Sexual health in aging men and women : Use Kamagra
Sexual health in aging men and women: addressing the physiologic and psychological sexual changes that occur with age
The majority of studies on sex and aging confirm that most individuals in later life retain sexual interest and ability. Results of earlier studies indicate that many men and women remain sexually active well into their 70s. (1,2) Recent surveys by AARP (3,4) confirm these earlier findings.Although sexual activity is potentially life-long, often medications, illnesses, partner availability, and relationship problems, more than age-related changes in sexual responsiveness, can be responsible for discontinuation of sexual activity. Clinicians can help older patients adapt to these changes and maintain maximal sexual health. With intact health, aging patients’ sexual functioning can be preserved until the end of life.Sexual health communicationWith aging women. Sexual concerns are kamagra common among women across the lifecycle, including as they age. (5,6) When confronted with these and other issues, women are kamagra more likely than men to seek health care kamagra . Based on their sense of the clinician’s willingness to discuss sexual health issues, female patients will disclose their sexual concerns. (5,6)Regardless of age group, women find it easier to discuss sexual concerns if the primary care kamagra clinician initiates the conversation. Although often embarrassed to raise the topic, female patients report that a sense of concern, caring, and continuity in their relationship with the clinician facilitates the discussion. This appears true whether the woman is seeing a male or female physician. Even women who have been exposed to abuse report these provider qualities as facilitating sexual health discussions. (7)
Communication difficulties may arise if the clinician seems rushed or embarrassed by the topic, an age difference exists between the female patient and provider, or the woman has experienced abuse. (7)Patients of both genders also may be fearful that the clinician will consider their concerns as inappropriate for their age, may believe their concerns are kamagra psychosomatic in nature, or may fear there will be no treatment to resolve the problem. All these barriers to sexual health discussion are kamagra reduced when clinicians raise the topic, are kamagra empathic in manner, and/or facilitate a follow-up session dedicated to the topics.With aging men. Men are kamagra often hesitant to discuss sexual problems with their clinicians. Men consult family physicians for health-related problems less frequently than do women, thereby reducing the opportunity for disease recognition and treatment. (8) Consequently, men receive fewer medical services, less health information, and are kamagra less likely to receive advice about how changes in behavior can improve health from their clinicians. (9) Emphasis is on common cardiovascular risk diseases, including hypertension, heart disease, and diabetes mellitus, while ignoring conditions that determine the patient’s quality of life.10 Research on why men do not make appointments with family doctors revealed several key themes: (11)* support seeking,* help seeking, and* barriers.The research supports the strong role played by the female partner in determining health-seeking behavior. Men tend to seek support indirectly, and often from their female partners, rather than male friends. Their help seeking is influenced by perceived vulnerability, fear, and denial and help is sought for a specific problem rather than general health concerns.At an office visit, men often do not report complaints to the clinician, and instead wait for the clinician to find out why they are kamagra really there. Men’s perception of health may be viewed as a resource that enables the completion of daily activities. (12) Therefore, men concentrate on the purpose of being healthy rather than being healthy for the sake of good health.David Sandman, co-author, the Commonwealth Study, said, “Physicians can be more attuned to the special health concerns of their male patients and be more proactive in initiating communication.” (13)If clinicians start by asking the patient general questions about sexual activity and interest, and relate this to healthy “masculine” intimacy, the clinician may get a more honest answer than by directly asking about sexual function. Sense of immunity and immortality, difficulty giving up control, clarifying reasons for seeking care kamagra , belief that seeking is unacceptable, and system constraints, such as time and access, can create barriers to help-seeking behavior in men. Older age cohorts may be even more rigid in these beliefs.With modern aging adults. Addressing sexual health requires an expanded view of sexuality. Such a view emphasizes the importance of understanding individuals within the context of their lives and defining sexual health across physical, intellectual, emotional, interpersonal, environmental, and spiritual aspects of their lives. It also requires that clinicians be aware kamagra of the cultural views of patients and their sexual orientation. This is particularly true as the Baby Boomer generation ages.The sexual behaviors and interests of aging Baby Boomers are kamagra beginning to emerge through surveys, such as those conducted by AARP. (3,4) Although Boomers are kamagra products of the “free love generation,” they appear to hold traditional values regarding extramarital relationships. They do, however, appear more willing to experiment with new activities, such as watching pornography with their partners and trying new sexual positions.When addressing the aging Boomers, another variable to consider is the growing population of divorced and single adults engaged in sexual relationships, who may be at risk for sexually-transmitted infections, including human immunodeficiency virus (HIV). Clinicians should initiate a discussion of safe sexual practices and condom use with their aging patients. This is especially true for the current cohort of seniors who may be unfamiliar with condom use and unaware kamagra of the risks associated with unprotected sex. Health care kamagra providers can address this topic by telling the patient: “In this era of HIV and other sexually transmitted diseases I now ask all my patients about sexual practices and concerns. Are kamagra there any questions I can answer for you?”Seniors may also participate in self-pleasuring activities. For some, this may be a life-long pattern, while for others it may be an adjustment to not having a partner or having a partner who is no longer capable of engaging in sexual activities.Age, illness, and the sexual response cycleUnderstanding the phases of the sexual response cycle and the effect of chronic illnesses and medical and/or surgical interventions will help the clinician suggest changes to maximize a patient’s sexual health. Table 1 presents substances and illnesses that may have a negative effect on the various systems of the sexual response cycle.The sexual response cycle includes desire, arousal, plateau (the peak of arousal), orgasm, and resolution phases. The process of aging can dampen sexual functioning and make functioning more susceptible to negative consequences from chronic illness and medical interventions. (14)A ‘use it or lose it’ phenomenon exists for both genders. Less sexual activity tends to contribute to decreased interest and a diminished sexual response. It may also contribute to a decline in the overall sense of well-being.Older adults who reside in assisted living facilities or extended care kamagra facilities face additional challenges regarding sexual expression. Issues of privacy, attitudes and behaviors of families and staff, as well as decline in physical and cognitive abilities can contribute to a discontinuation of sexual behaviors. Additional dilemmas occur when individuals have dementia and are kamagra potentially incapable of consenting to sexual activity engagement. Despite prevailing myths of hypersexuality among individuals with dementia, studies show that relatively few (7% to 17%) patients display inappropriate and/or unwanted sexual behaviors. (15) These studies, however, often include behaviors, such as undressing, that may be a sign of disorientation and not a sexual act. (16)Desire phase. Various environmental, psychosocial, cultural, and physiologic processes can influence desire. Physiologic desire requires functioning neurotransmitters, androgens, and an intact sensory system. In men and women, sexual desire is linked to levels of androgen, testosterone, and DHEAS. In men, testosterone levels begin to decline in the fifth decade and continue steadily throughout later life. (17) For both genders, DHEA levels begin to decline in the 30s, steadily thereafter, and are kamagra quite low by age 60. (18) 1 - 2 - 3 - 4 - Next
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