An 82 year old male patient of mine came to see me last week. He and his 78 year old wife look and act decades younger. He shared with me, that he attributes one of the important reasons for his continuing youthfulness was still having a great and fulfilling romance with his wife. They have been together for over 40 years and are still in love. They certainly belied the stereotype that an intimate romantic life is only for the young.
Yet, today there are many older couples, and singles, who have active love lives and you can too. It all hinges on knowing basic information about what influences intimacy as you get older and what you can do to maintain an active intimate, romantic relationship. In this two-part series, we’ll look at the issues that affect intimacy in both older men and women. Ladies first…
Part I: Intimacy and Older Women
A woman’s romantic life has its issues at all ages. When you’re younger, the concerns are more focused on reproductive issues, childbearing, and avoiding sexually transmitted diseases. As you get older, your romantic life centers more on the physical effects of hormone changes, partnership and social issues, other health issues and changes to your body that can affect your romantic life. Let’s look at those things you, as a woman, should know about maintaining fulfilling intimate relationships as you get older and what you can do about them.
Menopause is the #1 deterrent of romantic intimacy in older women. Social issues – like the death/divorce of a spouse, or just being spread too thin in many directions, is the second. But, neither of them has to be the end of your romantic life. Let’s look at how menopause can affect intimacy:
1. Lack of desire. The male hormone testosterone fires a woman’s libido as well as a man’s, but in different amounts. The small amount of testosterone that a woman produces can decrease even further in menopause (as well as stress, lack of exercise) and her desire for sex can depart with it. Boosting hormone levels can work wonders for this issue, see below.
2. Atrophy of vaginal tissues. The decrease in the female hormone estrogen can create a “shrinking” and drying/inflammatory condition of vaginal tissues known as atrophic vaginitis. Normal lubrication of the vaginal tissues decreases and tissues can become dry, inflamed, and even bleed with the friction of sexual intercourse. All these things can make sexual intercourse very uncomfortable/painful and is the #1 reason older women stop having sexual intercourse. Yet, this condition can also be easily treated.
3. Depression/Mood Swings/Hot Flashes/Insomnia. Menopause can affect your mental health as well. The fluctuations in estrogen can cause you to become depressed, moody, and suffer from very uncomfortable hot flashes. Hot flashes can make you sweat profusely, especially at night while sleeping (or trying to) as you may not sleep very well at this time in your life either. As a result, you’re going through your life tired, depressed, moody and sweating, all of which can make you not feel so great as well as dampen any desire for sexual relations.
Now, let’s talk about those important social issues:
1. Loss of partner. People can lose their spouses, or significant other, through death or divorce. When you’re older, the opportunity to meet a suitable, available partner is not as easy to do as when you’re younger and all your friends are single. Not having an ongoing relationship/partner can cause people to ignore their sexuality as if it didn’t exist. As one of my female patients told me, it’s less emotionally painful to just pretend it’s not there anymore.
2. Social/Family Issues. Let’s face it, women are almost always the primary caretakers of their family. An older woman’s caretaking responsibilities may still be extending to her children (for whatever reason) and also to her elderly parents, or other relative, at the same time. This can leave you physically and emotionally exhausted and your sex life may be pushed to the back burner to tend to everyone else’s needs first.
What You Can Do To Save Your Sex Life:
All these issues that affect older women’s sexuality can be successfully addressed and remedied to allow you to continue a fulfilling sex life. Treating sexual issues in older women starts with a visit to your gynecologist, or internal medicine doctor, and speaking honestly about all of your symptoms. Many women are embarassed to tell their doctor about their symptoms – especially if their doctors are much younger males. But, trust me, they’ve heard the same symptoms from hundreds of other women – you’re not alone! Here’s some options for troublesome menopausal symptoms that can revive your sexuality:
1. Bioidentical hormone replacement. Replenishing decreasing hormone levels almost immediately turns off menopausal symptoms. In BHR, you’re replacing estrogen and progesterone using natural sources from herbs and plants (rather than dangerous synthetic or animal-based hormones).
