience slower arousal responses. This can lead to anxiety in people who do not understand that this change is normal.

Women's changing bodies

Women's bodies change is some of the following ways:

• The lips of the vagina (the labia) and the tissue covering the pubic bone lose some of their firmness.

• The walls of the vagina become less elastic.

• The vagina itself becomes drier.

• The clitoris can become highly sensitive, even too sensitive.

• Uterine contractions with orgasm may at times be painful.

Men's changing bodies

The entire male sexual response tends to slow down in the following ways:

• There is a delay in erection.

• There is a need for more manual stimulation to achieve an erection.

• The "plateau" phase, or period between erection and ejaculation, is prolonged.

• Orgasm is shorter and less forceful.

• The penis loses its firmness rapidly after ejaculation.

• The "refractory period", or time interval before erection is able to be achieved again, can be quite long, even up to a week in very elderly men.

Chronic Diseases

Many chronic diseases that elderly people experience can also modify sexual expression.

Coronary artery disease: Coronary artery disease may lead to chest pain with sexual activity, or fear of having a heart attack during sex.

Chronic lung disease: Chronic lung disease can lead to breathlessness.

Arthritis: Arthritis may impair the ability to use some positions for sex.

Embarrassment: Some older persons may find that embarrassment over the loss of a breast, or the presence of a colostomy bag or some other apparatus, may inhibit free sexual expression, especially with a new partner.

Medications: For other people, medications taken for many chronic diseases, especially hypertension and heart disease, may cause either a loss of libido or impaired performance.

The Key to Continued Pleasure: Flexibility and Willingness

So is all of this enough to make older people pack it in and forget about sexual activity? Of course not! The key is a willing spirit and the ability to be flexible and adapt to change. Here are some of the numerous ways men and women can adapt to aging changes and continue to be, or become, a sexual person:

Slow down: Realize that sexual arousal takes longer and requires more manual stimulation.

Make the most of foreplay: Take all the time that you often didn't have in your younger days to pleasure each other or yourself.

Communicate: Share what makes you feel good with your partner.

Use your sensory skill: Take time to explore in great detail all the tactile, visual, auditory, and even olfactory aspects of being intimate.

Play with the mood: Take time to set the stage for a special experience - experiment with lighting, music, candles, oils, perfumes, and incense. Try a new place.

Adaptations for women

Here are some suggestions for older women:

Lubrication: Make adequate lubrication part of your routine, to avoid irritation of the vagina or painful intercourse. The first part of lubrication is adequate stimulation, but an over-the-counter lubricant can be a very helpful adjunct. A water-based lubricant, such as Astroglide, K-Y Jelly, or Today, is best; oil-based lubricants and petroleum products such as Vaseline may be difficult to flush out of the vagina, and may cause irritation or infection. Applying the lubricant yourself can be a good way to get in the mood. You could also make applying the lubricant part of your lovemaking routine!

Vaginal estrogens: Some women with extreme vaginal dryness and irritation may benefit from a short course of vaginal estrogens, but remember that estrogens are absorbed through the vagina, and the systemic effects of estrogens, both positive and negative, should be considered and discussed with your doctor. If you use estrogen cream, use as little as is effective for as short a time as possible to get the desired effect. Of course, you may be taking oral estrogens for other reasons, in which case you will also experience beneficial effects on the vagina.