RELATIONAL ADJUSTMENTS
These physical symptoms of aging may diminish sexual enthusiasm and comfort in lovemaking. Couples will need to creatively address these issues for intercourse to be possible, let alone enjoyable. Because arousal and lubrication will often take longer, it is important for the couple to use the extra time to create an atmosphere that facilitates love play on this more relaxed journey into intimacy. Intercourse may need to be gentler at first and care taken on entry. Artificial lubrication ceases to be optional, as more liberal and frequent applications are necessary to counteract some of these physical changes. The husband may need to be more charming and alert to what pleasures his wife, so she feels cared for and open to his sexual advances.
It may take longer to reach orgasm, and its intensity and duration can diminish. However, even if the orgasm is less intense and takes more time to occur, a woman's ability to have multiple orgasms remains the same with age and, unlike in men, her refractory period does not extend.6 With aging, he will need more time also, so this becomes a great time for the couple to relax and explore each other's bodies and begin to discover what each enjoys.
A difficult paradox exists with regard to female sexual changes and intercourse. On the one hand, regular sexual activity can contribute to a delay or reduction in the physical effects that begin at midlife. Sex enhances virginal lubrication, reduces vaginal thinning, maintains the muscle tone of the vagina, and increases the blood supply to the vagina, helping to prevent atrophy. Women who have sexual intercourse once or twice a week before, during, and after menopause also tend to have fewer sexual dysfunctions.7 The paradox is that it is often difficult "to use it or lose it" if one is experiencing
painful intercourse, infections, vaginal dryness, low energy, sleep disturbances, depression, concern about attractiveness due to a change in body image, and overall lowered sexual desire.
To resolve this paradox will require regular and clear communication with patience and understanding between partners. The majority of complaints concerning sexuality in aging adults are produced by a lack of knowledge of the normal physiological changes linked with age and an inability to communicate needs and preferences. Women, in particular, have difficulty identifying and expressing their sexual needs.8
When it comes to sexual response, perhaps even more significant than the physical and hormonal changes a woman experiences with aging is what occurs in her thoughts, feelings, and relationships. The combination of menopause, the changing roles of an empty nest, and an inability to have an orgasm can cause some wives to come to the erroneous conclusion that they are "too tired" or "too old" for sex. Many times this is because sex is perceived by the woman as another instance where someone is taking from her and she is not receiving a tangible benefit. Everyone tires of constantly giving when there is little received in return. This mind-set will pollute her perspective on sex, and her spouse will need to be very involved in restoring her joy.
Many women may struggle with long-standing sexual inhibitions, have experienced sexual abuse or victimization, have fears about losing their attractiveness, or be in an unsatisfactory relationship. Perhaps after many years of marriage, predictability has replaced spontaneity, and sex has become routine and mechanical. Sex therapy or counseling may be helpful in these situations.
So much of sex is in the head. This can be a rich time for you sexually; you have lost some of your earlier inhibitions and know more about what arouses you. Pregnancy is no longer a fear. You may have to engage in some self-talk about your attractiveness as your body loses its firmness and skin tone decreases. Again, maturity can be associated with greater skills and more comfortable attitudes. Older women make great lovers, but they may need their partners to help convince them of this fact.
Remember how we began this discussion: "I am woman, hear me roar." As you work to accept the many physical changes in your life, what kind of roar will be heard from you?
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