SEX FOR AGING WOMEN

As men age, they normally experience changes in their erectile function. It may take a longer time and greater stimulation to get an erection, orgasms may be less intense, and the time between erections may increase. Nevertheless, they rarely report much change in their levels of desire across their lifespan. If they had high sex drives as young men, they maintain them, whereas if they had little interest in sex when they were young, they probably have little as they age. This is true for both genders.

The Janus report of the 1990s noted little change in sexual activity across the female life span. Sixty-eight percent of women aged 39 to 50 engaged in sexual activity at least once a week, as did 65% of women aged 51 to 64, and 74% of women over the age of 65. Women’s masturbation frequency declines with age but approximately half of healthy women over age 60 are still doing it. Some women report an increase in sexual desire after menopause.

But some complain of the opposite. One cause of decreased sexual desire is actually physical discomfort during sex. In postmenopausal women decreased vaginal lubrication and/or a thinning of the vaginal lining can lead to pain during vaginal intercourse. Vaginal lubrication is delayed and reduced in quantity. Whereas in younger women the excitement stage with lubrication may take only 10 to 15 seconds, in the postmenopausal woman it may take up to 5 minutes or longer.

A lack of testosterone can reduce women’s sexual desire. Although there is no absolute level of testosterone necessary for sexual desire, there does seem to be a threshold below which desire levels are affected. Though this affects only a small number of women, the results of testosterone treatment are immediate and remarkable.

The decline in estrogen accompanying menopause leads to a number of normal, age-related changes in genital appearance. Such changes include a reduction in pubic hair, a loss of fat from our mound, thinning of our outer lips, and shortening and loss of elasticity of the vagina. Vaginal secretions decrease because of shrinking of the lubrication-producing Bartholin glands and a decrease in the number and maturity of vaginal cells. The cells that line the vagina, which are highly estrogen dependent, become flattened and lose glycogen, which in turn leads to a decrease in lactobacillus, lactic acid, and a rise in vaginal pH. These alterations affect the vaginal microbial population and put aging women at a greater risk for developing bacterial infections. Together with decreased vaginal lubrication, the thinning of the lining cells may lead to mild burning sensations during intercourse, pain, or bleeding afterwards. Leaking urine during intense arousal, as sometimes happens, adds embarrassment to discomfort.

What to do?

Using sexual lubricant solves the problem for many women. The addition of liberal amounts of warm cocoanut oil as part of foreplay’s caressing can lubricate the genital area as well, provided you are not using latex, which would degrade with the oil product. Non-hormonal preparations such as Replens or a dab of Premarin ointment (a prescription from your doctor) applied to the inner labia every other day may significantly improve vaginal dryness.

The bad news is that it takes us longer to reach orgasm, and the uterus is less responsive once we get there, the labia do not swell to the same degree as in our younger years, our breasts no longer plump the way they used to and nipple erection is less likely to occur.

The good news is that age does not significantly affect our orgasms. Women retain multi-orgasmic capacity, although the number and intensity of orgasmic and rectal contractions may drop. While younger women average 5 to 10 vaginal contractions with orgasm, the older woman averages 2 to 3. As is the case in men, we hold that post-coital glow for a shorter time physically, but not necessarily psychologically.

Despite these physiological changes of aging, many postmenopausal women report little or no changes in the subjective or psychological experience of sexual arousal. In a loving relationship with an understanding partner (who is also aging), open dialogue is the key to discovering new methods of love making that accommodate the body’s changes so that the couple’s interpersonal bond continues to flourish.

Just as with men, women’s bodies undergo changes as they age, and some of those changes affect sexual performance and experience. There’s nothing to do but understand and accept the inevitability of change and learn to adjust our lovemaking to make the most of what still works gloriously and savour every moment!

© 2007. Dr. Pega Ren.