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Senior Citizens & Sex
Nine Health Issues That Can Impact Sexual
Satisfaction
Geriatrics Center at U. of Michigan provides 'Sex
Matters Clinic'
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Read below about 'Sex
Matters Clinic' at U. of Michigan Geriatrics Center and view
video. |
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Feb. 5, 2007 – Health and lifestyle matter when it
comes to a health sex life, particularly for senior citizens, too often
plagued by various health issues. Here’s the good news, the bad news,
and some more good news about Americans’ sexual health: Most (64 percent
of Americans, according to one recent study) are satisfied with their
sex lives. But many health issues can get in the way of having a good
sex life, from prescription medication side effects to depression to
sexually transmitted diseases. (See story for link to video and more on
help for senior citizens at U. of Michigan Geriatrics Center.)
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Senior Citizens & Sex |
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In many cases, physicians can work with their
patients to improve the situation, whether by changing the dosage of a
medication, helping to treat depression or other medical conditions, or
by providing sound medical advice for people who have STDs.
“For people who are not satisfied with their sex
life, they really should talk to their primary care physician,” says
Pamela G. Rockwell, D.O., assistant professor of family medicine at the
University of Michigan Medical School. “He or she may be able to
diagnose something that was previously undiagnosed, change medications,
or offer some lifestyle recommendations. In many cases, the patients can
improve their sexual satisfaction.”
Here, Rockwell explains how nine health issues can
affect sexual satisfaction for adults of all ages.
1. Prescription medications. Many common
drugs can have side effects that impact sexual health, including
medications that treat blood pressure, heart conditions and depression.
Diuretics (“water pills”) that treat heart and
blood pressure conditions can cause erectile dysfunction among men. ACE
inhibitors and other calcium channel blockers, which are used to treat
some heart-related problems, also have been found to cause erectile
problems.
For patients whose depression is being treated with
selective serotonin reuptake inhibitors (SSRI) medications – such as
Prozac, Paxil, Celexa and other drugs – or other antidepressants, side
effects can include a loss of interest in sex and ejaculation problems.
With all of these types of medication and any
others that may cause sexual side effects, Rockwell says, patients can
talk with their doctors about possibly lowering the dosage, adding a
second drug to combat some of the side effects or changing to a
different medication.
2. Cardiac health. First, Rockwell would
like to dispense with a common misconception. “I think the most common
fallacy is that having sex is going to cause a heart attack,” she says.
“The good news is it really isn’t the case.”
The majority of people with cardiovascular disease
don’t need to alter their sex lives, she says. Some people may need to
be careful about all physical activity immediately after a heart attack,
or after the implantation of a pacemaker or cardioverter defibrillator,
but even then, sex generally is safe as soon as the patient’s physician
gives the go-ahead to resume physical activity.
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The Sex Matters Clinic
for Seniors
Geriatrics Center Clinic at
University of Michigan East Ann Arbor
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The Sex Matters Clinic is a specialty program at
the University of Michigan Health System targeting people who are 60 and
over. The mission of the clinic is to provide comprehensive sexual
health care for older adults. It is staffed by a physician and two sex
therapists who are professionals with a specialization in treating
sexual difficulties. Referral to the clinic may begin with self-referral
or physician referral. Appointments are at the Geriatrics Center Clinics
at the University of Michigan East Ann Arbor Health and Geriatrics
Center.
 The Sex Matters Clinic - Q&A
What causes sexual difficulties?
Sexual difficulties may be life-long or may begin
in response to certain life events such as an illness, medical
treatment, or change in a relationship. Sometimes a life change such as
retiring, job stress, or moving can cause changes in sexual functioning.
What sexual difficulties can be treated?
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About 50% of sexual difficulties are caused by the physical and
psychological symptoms of a medical condition such as:
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Absent or low sexual desire
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Painful intercourse or penetration
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Difficulties with erection or ejaculation
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Inability to have orgasm
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Problems associated with post-menopause, such as vaginal dryness
● Problems associated
with an illness, accident or medical treatment
What services are available at the clinic?
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Evaluation by both a physician and sex therapist
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Recommendations for treatment
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Education and counseling about sexual functioning
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Short term or ongoing medical interventions
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Short term or ongoing sex therapy for individuals and couples
Who seeks help from the Sex Matters Clinic?
