Sex over sixty

The spirit is willing...

If shifts in desire or ability go beyond what you understand to be the normal changes of aging, don't ignore them, as health-related factors could be involved:

• Diabetes, high blood pressure, depression, and prostate problems can affect sexual desire and performance.

• Heart disease, osteoporosis, arthritis, incontinence and emphysema can also affect ability and enjoyment.

• Prescription drugs to treat conditions such as depression and high blood pressure can dampen libido and performance.

  A miracle pill? Sildenafil citrate (Viagra®) is medication for erectile dysfunction. It's not an aphrodisiac. Arousal time and a willing partner are still needed. The medication is highly effective but not for all conditions. Suitability can only be determined through consultation with your doctor. Needed dosage varies and may have to be adjusted over time. There are side effects: one in three men may get a headache, feel flushed or experience indigestion. Blurred vision is also common. Men with angina or other coronary artery disease may be at some risk with Viagra®. It should not be used in individuals taking nitrate therapy. A sudden surge in sexual activity has an impact on the partner and on the couple. Make sure your partner participates in the decision. (from the Mayo Clinic website)

The solution: talk to your doctor - and be frank about why you're seeking help. You might both find it difficult, but openness ensures the real issue gets dealt with. Many of these conditions can be treated, or options such as injections, medications, implants and other adaptations are available to facilitate sex. If that's not possible, explore other ways to enjoy sexual expression - a therapist or counsellor can offer advice on restoring intimacy in a relationship and suggest helpful resources.

Know thyself

Be aware, however, that other factors are much more likely to influence desire and ability: excessive alcohol and tobacco use; obesity and lack of self- confidence; negative reactions to changes caused by aging; performance anxiety; and the closed attitudes of adult children and health professionals about sexuality.

Lifestyle change - reducing alcohol and tobacco use, eating well and exercising regularly, finding therapy or a support group for depression - may do wonders for your sex life. Similarly, recognizing and dealing with your feelings about body changes after illness or surgery may help. If the attitudes of your children or health professionals are getting in the way, remember that you're entitled to the life you choose for yourself - and that includes a sex life if you want one.

If anxiety is the issue, knowledge is your best ally. Ignorance about what's normal may cause you to overreact to any change in your body, undermining the ability to perform.

Learn what to expect and where to get help. Understand the differences between men's and women's sexual interests, experiences and responses. When both partners are well informed, you can make allowances instead of unrealistic demands.