Keep the Fires Burning
A common complaint among women at mid-life is
a decline in sexual desire and a decreased interest
in sex. For many, this change is a departure
from normal and can be disturbing. Although there
are changes that occur with aging and menopause,
the ability to experience a rewarding sex life
continues well into old age.
There are many factors that contribute to a
rewarding, intimate relationship and disruption
of any of these factors can affect sexual function.
Fortunately, most factors, such as stress and
energy levels, are within your control.
What to expect?
The "normal" sexual response involves four phases: desire, arousal,
climax/orgasm and resolution. Sexual dysfunction is usually divided into four
categories: disorders of arousal, excitement, painful intercourse and orgasmic
dysfunction. Arousal and pain disorders are among the most common for healthy
adults at mid-life.
As we age, arousal can take longer in both men
and women. Although the ability to reach orgasm
continues in healthy adults as they age, it requires
more time, more stimulation and more work. With
the overloaded schedules of modern day life,
this fact alone can make it hard to have a satisfying
sex life. Sometimes this is mistakenly perceived
as a loss of interest or ability rather than
a physiologic change. Most times, an awareness
of the changes that come with aging and making
adjustments in the sexual routine may be all
that is necessary to combat this problem.
With the loss of estrogen at menopause, women
can experience changes in the vagina that can
lead to vaginal dryness and painful intercourse.
Wishing to avoid a painful encounter, women can
begin to lose interest in sex. Replacement of
estrogen, using a vaginal cream, tablet or ring
is a simple answer to remedy this all-too-common
problem.
There are many other things that can affect
sexual arousal in women. Your intellect and your
mind play an important role in sexual function.
Feelings toward your partner and feelings about
yourself can all impact desire. Many women gain
weight in the mid-life years and find it hard
to feel "sexy" and desirable.
In addition, hormonal levels start to fluctuate,
androgen levels decline and estrogen production
drops. Testosterone, the male hormone, is also
found in women. As women go through mid-life
changes, testosterone levels can change too,
potentially impacting libido. The subject of
testosterone replacement in women is an area
of current research and new treatments for women
are on the horizon.
The diagnosis and treatment of serious diseases
like breast or gynecologic cancer, as well as
chronic health conditions, can affect normal
sexual function. Cardiovascular disease and diabetes
for instance, can lead to changes in blood vessels
causing difficulty with excitement and orgasm.
Medications used to treat high blood pressure
and depression may interfere with arousal, excitement
and orgasm. Arthritis or other painful disorders
may interfere because of pain and limitations
in movement.
And, of course, a sexual relationship requires
a partner with normal function. As women get
older, a frequent underlying issue is either
the loss of a partner or impairment of sexual
function in a partner. Often couples in long
term relationships can find gratifying intimacy
within their own limitations of function without
sexual intercourse.
What should you do?
If you have noticed a change in your sexual relationship that bothers you,
stop, take inventory and take action. Evaluate and work on those factors
in your own life, your partner's life or your relationship that may be affecting
sexual function.
- Review your medications. Perhaps you should
discuss with your physician a change in a type
or dose of medication.
- Consider the impact of recent illnesses.
- Consider the role of hormones. Think about
using estrogen and possibly testosterone replacement.
- Encourage a partner with erectile dysfunction
to seek evaluation.
- Get the help of a healthcare provider you
trust.
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