Sexuality in Older Women and Their Partners
The Healthcare Providers Role in Maintaining Sexual Health
Although aging may contribute to changes in the sexual dynamics of a relationship, a number of treatment modalities are available, both psychological and medical. Physicians and other healthcare providers are expected to be able to manage the sexual health issues of their patients. Even those who are not trained experts in sexual health can provide help simply by minimally expanding what they are already trained to do: First, assess and evaluate. Second, treat and/or refer. Simply initiating a discussion of sexual concerns is often the most valuable component to treatment for women and their partners. By asking about sexuality the healthcare provider informs the patient that it is appropriate to discuss sexual problems in that setting and validates an older woman's self-perception as a sexual being. It is hard to provide an effective intervention, regardless of the type of treatment, if there is no mention of a problem.
Healthcare providers can be extremely helpful in giving permission to women to expand or change their sexual repertoire or by providing basic sex education. For example, many couples are ignorant of the fact that despite erectile dysfunction, men are still able to experience desire, arousal and orgasm. Despite our sexually enlightened culture, many older couples still hold onto fairly restrictive and conservative views of what is "appropriate" and "normal." Therefore, treatment would be defined as helping older women and couples to redefine what "normal" sexual activity entails. For example, the suggestion that some heterosexual couples may no longer want to rely on intercourse as their main sexual event can provide an optimistic perspective for couples having difficulty due to genital atrophy or erectile dysfunction. It may be difficult, though very satisfying, for older couples to move away from the standard missionary position and intercourse and towards different positions and ways of stimulation (e.g., increased use of oral sex, manual stimulation, sexual aids, and sensual non-genital activities like bathing together, massage or erotic movies/literature) (Leiblum, 1991). Change does not have to be extreme for couples to notice significant improvement in sexual fulfillment. It may imply something as simple (but often not considered) as suggesting that couples make love in the morning when older people have more energy rather than late in the evening when there is a greater likelihood of fatigue. Furthermore, it is important to remind older couples to learn to communicate better both in and out of the bedroom. As their sexual repertoire requires some adjustment or change, a couple needs to effectively communicate in order to smoothly accomplish this. In addition, communication itself can be seductive, enticing and sexual. Effective communication in every day life is also important for the quality of the overall relationship, which is also critical to couples' sexual lives.
Last Modified: September 5, 2006
