Sexual Health

Midlife sexuality

Declining hormone levels cause subtle changes in the genital tissues. The pelvic muscles may need strengthening. Lower estrogen levels decrease the blood supply to the vagina and the nerves and glands surrounding it. This makes delicate tissues thinner, drier, and less able to produce secretions to comfortably lubricate before and during intercourse. The vagina becomes dryer, less elastic, and more prone to irritation. Most women find it helpful to use an additional lubricant for sexual activity. Water-soluble lubricants are preferable, as they help reduce the chance of infection. Try to avoid petroleum jelly; many women are allergic, and it damages condoms.

Certain medications and alcohol may diminish sexual drive, too. But there are also important emotional issues to face. Sexuality is often a delicate balance of emotional and physical issues: How we feel may affect what we are able to do. For example, men may fear impotence will become a more frequent problem as they age. As a woman ages, she may become more anxious about her appearance. This emphasis on youthful physical beauty can interfere with a woman's ability to enjoy sex.

Older couples may have the same problems that affect people of any age. But they may also have the added concerns of age, retirement and other lifestyle changes, and illness. These problems can cause sexual difficulties. Discuss any concerns you may have with your health care provider.