We see all sorts of people who are older adults,
both women and men, heterosexual and gay, from every kind of background,
and many countries. Many people we see are married or are in permanent
partnerships, but others are single. Some people have had many
partnerships; others have never had a partner.
Will I be talking about my sex life?
Yes, you will be talking about your sex life. Very
few people have been brought up to talk about sex in an easy, open way.
It is normal for a person to feel anxious when anticipating their first
appointment to the clinic. Both your physician and your sex therapist
understand this and will help you be more comfortable discussing sex.
Will insurance cover the cost of the
appointment?
Insurance will cover most of the cost. Specific
questions about appointment costs and your insurance coverage can be
answered by the administrative assistant at the time you schedule your
appointment.
>> Sex Matters Clinic main page
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3. Depression. Untreated depression,
Rockwell says, can lead to many sexual difficulties. “People can
experience lack of pleasure, lack of desire and lack of ability to
perform,” she says.
Adding to the challenge is that some people with
untreated depression have heard that antidepressants can negatively
affect their sex lives. In reality, Rockwell says, most people on
antidepressants don’t experience these problems. For those who do,
doctors often can prescribe different dosages or different drugs to
minimize the side effects.
4. Alcohol. As anyone who has ever seen a
beer commercial knows, alcohol and sex are linked in the minds of many
people. Indeed, Rockwell says, many people believe that alcohol will
“get you in the mood.”
While a few drinks initially lower one’s
inhibitions, drinking can lead to risky sexual behavior – not just for
people with serious alcohol problems, but also among people who only
occasionally have too much to drink. Additionally, Rockwell says, it
doesn’t really help with one’s enjoyment of sex. “Overall, it decreases
sexual pleasure because alcohol lowers your sensations,” she says.
5. Sexually transmitted diseases. For people
with STDs such as HIV, the human papillomavirus (HPV), or hepatitis, sex
isn’t out of the picture. In fact, Rockwell says, “people with STDs can
certainly have healthy, satisfying sex lives.”
Protection is a must, she says, and condoms must be
used 100 percent of the time. An important caveat is that with HPV,
which can cause cervical cancer, condoms do not necessarily protect
one’s partner against contracting the virus.
6. Stress. Got stress? If so, then you may
have more trouble experiencing an enjoyable sex life.
“Stress often has effects on our sex lives. When we
are consumed with time management, working, raising children and
providing for our families, we often don’t leave a lot of time for
ourselves,” Rockwell notes. “What happens is the libido goes down, and
the ability to accept and give pleasure decreases. People who suffer
from unsatisfying sex lives may not even realize that it could be caused
by stress.”
7. Pregnancy. “Physically, there is no
barrier to sex during pregnancy,” Rockwell says. Intercourse will not
harm the fetus or the woman, unless she has a medical problem and has
been advised by her physician not to have intercourse. Levels of desire
can vary. The use of lubricants and changes in positions as the
pregnancy progresses may be necessary.
8. Menopause. Some physical limitations may
affect a woman’s enjoyment of sex after menopause, but that doesn’t mean
a woman’s sex life is over. “Many women can experience a very healthy
sexual life after menopause,” Rockwell says. “There is no reason that
menopause should mean an end to your sex life.” Topical estrogen cream
and lubricants may help after the drop in hormone levels that occurs
during menopause.
9. Poor body image and self esteem. A
woman’s self esteem can significantly affect her sexual satisfaction,
and low self esteem based on a poor image of her body can detrimentally
impact her enjoyment of sex. “Some studies show that as little as five
pounds of weight loss can greatly improve a woman’s sexual
satisfaction,” Rockwell notes.
For more information, visit these Web sites:
U-M Center for Vulvar Diseases: Pain during sexual
intercourse/vulvodynia
http://www.med.umich.edu/obgyn/vulva/links.htm
U-M Health Topics A-Z: Sexual problems
http://www.med.umich.edu/1libr/aha/aha_psycholo_bha.htm
U-M Health Topics A-Z: STD prevention
http://www.med.umich.edu/1libr/aha/aha_stdpreve_crs.htm
U-M Sex Matters Clinic: Sex in later life
http://www.med.umich.edu/geriatrics/TurnerGeriatricClinic/questions.htm
UMHS press release: Sex and the silver years
http://www.med.umich.edu/opm/newspage/2006/hmsex.htm
U-M Health Topics A-Z: Sexual problems and aging
http://www.med.umich.edu/1libr/aha/aha_intro_crs.htm
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