Sexuality in Later Life
What Causes Sexual Problems? continued...
Diabetes. Many men with diabetes do not have sexual
problems, but this is one of the few illnesses that can cause impotence. In
most cases medical treatment can help.
Heart disease. Narrowing and hardening of the arteries
known as atherosclerosis can change blood vessels so that blood does not flow
freely. This can lead to trouble with erections in men, as can high blood
pressure (hypertension). Some people who have had a heart attack are afraid
that having sex will cause another attack. The chance of this is very low. Most
people can start having sex again 3 to 6 weeks after their condition becomes
stable following an attack, if their doctor agrees. Always follow your doctor's
Incontinence. Loss of bladder control or leaking of urine
is more common as we grow older, especially in women. Stress incontinence
happens during exercise, coughing, sneezing, or lifting, for example. Because
of the extra pressure on your abdomen during sex, incontinence might cause some
people to avoid sex. The good news is that this can usually be treated.
Stroke. The ability to have sex is rarely damaged by a
stroke, but problems with erections are possible. It is unlikely that having
sex will cause another stroke. Someone with weakness or paralysis caused by a
stroke might try using different positions or medical devices to help them
continue having sex.
What About Surgery and Drugs?
Surgery. Many of us worry about having any kind of
surgery-it is especially troubling when the genital area is involved. Happily,
most people do return to the kind of sex life they enjoyed before having
Hysterectomy is surgery to remove the uterus. It does not interfere
with sexual functioning. If a hysterectomy seems to take away from a woman's
ability to enjoy sex, a counselor may be helpful. Men who feel their partners
are "less feminine" after a hysterectomy may also be helped by
Mastectomy is surgery to remove all or part of a woman's
breast. Your body is as capable of sexual response as ever, but you may lose
your sexual desire or sense of being desired. Sometimes it is useful to talk
with other women who have had this surgery. Programs like the American Cancer
Society's (ACS) "Reach to Recovery" can be helpful for both women and
men. Rebuilding of the breast (reconstruction) is also a possibility to discuss
with your surgeon.
About 1500 American men develop breast cancer each year. In them the disease
can make their bodies make extra "female" hormones. These can greatly
lower their sex drive.
Prostatectomy is surgery that removes all or part of a man's
prostate. Sometimes this procedure is done because of an enlarged prostate. It
may cause urinary incontinence or impotence. If removal of the prostate gland
(radical prostatectomy) is needed, doctors can often save the nerves going to
the penis. An erection may still be possible. Talk to your doctor before
surgery to make sure you will be able to lead a fully satisfying sex life.
Medications. Some drugs can cause sexual problems. These
include some blood pressure medicines, antihistamines, antidepressants,
tranquilizers, appetite suppressants, diabetes drugs, and some ulcer drugs like
ranitidine. Some can lead to impotence or make it hard for men to ejaculate.
Some drugs can reduce a woman's sexual desire. Check with your doctor. She or
he can often prescribe a different drug without this side effect.
Alcohol. Too much alcohol can cause erection problems in
men and delay orgasm in women.