2. Exercise. Surprisingly, many women who exercise frequently have much milder menopause symptoms, if any. Why? Exercise helps release stored estrogen and testosterone from your fat cells. It also helps regulate your body “thermostat” which can greatly weaken the severity of hot flashing and decrease sweating.
3. DHEA. Italian researchers in 2011 proposed using DHEA supplementation for women suffering from menopausal symptoms instead of hormone replacement. Their studies showed that not only did it improve their symptoms but their desire for sexual relations improved dramatically. DHEA is a hormone precursor which your body makes naturally. With age, it can decrease significantly. Ask your gynecologist about testing your DHEA levels to understand how supplementation may benefit you.
4. Melatonin. Nature made this incredible substance so humans could sleep. Taking between 1-3 mg a night can really help you get back on a normal sleep pattern.
5. Nutrition. Nutritional deficiencies can really wreak havoc on your sexual desire. The following nutrients can help reboot your sex drive. Fish/Krill oil, Super Primrose oil at 1,000 mg daily; vitamin/mineral packed super-multi supplement (should contain all the B vitamins, Vitamin A as beta carotene, C, D, antioxidants selenium, calcium/magnesium/zinc, and the trace mineral boron which many menopausal women are seriously deficient in). Menopausal women can also be deficient in calcium and magnesium – especially if you’re sweating from hot flashes. They both help decrease hot flashes as well. Protein is necessary for maintaining muscle strength as well as tissue integrity throughout your body – including the vagina. Water is crucial in replacing loss from sweating which can lead to dehydration and a whole list of related issues. Just as importantly, water also helps fight vaginal dryness. Drink half your weight in water ounces daily. For example: 160 lbs equals 80 ounces of water.
Your doctor may not have the answers for any social issues that might be diminishing your sex life, but here are a few good recommendations:
1. Partner/Spouse Issues. Your sexuality may be functioning fine but perhaps it’s your spouse or your significant other’s whose sexuality is problematic. You may be living with a man who has impotence issues and sexual relations between the 2 of you has stopped or unsatisfactorily changed. There are many couples sexual therapy that the two of you can attend to address this issue which cover things like alternative methods of sexual activity to medical help for your partner’s/spouse’s particular issue.
2. Dating Sites/Events. Although you wouldn’t know it, the world doesn’t belong to the Milleniums (20-30-year-olds) or even Generation X’ers (30-45 year-olds). There’s still a lot of fun and excitement out there for Boomers and older. It all depends on where you’re looking. Older persons in 2013 have a lot more opportunity to meet available partners their age than your predecessors. Online dating sites like OurTime, is specifically geared to older people who are looking for a relationship. Joining a Recreation Center where people of all ages go can help you stay fit, as well as meet people of your age and interests. Another great place to meet people of all ages and participate in activities you enjoy is Meetup.Com. You can join an existing group or create your own!
3. Caretaking concerns. If you’re involved in caretaking for elderly parents or even a sick, or disabled child, you deserve some help and there are many agencies out there that offer it. Get someone to come in 1 or 2 days a week to take over for you so that you can have needed time-off to both recharge your own battery and reconnect with your spouse or significant other. Going around exhausted and irritable is not only dangerous for your own health and a major wet blanket to sexual desire, but it also deters you from giving the best care to your loved one.
Well, there you have some of the basic issues and recommendations to keep your sexual fires burning. Remember to address all your symptoms with your doctor, or a nurse practitioner. Sexuality is one of the best parts of life – at any age. Why ignore, or give up on, one of the best parts of your life when, with a little tweaking of your hormones or adjustments to your lifestyle, you can regain that essential part of yourself and re-create a fulfilling sexuality.
Please come back and read Part II –Men and Romance After 50: What You Need to Know
Mark Rosenberg, M.D.