Aging and Sexuality- Guest Lecture Reflection

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.