Today’s guest lecturer was a Certified
Sex Therapist. She came to talk about Aging and Sexual Health. There were four topics
she addressed: disprove the myth that older people are asexual, describe the
physical changes and changes in sexual response that happen with age, and other
factors that impact sexuality.
I think the
biggest thing that she wanted us to take away from the lecture was that older
adults remain sexual into their later years, and this has a big impact on an
individual’s quality of life. The majority of older adults said that emotional
well-being and quality of the relationship had more impact on desire compared
to the aging process. It also should be noted that studies have shown that an
orgasm helps to relieve pain, reduce stress, and improve sleep, which are
common problem areas that older adults face. Orgasms also boost the immune
system and increase an individual’s life span which we know to be big desires
of the older population. Overall, any form of sexual activity has a direct
impact on an older adult’s health.
There are
physical changes in both the man’s body and the woman’s as they age. However, these
changes often do not get discussed with older adults, so they don’t know why
these new things are happening to them. It is up to us as health care providers
to not only educate older adults on these changes, but to assure them that it
is fine that they are happening. During menopause, women’s hormone levels are
changing constantly. This can result in a diminished arousal, lubrication, and
sensation. As a man ages, his testosterone declines and blood flow decreases which
can cause a change in erections and ejaculation. These changes might be alarming
to older adults, which is why it is so important for us to understand the
functional and physical implications of aging.
After an
individual has been in a relationship for longer than 2 years, their sexual
response can change. This typically happens in women but is not to say this is
the case for ALL women. In a short-term relationship, the course to an orgasm
usually follows a desire, arousal, and then an orgasm. However, after two
years, this changes to arousal, then desire, and finally an orgasm. This
functionally means that women who are in a long-term relationship need to feel
aroused, and then they have a desire to engage in sexual intercourse. This
process can also be derailed if a woman’s negative feeling or cognitive thought
(for example stress or a negative body image) gets in the way from her ever progressing
from arousal to desire. However, men still follow the first model which means
they’ll have a desire and then the arousal. This can be really hard for a
long-term couple, especially if they are not educated on the changes taking
place. This might lead to the woman’s partner feeling like she was not
attracted to them anymore or the woman feeling like sex was more of a task than
for pleasure.
Some other
factors that affect sexual activity for older adults include how sex was taught
to them growing up in the home. It could have been frowned upon and never talked
about, or really open and well educated on the importance of safe sex. Another factor
can be an individual’s religion and what their religion says about sexual intercourse.
It could be that it is a celebrated act between a husband and a wife, or it
could be a very strict and non-pleasurable act. A third factor is a history of
trauma. If an individual has experienced trauma, she/he may perceive sexual
intercourse as a trigger, and not a leisure pursuit. This may bring on anxiety,
stress, depression, and PTSD. A fourth factor is that several diagnoses can
have impacts on an individual’s sexual response. These diagnoses include atherosclerosis,
diabetes, arthritis, cancer, hypertension, or body habitus. Several types of
medications may also have sexual side effects such as antihistamines, beta blockers,
blood pressure medications, diuretics, antidepressants, psychotropic medications,
chemotherapy, and radiation. Smoking, drinking alcohol, and THC may also impact
an individual’s sexual response. A fifth factor is society’s pressure on both
men and women and their conceived body image. A sixth factor is the quality of
the relationship and the dynamics between the members of the relationship.
Some interventions
that an OT might address when it comes to an individual’s sexuality activity
may be working on positioning with pillows and their partner for someone with a
spinal cord injury. This is a major aspect of their quality of life which is
going to look much different after their injury. A group intervention could be
held at a woman’s health facility in which an OT educates women going through
menopause about the changes happening to their body and the occupational
changes that may take place. We can also educate them on ways to compensate or
modify to increase their satisfaction in their occupational performance.
