EFFECTS OF AGEING ON

SEXUAL FUNCTION IN MEN

TREATMENT


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Treatement :

  1. Psychosocial Interventions:
    1. Prevention: by adequate information about expected physiological changes as part of general health care, so that people understand that sexual activity can con­tinue albeit with some changes – which may be minimal in some instances, and more obvious in others.
    2. Improve body image and self esteem: diet, exercise, hairstyle, clothes, personal hygiene, explore hobbies that you and your partner can enjoy together.
    3. Social support: should be given for single individuals and privacy to establish intimate relationships. Fa­milies may need counselling concerning the sexuality of their ageing parents or grandpa­rents. A new relationship or remarriage may be threatening to adult offspring and draw protests often due to fear of inheritance redistribution. New relationships should be encouraged among older people, as loneliness can lead to despair. In institutions, ar­rangements should be made to allow privacy to enable elderly people to develop close relationships and enjoy physical intimacy if they wish.
    4. Couples in new relationships should adopt safer sex practices.
    5. Relationship therapy: should help to deal with anger, rejection, perform­ance anxiety and fear of causing pain; communication skills and re-establish intimacy, and encourage leisure time spent in mutually enjoyable activities.

  1. Medical treatments:
    1. History and examination: will be taken to determine, exclude or initiate treatment for physical or psychological causes of sexual dysfunc­tion.
    2. Medications for ED: Cialis, Levitra and Viagra have made an enormous contribution to the ability of couples to continue satisfying sexual activity into old age. These treatments are safe, effective and well tolerated. Injections into the penis and vacuum pumps are also effective treatments for ED [See ED].
    3. Testosterone supplementation: is indicated for men who have low testosterone levels and symptoms of ‘andropause’, and also for those who have low T and do not respond to the medications for ED. If you are given this treatment, your prostate gland must be checked before treatment starts with T and annually.
    4. Drug treatments: to control hypertension, high cholesterol, and pain may all impair sexual function, but as treatment for these conditions is essential it should not be discontinued. Adjusting the timing of taking the drug, or dose, or to a different type of anti-hypertensive drug may reduce the effect on sexual function, and varies for different patients. Discuss these issues with your doctor. Anti-depressants: improve low libido once mood is elevated, but some [SSRI’s] may delay or inhibit orgasm.
      Don’t stop taking your medication but check with your treating doctor if this effect can be reduced by changing the type of anti-depressant.

 

  1. Specific sexual techniques:
    1. Counselling should be sensible and sensitive and consider the spe­cial needs of elderly  people so that they can achieve their optimal sexual enjoyment even though their patterns of response may have altered.
      Counselling involves: giving permission to enjoy sexual activity and be spontaneous and adventurous, to try new positions, oral sex, a vibrator, or masturba­tion especially if the partner is not well or unable or have intercourse, to guide one another so that stimulation ensures the maximum potential arousal for each partner. VENIS [very erotic non-insertive sex] is especially helpful for elderly couples with physical disabilities [5].
    2. Sensual assignments: see Sensate Focus and Genital Stimulation exercises. These are helpful in restoring or maintaining intimacy and sensual and sexual arousal. Intercourse should always be preceded by caressing and direct genital stimula­tion. Oral and manual stimulation as part of foreplay may make the difference between partial and full erections, and may be accept­able alternatives for both partners if intercourse is not possible.
    3. Positions: the side by side position is comfortable and reduces effort for older people with infir­mities. The weight is on the bed, hands are free for caressing, and both can thrust as de­sired. Pillows can be used for support if ne­cessary. 

Avoid making love when fatigued, after excess alcohol [the usual "nightcap" may be "excess" at this age], or after a heavy meal, or when under stress or in pain.

As you grow older if you encounter any of the problems mentioned above, you should consult your doctor to determine if your state of health or medical condition or medication needs attention or adjusting. A sex therapist or psychologist should enable you and your partner to continue to enjoy love-making, even if there are some changes in response, and sexual intercourse is limited by infirmity or ill health, and to maintain sensuous pleasure and intimacy throughout your lives.

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