Alessandra Paul

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Sexual health in the Medicare patient

Your sex life doesn't have to be boring or end because your body changes or age.

As you age, so does your body, muscles, comfort levels, and mental ability, and what’s more, the way we see ourselves also changes. Older adults may also be living with other physical and mental conditions, which can create disconnection in their sexual lives. According to the National Institute on Aging, “Two common changes that older adults experience are related to the sex organs. The vagina can shorten and narrow, and the vaginal walls become thinner and stiffer. For most, there will be less vaginal lubrication, and it may take more time for the vagina to lubricate itself naturally. These changes could make certain types of sexual activity, such as vaginal penetration, painful or less desirable.”

Likewise, men's impotence (erectile dysfunction) can also be a significant change within a male body. However, ED should not stop you from asking your doctor about ways of maintaining a firm and longer-lasting erection. ED is a common occurrence and can often be dealt with by using medicine and/or testosterone.

On the other hand, Menopause can also affect a female’s sexual life, causing them to experience hot flashes and mood changes during this new transition. Menopause in females can also cause sexual interest to peak or drop. In addition to these changes, certain illnesses and medicines can also make it more difficult to live a life with sexual pleasure.

However, this should not discourage you from living a sexual life; instead, it can offer you and your partner(s) a wonderful chance to get to know each other's pleasure points, and improve your sexual relationship, not only with them but with yourself.

The American Sexual Health Association states that sexual health is the ability to embrace and enjoy our sexuality throughout our lives. Sexual health goes beyond sexual pleasure; everyone is entitled to access resources and the freedom to talk about any experiences with doctors and others. According to the National Council on Aging, “sexual health is critically important as we age. First, it allows us to create and maintain emotional intimacy and a sense of closeness with our partner. Sex has also been shown to help reduce stress by releasing a hormone that helps us feel more relaxed.” Being sexually healthy is also closely intertwined with our overall health. For example, engaging in regular sex can reduce our risk for high cholesterol and even lower blood pressure.

Talking about sex might be fun, but it also involves talking about STI/HIV. Studies from the CDC show that the elder community and the elderly LGBTQ+ community are more likely at risk of contracting an STI. According to the National Resource Center on LGBT Aging, “Older adults have unique age-related biological risk factors, such as vaginal dryness. Vaginal dryness can make penetrative sex uncomfortable and also increase the likelihood of vaginal abrasions,

which makes transmissions of STIs more likely. Erectile dysfunction may increase the difficulty of using condoms. As a result, some men may not use condoms during sex.”

Older adults still need to get tested for STIs, STDs, AIDS, etc. While shame and fear may be accompanied with having a sexually transmitted disease, it’s better to be safe than sorry. Ensuring that you and your partner are free of STIs and STDs is an essential step to being sexually active in the safest ways possible.

Here are some approaches to living a more healthy sexual life (they may not be for everyone, so make sure you explore options that feel comfortable for you and your partner):

●  Use condoms and mouth protection during sexual intercourse and other sexual activities.

●  Don’t be afraid to use sex toys!

●  Don’t share sex toys, and make sure to wash them after every use.

●  Use the lube that is best for you.

●  Vaginal dryness can be more common in older females (as medication can shift the pH levels in that region). Use a water-based lubricant.

●  Communicate your needs, and disclose any pain (discomfort, surgeries, hard no’s, and triggers) to your partner.

●  Know your sexual partner’(s) background.

●  Get creative with different sexual positions and use physical aids for support if

necessary.

●  Watching ethical porn that is inclusive (either with your partner or alone) can help give

you ideas and spark sexual arousal and desire.

●  Talk to your healthcare provider about any pains or concerns you may have related to

your sexual organs.

Learning to embrace yourself fully and adapting to a new sexual lifestyle can be challenging but well worth it. You can start by self-exploring and talking to a sexology therapist who is sex-positive to regain your sexual confidence. The journey can be long, especially if you are experiencing new changes in your body all at once, living with a physical or mental ailment, taking medications, or just undergoing surgery. However, the journey is worth it and comes with many rewards.

Your sex life doesn't have to be boring or end because of your body changes or age. You can still have as much fun, if not more! Sexual health is essential at any age, and it can be fun to discover how to fulfill it in new ways.

To find more information about sexual intimacy in the elderly community, please visit the National Insitute of Aging. Most importantly, have lots of safe fun!