Living Life to the Fullest - Sexuality during the middle years

In spite of the so-called sexual revolution, it is still very difficult for most people to sort out their attitudes towards sexual activity. It is a subject that continues to be clouded by feelings of guilt and anxiety, surrounded by taboos, saddled with misinformation, and complicated by personal concepts of love and morality.

Many people were shocked when the Kinsey reports on male and female sexual behavior appeared. More recently, militant efforts have been made in various communities to prevent the schools from including sex education in their courses of study. Yet marriage counselors, family physicians, ministers, and all other specialists in human relations can attest to the amount of human misery caused by ignorance about sex—all the way from the ignorance that results in a 15-year-old's unwanted pregnancy to the ignorance of a 50-year-old man about his wife's sexual needs.

Sexuality After Menopause

Sexual relations between partners can continue throughout the life of the marriage. There is no reason that a person cannot remain sexually active, barring medical complications, for one's entire life.

Sexual function will change with aging. It takes longer for a man to obtain an erection and it takes longer to achieve orgasm for both partners. Women may suffer from thinning and drying of the vaginal walls following menopause, but the difficulties that this may cause are easily remedied. Lubricants that are water-based (unlike petroleum jelly, which is oil-based) can be used to replace natural lubricants. If it takes longer to arouse one partner, then set aside a little more time for romance.

It may be easier for the couple to enjoy lovemaking in the morning, after a good night's rest, rather than the end of the evening when they both may be tired. Since it is likely that there will be no children in the house to interrupt, couples may find that there is a renewed interest in sex, because of a new-found freedom that comes with having grown children and having no fear of pregnancy.

There are circumstances, though, that may arrive that hinder or block sexual relations. These are discussed in brief here.

Problems with Sexual Activity

Occasional problems with sexual drive or capabilities are normal. Most people will experience some fluctuation during their lifetime. If a problem persists beyond a few weeks, or if any pain is associated with sexual intercourse, you should consult with your doctor. Although the causes may be psychological, it is best that you do not draw this conclusion without speaking with a medical expert first. Some of the problems that may be experienced follow.

Impotence

Impotence is defined as a lack of adequate erection to complete intercourse. This can be experienced on a temporary basis because of fatigue, overindulgence in alcohol or drugs, stress, or other factors that physically affect the system. It can be experienced on a more long-term basis and still not be physiological in origin.

Some of the psychological causes for impotence include: resentment, hostility, and anger at one's spouse; stress and anxiety from any aspect of one's life; and fear of sexual inadequacy and impotence. This last point is important because the fear of impotence can bring on impotence. If one experience of impotence triggers fear, the cycle of fear and inability to perform can prolong recovery. It is important to remember that over half the cases of impotence are psychologically based and are cured once the cause is resolved.

Physiological reasons for impotence usually involve the blood flow and the nerve response to the penis. In diabetics, the combination of nerve loss and restricted blood flow can reduce sexual capacity. With some men, artery blockage restricts the flow of blood to the penis. Surgery may be able to remedy some causes of impotence. Your doctor can advise you on any specific problems you encounter.

New Treatments

Where other approaches fail, the impotent male can either undergo a test for erectability or try one of the new treatments currently available. Conducted during sleep, the tests provide evidence indicating that impotence in any given case has physical or psychological causes. Physical causes may include such diseases as diabetes; some drugs or medication, including those used to treat high blood pressure; alcohol abuse; hardening of the arteries; and testosterone or thyroid hormone deficiencies.

These tests have shown that physical causes underlie impotence in nearly half of all cases. As a result much research has been conducted into physical “cures.” All of the tests operate on the accepted medical principle that “normal” men have approximately five erections during every sleep period. In what is called the stamp test , a strip of stamps is wrapped around the penis before the subject retires for the night. Fitted snugly around the shaft of the penis, the strip tears along one of the perforated edges if the subject experiences an erection while sleeping.

Two other tests are more reliable. In one, a snap gauge band made of elastic fabric and Velcro is wrapped around the penis; the band has three snaps designed to open at various stages of penile rigidity. A third test utilizes a Nocturnal Penile Tumescence Monitor to tell exactly when erections occur, with what rigidity, and for how long. Two circular elastic silicone bands are attached to the penis; sensor wires connect the bands to an apparatus like an electrocardiograph machine.

Of the prosthetic devices used to “cure” impotence, three can be implanted in the penis in operations that take one to three hours under local anesthetic. The simplest utilizes two semirigid rods that keep the penis permanently erect. A second implanted type, made of flexible, plastic-covered metal wire, also maintains the penis in a constantly erect state but can be bent into an erect or downward position. A third type works hydraulically to pump the penis into a naturally erect state. Two expandable metal tubes implanted in the penis function with an attached tiny pump in the scrotum and a water reservoir placed behind the muscles of the lower abdomen. Pressure on the pump causes the penis to erect; valves make possible penile relaxation.

Disinterest

Disinterest, which was referred to as frigidity in women, can be experienced by both women and men. It may be traced to hostility or resentment toward the partner, lack of adequate satisfaction during intercourse, other psychological impediments, or physical problems. Some medications can reduce libido; depression may also reduce the sex drive. Consult with your physician to eliminate physical reasons, and follow up with therapy if no physical ailments are suspected.

Self-Image Problems

If you do not believe yourself to be physically appealing, it is likely that you will regard a partner with suspicion and hostility if he or she finds you physically appealing. You may be willing to perceive insult and ill-intent where none is meant if you do not believe yourself to be a desirable partner.

Self-image is one of the most important aspects of sexuality. The belief that one is too old, too fat, too thin, too wrinkly, too whatever can be a huge obstacle to a satisfying life. Self-image is estimated to be a problem for half of the male population and the majority of the female population. One cannot change the view others have of beauty, but one can improve a self-image. This may require counseling, but is worth it in the long-run, since the ability to be happy rests with the ability to be happy with oneself.

Sexual Activity and Disability

Disabilities, whether the result of genetics, disease, accident, or aging, need not be a complete barrier to sexual satisfaction. Most disabilities allow some form of sexual gratification and with an understanding partner, this can be worked out. Counseling and training may be needed to develop the emotional support and understanding necessary to achieve a fulfilling relationship with your partner, but if both are willing participants in the learning process, this can be achieved. Talk with your physician or a therapist specializing in disabilities about your situation. If they cannot provide guidance, they should be able to direct you to someone who can.