When I began to train health professionals in human sexuality, there was little available to them. Few physicians or nurses had the train needed to be able to provide accurate, up-to-date information about sexual health, or the comfort level to do so with their patients.
Alas, despite more than 30 years, and oodles of available training, for most health professionals, the issues remain “time” and “comfort.”
Unless you insist on having a candid talk with your physician about the sexual problems you are having, it is likely that you’ll never talk about your sexual concerns.
This is a big mistake for couples as they age.
I have no medical training. I’m a clinical psychologist. However, I do know that there is concrete, helpful medical interventions that make a huge difference in the lives of couples. It enables them to expand their choices of sexual activities for those who are post-menopausal.
It is also not helpful to give an erectile drug (like Viagra) to a man who has been inactive sexually for years and say “go to it!” Sex is quite a bit more than genital interaction.
However, the way your genitals change as a result of aging should be understood, and these changes taken into account when you are sexual.
Here are a few tips to consider:
Allow yourselves more time to become aroused. Don’t take it personally when either one of you doesn’t instantly get turned on. Stick with it. Recognize that while the physical changes might be gradual, they may also have happened in a step-wise manner. Bigger changes may have shown up in what seems like a sudden way. Begin a conversation about what’s happening between you right now, not what should be happening, based on past sexual behavior.
For example, as people age, they usually need more direct stimulation. Whereas once it took only a look, now you may need to be physically touched.
Sometimes women don’t want to talk about the burning or stretching feelings that happen vaginally after menopause, so they try to “grin and bear it.” This is a mistake. This can result in tiny tearing of the vaginal walls. These tears can take a long time to heal.
There are now products on the market that can release tiny amounts of hormones directly into the vagina, and make a remarkable difference to older women in terms of vaginal lubrication, tissue flexibility, and clitoral sensitivity. They even help control other symptoms such as itching and urinary constancy.
However, as mentioned above, few physicians bring up the topic to their older female patients. And many older women assume that if their physician doesn’t mention it, it isn’t an appropriate product for them. This isn’t necessarily so.
Here are some conversation starters with your doctor or health practitioner:
It is unrealistic to expect that every sexual experience will go wonderfully, or that older men should be able to obtain and keep an erection each and every time they are sexual. However, it is not unrealistic to expect that MOST sexual situations will go PRETTY WELL, MOST OF THE TIME. In other words, if your erection wanes once in a while, or you lose your erection occasionally, this is not something to be concerned about. Like a trick knee or a tennis elbow, adjusting to growing old isn’t for the weak, and you have to allow for a certain amount of give-and-take.
However, you should seek out help if you find that out of 10 sexual experiences, 3-5 go poorly for you. Problems with erections can mean other serious health issues that should not be ignored, particularly vascular, neurological, and hormonal difficulties. Even stress, surgery, or medications can impact your erections. Or drinking alcohol or smoking.
So talk to your doctor.
Prepare to have a conversation about erectile problems by jotting down the following:
Then bring the list with you, and review it with your doctor, investigating all that can contribute to problems with erections.
Got a clean bill of health but would still like a better sex life?
Dr. K is the President and CEO of Couples Therapy Inc. She maintains her Intensive Couples Therapy practice over the winter in Miami, Fl and the rest of the year in Boston and on the edge of the Berkshires in Western Massachusetts. She is a Gottman Certified Couples Therapist, has advanced training in Emotionally Focused Couples Therapy, and has been a AASECT board-certified sex therapist from 1982-2017. She continues her work in sex therapy.
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