En español | Maybe you're no longer as healthy and fit as you once were — or as you'd like to be. Perhaps you have a chronic condition — arthritis, diabetes, heart disease — or maybe your body isn't as nimble as it used to be. But when it comes to making love, where there's a will, there's always a way.
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The sex you have now may not involve the same activities that it once did. You may not be able to have vaginal intercourse as readily as you could in the past. That's disconcerting, but it's okay. Even among older adults who are vibrantly healthy, intercourse often drops out of the erotic picture because of iffy erections and vaginal dryness and soreness. But intercourse is just one dish at the erotic banquet. There are plenty of other tasty treats — if you can make the transition from sex based on intercourse to lovemaking based on whole-body sensual touching and massage.
Of course there will be times when you just don't feel well enough to make love. If you have a cold or the flu, or a herpes outbreak, you probably won't feel very sexual, and if you do, you should abstain until you're well. You don't want to transmit anything to your honey.
If you're in pain — a sprain, a bad back, or a bum knee or hip — you may also not feel particularly erotic. But if you're among the one-third of older Americans who suffer the nation's most prevalent pain condition, osteoarthritis, sex is actually helpful. It gently moves the major joints through full range of motion, which is exactly what rheumatologists recommend to minimize osteoarthritis pain. Sex is good for chronic pain for another reason. It releases endorphins, the body's own pain-relieving, mood-elevating compounds.
Even people with a potentially serious medical condition can usually enjoy a rich sex life, but just in case, consult your doctor. After most heart attacks, physicians generally recommend abstaining for a few months. But sex is no more strenuous than walking up a couple flights of stairs. If you can do that without developing chest pain or feeling exhausted, you can probably make love enjoyably and safely.
Certain prescription drugs can get in the way of a healthy sex life. If you suspect your medications are hampering your sex life, talk to your doctor or pharmacist to see if there are any alternatives you can try. The SSRI antidepressants, such as Prozac, Paxil and Zoloft, are notorious for causing sexual side effects. But an equally effective antidepressant, Wellbutrin, is much less likely to limit erotic fun.
While most doctors are reasonably well informed about drugs' sexual effects, your doctor may be unfamiliar with all the sexual adjustments your particular situation requires. Fortunately, the organizations focused on the major chronic conditions, such as the American Heart Association, the American Lung Association, the American Diabetes Association, etc., can be great sources of information. They can connect you with experts knowledgeable with the sexual implications of your condition. You might also join a support group. The members know exactly what you face sexually, and can probably offer good suggestions.
Sex toys can be a great boon to lovers with erotic limitations. You might browse a sex toy catalogue online. Vibrators, in particular, can be the older couples' friend.
Finally, if you want individual coaching, the nation's sexuality organizations can refer you to sex therapists who specialize in sex and chronic conditions and disabilities. Visit the American Association of Sex Educators, Counselors, and Therapists, the Society for Sex Therapy and Research, or the American Board of Sexology. Sex therapists practice in every major metropolitan area. Most couples see sex therapists weekly for a few months.
Michael Castleman publishes GreatSexAfter40.com.
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