The improvement of education, medical science, and quality of life has resulted in longer lifespans. As a result, the importance of sexuality in older age is growing. However, there is an erroneous belief that sexuality becomes irrelevant as people age.
According to Myers (67), as individuals age, their sexuality experiences a decline. However, this decline varies from person to person and is influenced by changes in health and social aspects among individuals in this age group. Therefore, it could be essential to maintain sexuality for preserving relationships and enhancing quality of life. The impact of aging on sexuality involves sexual desire, behavior, and organ characteristics. Both men and women experience physiological changes due to aging that affect their sexual behavior and desire.
Nurses, physicians, and researchers have written numerous books summarizing the impact of aging on sexuality in this study.
...The research papers cover general effects of aging that affect sexuality and focus on hormonal fluctuations. They explore and discuss changes in sexual performance and needs related to aging.
According to researchers, sexual behaviors among ageing adults resemble those of younger groups. However, the need for sexual expression persists as long as both partners are healthy, despite changes in frequency due to reasons such as lack of a partner or poor health. Privacy issues can also limit sexual expression, but older individuals have the right to express their sexuality, including those residing in long-term care facilities. It is important to consider that families and staff may have differing opinions on what constitutes "appropriate" sexual expression compared to elderly individuals themselves (Campbell & Huff 45; National Institute on Aging 1994).
Despite disapproval from long-term care facility staff, evidenc
suggests that romantic and sexual relationships among elderly residents are on the rise. Over the years, researchers such as Kinsey have been amazed by ongoing sexual activity in older individuals, leading to numerous studies investigating their sexual interest.
Studies relying on self-reported data indicate that despite the decline in sexual activity associated with aging, the elderly maintain an interest in sex throughout their lives. These studies have examined various types of sexual expression, considering factors such as sexual orientation, interest and satisfaction, environmental restraints, age, income, race, education and gender. Furthermore, these studies have explored how medical, emotional and social factors influence sexual function.
Research conducted by Campbell & Huff (89) has explored the shifts in arousal rates and frequency of sexual activity. Sexual dysfunction in elderly individuals has a range of origins, encompassing both physical and mental factors. Concerns with sexual performance, a lack of interest, and reduced arousal abilities are all classified as forms of dysfunction. Commonly, authors and researchers incorporate the inability to participate in heterosexual activities into their analyses and discourse. The failure to adapt to natural aging progression and sickness is a frequent cause of sexual dysfunction.
Sexual dysfunction in elderly people can be caused by a range of physical and psychological factors. These include negative attitudes towards aging, lack of sexual partners, mental health issues, chronic pain, substance abuse, medication side effects, dementia, and limited privacy. Elderly individuals may become more vulnerable to health issues affecting their sexual well-being as they age and require more medication for conditions such as hypertension and arthritis. These conditions can negatively impact libido and hinder participation in sexual activities.
Sexual function can be affected by various health
conditions, including diabetes, Parkinson's disease, Alzheimer's disease, dementia, strokes, heart attack, stress, depression, colostomy and ileostomy, lung disease, obesity and cancer. Additionally head injuries and fractures can also impact sexual function. In elderly males impotence is the primary sexual dysfunction that may occur with changes in libido and erectile function as they age. Other sexual dysfunctions include premature ejaculation, impaired sexual interest retarded ejaculation and pain during intercourse. Females may experience changes in sexuality after menopause.
The leading cause of issues for women is attributed to a decrease in estrogen levels. Authors often highlight lowered sexual interest as the most frequently encountered sexual dysfunction. Additional factors that impact sexual behavior and satisfaction consist of heightened urinary tract infections, vaginal atrophy, vaginal dryness, lessened sex drive, vaginismus, dyspareunia, orgasmic dysfunction, and collateral issues impacted by other illnesses. A myriad of writers suggest options for medical professionals and nurses to handle sexual dysfunction cases, with the most popular approaches including counseling, education, sex therapy, marital therapy, and in some cases psychiatric referral.
The proposal is to improve privacy options. The benefits and drawbacks of hormone replacement therapy for women should be considered before it's recommended. Hobson (34) states that there isn't any proof supporting the advantage of male hormone therapy. Butler and Myrna (1976) discuss sexual activity in older age in their book, Sex after sixty: A guide for both genders.
As per the writers, sexual functionality can persist even after reaching 80 years of age and despite menopause. To address changes post-menopause, individuals can opt for regular sexual activity, hormone replacement therapy, K-Y jelly lubricants, cleanliness, hygiene or douching. The article examines how elderly males may experience
longer erection times and less explosive orgasms. Moreover, common medical conditions that could affect sexual expression are explored in addition to discussing the impact surgeries like hysterectomies, mastectomies, prostatectomies or orchidectomies (which involve removal of testes), colostomies and ileostomies have on sexual activity.
According to the authors, alcohol's impact on sexual performance is worth noting. Specifically, it can hinder sex and diminish male potency, female orgasmic ability, and cause drowsiness as a depressant. The authors advise individuals to recognize that alcohol qualifies as a drug and is a prevalent factor in sexual problems among older adults. Additionally, they suggest examining how age-related changes in kidney excretory function result in increased tolerance for alcohol over time.
Exploring emotional concerns associated with sexual activity, this article covers anxiety about sexual dysfunction, fatigue or disappointment, the impact of an unresponsive partner and how some females may feel without a sexual partner. Additionally, the authors examine particular demographics such as over 11 million women aged 65 and above in the US. Of these women, roughly 6 million are widowed, 1.2 million are divorced or single and 7% have never married. Within this context, they delve into topics like mourning and isolation following spousal loss as well as emotions of remorse or embarrassment that older individuals might experience when expressing an active interest in sex.
In order to enhance sexual experiences, the authors suggest engaging in various physical activities including exercise, brisk walking, and aerobic and flexibility exercises. It is recommended to focus on specific areas of concern such as sagging chins, potbellies, back muscles, flabby thighs, sagging breasts, and weakened pelvic muscles through exercise. To further optimize sexual health, maintaining a healthy
diet plan while reducing salt intake and increasing fiber/bulk content is advised. Additionally, it is important to avoid fried foods and laxatives while supplementing with Vitamin E and ensuring adequate rest. For older men specifically experiencing difficulty with achieving erections may require more direct tactile stimulation that could take longer.
While the ability to sustain an erection shortens and may now only last a few minutes, tactile sensitivity also decreases in this age group. In addition, men may encounter difficulty recovering an erection following sexual arousal, even if ejaculation has not yet occurred, and pre-ejaculatory mucus secretion decreases.
The fewer contractions a person experiences during ejaculation, the less powerful it becomes. This results in a reduction of seminal fluid volume. Similarly to women, the resolution process after orgasm is quicker (referring to Kinsey et al 1948 and Masters & Johnson 1966). In a study by Brecher (1984), 65% of older men reported having longer refractory periods, with 50% needing more time to achieve an erection and 44% describing their erections as less rigid when fully erect. Additionally, 32% of participants reported a greater likelihood of losing their erection during sexual activity. Despite these changes, the National Institute on Aging (1994) suggests that most older individuals are still interested in and capable of engaging in a satisfying sex life. It is also noted that delayed sexual response is a normal part of the aging process.
The article focuses on how various illnesses and disabilities can impact one's sexual health, specifically referencing heart disease, diabetes, stroke, and arthritis. However, advancements in medical care, dietary improvements, and emphasis on physical fitness have resulted in more individuals enjoying fulfilling sexual lives.
Additionally, there are beliefs that societal changes have influenced sexual activity levels, with a potential increase among older populations.
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