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Sexuality/Intimacy/
Companionship/Family
Sexuality is often defined
as important to the young and forgotten by the old. Cultural attitudes
that emphasize reproductiveness and youth contribute to this perspective.
In reality, sexuality is not jut about reproduction nor about age. Sexual
expression and physical contact can satisfy needs for intimacy, love, and
pleasure throughout the life span. The research on sexuality and aging
is limited in that samples have had limited numbers of older adults and
have included primarily heterosexual European Americans.
Intimacy is the freedom
to respond to and express human closeness as long as the closeness is mutual
and doesn't hurt other people. Avenues for expressing intimacy include:
sensory, sensual, sexual. The need and desire for intimacy varies greatly
among individuals.
(Genevay, 1999)
Factors
affecting sexual behavior:
-
Lifestyle - smoking, alcohol
consumption, stress
-
Emotional distress - depression,
anxiety
Physical
challenges Older Adults may face that affect sexual behavior:
-
Heart problems and medication
taken for them
Changes
in sexual function for women in later life:
-
Less lubrication, may result
in pain
-
Vaginal thinning, may result
in pain
Changes
in sexual function for men in later life:
-
Increased time to achieve
erection
-
More control over ejaculation,
but flow is reduced
-
Increased refractory period
before second erection is possible
Statistics
from NCOA 1998 survey:
-
48% of men and women over
60 are sexually active (some form of sexual activity once a month).
-
39% men and women over 60
would like to be more active than they are.
-
About 75% of sexually active
older Americans say their sex life today is as emotionally satisfying or
even more satisfying than it was when they were in their 40's.
Statistics
from NCOA 1998 survey:
-
48% of men and women over
60 are sexually active (some form of sexual activity once a month).
-
39% men and women over 60
would like to be more active than they are.
-
About 75% of sexually active
older Americans say their sex life today is as emotionally satisfying or
even more satisfying than it was when they were in their 40's.
Women
over 60:
-
62% say sex is better or
at least equally as physically satisfying as it was at 40.
-
Women who are not sexually
active often give the reason of not having a partner.
-
69% say sex is equally as
emotionally satisfying as it was at 40.
-
47% say sex is important
to a relationship
Men
over 60:
-
61% say sex is better or
at least equally as physically satisfying as it was at 40.
-
76% say sex is equally as
emotionally satisfying as it was at 40.
-
72% say sex is important
to a relationship.
Reasons
given for less sexual activity and less satisfied:
-
Medical condition prevents
from having sex (51% men, 12% women)
-
Partner with a medical condition
that prevents having sex
-
Less physical desire to
have sex (55% of both men and women)
-
Taking medications that
seem to reduce sexual desire (44% men, 16 % women)
Loss of estrogen as a part
of the menopause process is related to many of the age related changes
for women. These symptoms are often reduced by hormone replacement therapy
(HRT) which restores the hormone levels similar to before menopause. It
appears that HRT is a major factor in prevention of osteoporosis, cardiovascular
disease, and maintaining cognitive function. There is evidence that beneficial
effects of estrogen occur even when started after age 60. There is some
evidence that HRT may increase the risk of breast and endometrial cancer
so it is important to know your own risk factors and discuss the choices
with a physician.
Erectile dysfunction (ED)
is a common sexual problem for older men. This may be caused by high blood
pressure, diabetes, heart disease, high cholesterol levels, prostrate surgery,
depression, side effects of medication, smoking, alcohol/drug abuse, and
stress. ED is treatable. Once a physician has determined the cause, proper
treatment can be determined. These treatments include: vacuum devices,
self-injection drugs, surgical implants, intra urethral suppositories,
oral therapy (ex. Viagra), counseling.
Psychosocial
Factors:
-
Sexual activity in middle
age is a strong predictor of sexual activity in old age.
-
Negative attitudes toward
sexual activities other than intercourse such as kissing, masturbation,
interfere with the openness to try new ways of expressing intimacy.
-
Reactions and beliefs about
physiological changes or illness induced changes have negative impact on
function.
-
Reactions to attitudes of
others, society or adult children have powerful impact on self concept.
Living arrangements
that do not allow for privacy, such as long-term care facilities create
a barrier to sexual activity.
Diversity
and sexuality:
Sexual function and dysfunction
have largely been defined from a heterosexual, masculine, and European
American perspective that focuses on intercourse. The research on homosexuality
and bisexuality has ignored older persons so the needs of these individuals
are not clearly identified.
The current cohort of
older adults have not experienced much acceptance of different sexual preferences
and therefore many older gay, lesbian and bisexuals may not be open about
this aspect of their life. There is very little research about the sexuality
of elders from diverse cultures. What cross cultural research there is
has focused on teenagers. Within this literature there is sufficient information
to suggest that there are cultural differences in sexuality; however, since
this is based on a younger population it cannot be inferred that it includes
elders. (ASA's Lesbian and
Gay Aging Issues Network)
Safe
sex is just as important for older adults as it is for the young. Sexually
transmitted diseases do not differentiate based on age. Many older adults
have ignored the warnings related to human immunodeficiency virus (HIV)
which can become acquired immune deficiency syndrome (AIDS). In the late
1980's approximately 10% of persons with AIDS were 50 years of age or older
and these numbers have been increasing. To date, the most distinctive transmission
source among the elderly has been blood transfusions that occurred even
16 to 18 years earlier. Other high risk factors are male-to-male sexual
contact, heterosexual women that have sexual contact with a bisexual male,
or past (or present) intravenous (IV) drug use.

REFERENCES:
Bane, S. (1996). Mental
Health and Aging, Kansas City, MO., University of Missouri-Kansas City.
Genevay, B. (1999). Intimacy
and Older People: Much More than Sex. Dimensions Vol.6, No.3.
McCormick, W., &
Wood, R. (1992). Clinical decisions in the care of elderly persons with
AIDS. Journal of the American Geriatric Society, 40 917-921.
The National council
on the Aging. Healthy Sexuality and Vital Aging. Executive summary.
September 1998; 1,3.
Love and Life A Healthy
Approach to Sex for Older Adults,(1999) National Council on Aging and
Pfizer.
Schmidt, R. (1989). Biomedical
parallels and relationships in research and treatment of HIV and aging-related
diseases. Generations, 13, 6-14.

INTERNET
REFERENCES:
NIA
Age Page: Sexuality in Later Life
Site Administrator:
Lois
Fitzpatrick
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