Contrary to stereotypes, aging does not eliminate a person’s sexuality. Mid-life and elderly Americans care deeply about their sexual experiences and relationships. Not uncommonly, as a result of the aging process, men past midlife experience a reduction in sexual desire as a result of decreased levels of testosterone and sexual disorders such as erectile dysfunction and prostate problems. Men with erectile difficulties often react with feelings of failure, anxiety, depression, and loss of self-esteem. These feelings may be compounded by their partner’s disappointment or anger.

In older women, while the hormonal and physiological changes associated with menopause are factors, the predominant correlation with decreased libido, arousal, orgasm, and sexual enjoyment is relationship difficulties. Most female sexual problems are associated with anxiety, depression, and the loss of a partner. Sex therapy is useful in helping individuals and couples adjust to the various physical changes and the effects of medical treatments that come with aging.

• First and foremost, communication, communication, communication.

• Counseling and sex therapy.

• Sexual activity in the morning when an erection is more likely.

• Avoid times when your partner is stressed or tired.

• Ample amount of tactile stimulation, manually or orally, before and during intercourse.

• Ample use of sex-specific lubricants.

• Consider prescription vaginal estrogen cream.

• Positions in which vaginal tension is increased for heightened stimulation.

• Spending more time on sexual activities other than intercourse.

• Focus on sensuality and intimacy rather than sex.

• Achieving orgasm via other techniques.

• Trying new sexual activities outside of the usual repertoire.

• Encouraging the partner to experience sexual pleasure regardless of sexual difficulties.

• Taking turns at giving or receiving sexual pleasure.

• Consulting with a doctor about oral medications and impact of prescriptions.

• Genital devices for blood flow (vacuum pump).

• Over the counter supplements that impact the arousal pathway.

• Mechanical devices (vibrators) and sex toys.

• Other mediums for sexual outlets and support: self pleasure, videos, magazines, etc

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