Women over 50 often wonder if they can have a satisfying sex life. Although some conditions and medicines can affect libido, a healthy lifestyle and good communication can help keep sexual satisfaction high.
In fact, researchers have found that women who placed a higher value on sex as they got older were more likely to continue to value it later in life.
Menopause
The menopause (defined as when a woman has not had her period for 12 months) and the years that lead up to it, called perimenopause, can have many effects on a woman’s body, including a decrease in sexual desire. This is because estrogen levels take a dive during this time, and that can affect a woman’s ability to become aroused and have a normal vaginal lubrication that is important for sex.
In addition to that, other symptoms of the menopause include hot flashes, night sweats, irritability or mood changes, difficulty with concentration and memory, and physical changes like thinning skin, weight gain or vaginal dryness (which can make it uncomfortable during sex). Women who experience these issues should talk to their healthcare provider about what may be causing them and how they can help to manage the problem.
Exercise can be helpful for boosting a woman’s libido during the menopause. Kegel exercises can also be beneficial, as they help to strengthen the pelvic muscles that are needed for sexual stimulation. If these methods don’t work, then a healthcare provider may suggest using over-the-counter or water-soluble lubricants. They may also prescribe estrogen or non-estrogen hormones in a low dose cream, pill or vaginal ring. They will need to do a full exam to determine if these are the best option for her.
Sexually Transmitted Diseases (STDs)
Many STIs have zero or few symptoms, making it hard to know whether you have an infection. These infections can cause serious health problems, including pelvic inflammatory disease, infertility and enhanced transmission of HIV.
STIs spread through vaginal, oral and anal sex, as well as close physical contact like heavy petting. Symptoms may include itching, burning or discharge in the genital area, but many people have no symptoms at all. This is why regular STI testing is so important.
Some STIs are curable with medication, but others are not. The best way to prevent an STI is to use a latex condom every time you have sex. If you have an STI, tell your partner right away and ask them to get tested.
Research has shown that older adults are more likely to report having unprotected sex and have a lower awareness of how sexually transmitted diseases spread than younger adults. Older adults also are less likely to discuss sexually transmitted diseases with their partners or medical providers, which may contribute to their higher STI risk.
Older adults should make it a priority to talk openly with their partners about sexual behavior and prevention of STIs. They should also be sure to use a condom every time they have vaginal, oral or anal sex and get tested regularly with a doctor for STDs.
Physical Changes
For women, hormone changes at this age can cause a shift in sexual pleasure. They may experience less desire, vaginal lubrication issues, and difficulty in achieving orgasms. In addition, the vaginal tissue may become drier and less elastic (a condition known as atrophic vaginitis). Breasts also change at this time, becoming less firm and more fibrous, which can make finding lumps or other abnormalities during self-exams harder.
A decrease in sexual enjoyment is also common for people with chronic health conditions, such as diabetes and hypertension. Medications used to treat these conditions can interfere with a person’s libido, as can underlying psychological factors such as depression and anxiety.
In a study of sexually active women aged 45-60, participants reported both negative and positive changes in their sexual functioning as they grew older. Negative changes were attributed to physical issues, such as menopause, and psychosocial factors, such as life stressors. Many of the participants adapted to these changes by altering their sexual behavior or prioritizing different aspects of sex.
If you’re experiencing problems with your sexual function, talk to your doctor. They can help you determine the root of the problem and find a treatment that works for you. For example, if urinary incontinence is affecting your sexual pleasure, medication or a bladder lift device can help. If you’re overweight, losing weight can improve your sexual functioning.
Mental Health
Mood disorders and chronic illnesses can affect sexual functioning, especially in midlife. Depression can lower libido, while certain medications such as selective serotonin reuptake inhibitors (SSRIs) or antidepressants like paroxetine (Paxil) may reduce it as well. Chronic health problems such as cancer or diabetes, and the stress of caring for aging parents can also have a negative impact on libido.
Women who are able to maintain positive self-esteem and a healthy relationship report higher levels of sexual satisfaction. However, for many middle-aged women who experience sexual dysfunction, it’s not clinically significant or distressing enough to be a focus of treatment in their healthcare providers’ offices. The NHSII study found that 50% of surveyed women reported experiencing some level of sexual dysfunction, and it’s important for healthcare providers to recognize these symptoms as part of routine medical care for women in midlife.
Talking about your sexual health can feel awkward, but it’s an important topic to discuss. Changing your lifestyle can help improve your libido, including eating healthier and getting regular exercise. Using water-based lubricants and vaginal moisturizers to ease penetration may make intercourse more comfortable, while sexual positions that don’t require lifting the pelvic floor can reduce pain and discomfort. If your libido has decreased, you may benefit from counseling or hormone replacement therapy if appropriate. If you have urinary incontinence, a prescription medication or vacuum pump device could be beneficial as well.
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