Understanding and Embracing Sexuality in Old Age

 Hello my dear followers, today I will be writing about sexuality in older adults, which is an important and often underestimated topic. 

 I begin by stating that sexuality is an integral part of human well-being throughout all stages of life, including old age. As people age, their sexuality may undergo changes, but it remains a significant source of pleasure, intimacy, and emotional connection.

Physical Aspects

1. Physiological Changes:

   – Men: They may experience erectile dysfunction, decreased testosterone and less firmness in erections.

   – Women: They may experience vaginal dryness, decreased estrogen and changes in vaginal elasticity, which can cause pain during sexual intercourse.

2. General Health:

   – Chronic diseases, such as Diabetes and Heart disease, and the use of certain medications can affect sexual function.

Some of the most common are:

1. Antidepressants:

   – Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline and paroxetine can cause decreased sexual desire, erectile dysfunction and difficulty achieving orgasm.

   – Tricyclic antidepressants such as amitriptyline and imipramine can also reduce sexual desire and cause erection problems.

2. For high blood pressure:

   – Beta blockers (such as metoprolol and propranolol) can cause erectile dysfunction and decreased sexual desire.

   – Diuretics (such as hydrochlorothiazide) can decrease blood flow to the penis, causing erection problems.

3. Cholesterol medications:

   – Statins such as atorvastatin and simvastatin may be associated with decreased sexual desire and erection problems.

4. Medications for the prostate:

   – Alpha blockers (such as tamsulosin) and 5-alpha-reductase inhibitors (such as finasteride and dutasteride) can cause decreased sexual desire and erection problems.

5. Medications for heart conditions:

   – Digoxin can reduce sexual desire and cause erectile dysfunction.

6. Medications for Diabetes Mellitus:

   – Some diabetes medications can have side effects that include sexual problems, although proper control of blood glucose is crucial to avoid sexual problems related to this disease.

7. Pain relief medications:

   – Opioids such as morphine, oxycodone and codeine can cause decreased sexual desire and erection problems.

   – Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, when used long term, can affect sexual function.

8. Antihistamines:

   – Medications such as diphenhydramine and chlorpheniramine can cause erectile dysfunction and decreased sexual desire.

9. Antipsychotics:

   – Medications such as haloperidol, risperidone and olanzapine can reduce sexual desire and cause erection problems and difficulties reaching orgasm.

It is important for older adults to talk to their doctors about any sexual problems they experience, as in many cases there are alternatives or treatments available to mitigate these side effects.

Psychological and Emotional Aspects

1.Self-esteem and Body Image:

   – The perception of one’s own body can change with age, affecting self-esteem and sexual desire.

   – Maintaining a positive body image and accepting the natural changes of aging is crucial.

2. Intimacy and Connection:

   – Sexuality in old age can be an important source of intimacy and emotional connection, not just physical pleasure.

   – Open communication with your partner about wants and needs is essential.

Social factors

1. Stereotypes and Taboos:

   – There are many negative stereotypes about sexuality in old age that can inhibit sexual expression.

   – It is important to challenge these taboos and recognize that sexuality is a natural part of life at any age.

There are several stereotypes and taboos that can negatively affect sexuality in older adults. These myths and misconceptions can limit sexual expression and decrease quality of life in old age. Here are some of the most common:

1. “Sexuality is only for young people”:

   – This stereotype suggests that sexual desire and activity inevitably decline with age and that older adults should have no interest in sex. The reality is that many older people continue to have an active and satisfying sexual life.

2. “Aging eliminates sexual desire”:

   – It is mistakenly believed that the physiological changes associated with aging completely eliminate sexual desire. While there may be changes in sexual response, desire may persist and adapt to new forms of expression.

3. “Older adults are not sexually attractive”:

   – This taboo is based on youthful beauty standards and can affect the self-esteem of older people, making them feel that they are not desirable.

4. “Sex is only for reproduction”:

   – The perception that sexuality has to do exclusively with procreation can lead to the devaluation of sexual life in old age, ignoring that sex is also a source of pleasure and emotional connection.

5. “Older people should not talk about sex”:

   – There is a belief that sexuality is an inappropriate topic for older people, which can make open communication about sexual desires and needs difficult.

6. “Sexual problems in old age are normal and have no solution”:

   – This myth can lead older adults not to seek help for sexual problems, assuming that they are inevitable. However, many problems can be successfully treated with the help of health professionals.

7. “Older people in care institutions should not engage in sexual activity”:

   – In settings such as nursing homes, there may be a lack of privacy or even explicit restrictions on sexual activity, based on the belief that it is inappropriate.

8. “The use of medications to improve sexual function is only for young people”:

   – Older adults may be hesitant to use treatments such as hormone therapy or erectile dysfunction medications due to the belief that they are not right for them.

9. “Older people should not form new romantic relationships”:

   – There is the idea that, after a certain age, it is not appropriate or necessary to seek new romantic relationships, which can limit the opportunity for older adults to find a partner and enjoy intimacy.

It is essential to challenge and dismantle these stereotypes to promote a more inclusive and positive understanding of sexuality in later life, allowing older adults to fully live their sexual lives.

2. Loss of Partner:

   – The loss of a partner can have a significant impact on the sexual and emotional life of older adults.

   – Some may find new relationships, while others may focus on self-exploration and personal pleasure.

Tips for a Healthy Sex Life

1. Communication:

   – Talk openly with your partner about desires, limits and any sexual problems.

2. Education:

   – Find information and resources about sexuality in old age, including therapies and treatments available for sexual problems.

3. Healthy Diet: A diet rich in antioxidants, vitamins and minerals improves sexual function, a Mediterranean diet is perfect, for example.

4 Avoid excess alcohol and tobacco

5 Create a comfortable and safe environment, clean, adequate lighting, soft music, light underwear, comfortable bed and above all privacy invite sex.

6 Explore new forms of intimacy: Penetration is not the only form of sexual intimacy, arms, kisses, caresses, oral sex, massages as well as the use of erotic toys can be equally pleasurable and satisfying.

7 Reduce stress: The practice of relaxation techniques such as meditation, yoga and deep breathing help mitigate stress

8 Medical Care:

   – Consult with health professionals to address any physical or emotional problems related to sexuality.

Sexuality in older adults is as valid and important as at any other stage of life. Promoting a positive and open vision about sexuality in old age contributes to general well-being and a better quality of life. In a future publication I will talk to you about stress.  

References

Kalra, G., Subramanyam, A., & Pinto, C. (2011). Sexuality: Desire, activity and intimacy in the elderly. Indian journal of psychiatry53(4), 300-306.

Merghati-Khoei, E., Pirak, A., Yazdkhasti, M., & Rezasoltani, P. (2016). Sexuality and elderly with chronic diseases: A review of the existing literature. Journal of Research in Medical Sciences21(1), 136.

Uchôa, Y. D. S., Costa, D. C. A. D., Silva, I. A. P. D., Silva, S. D. T. S. E. D., Freitas, W. M. T. D. M., & Soares, S. C. D. S. (2016). Sexuality through the eyes of the elderly. Revista Brasileira de Geriatria e Gerontologia19(06), 939-949.