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Fifty Shades of Great

Sorting out sexual issues in senior señoritas

Senior couple with heartAs Singapore enters its 50th birthday, mid-life women have a lot to celebrate. Singaporean women have amongst the longest life expectancies, and Singapore is one of the happiest places in the world to live. Health plays a big part in both… but what about sexual health?

“Gentle ladies don’t speak about such things!” you might say, but the physical, emotional and social aspects of sexual health are key components of health and happiness. Each year, many Singaporean women have an annual check-up. Weight, blood pressure, mammogram, cholesterol, Pap smear, fasting glucose and other tests are diligently performed. If you underwent a sexual health check-up, what would it reveal?

Intimacy sets marriage and long-term partnerships apart from other relationships. How is the intimacy between you and your partner? Mid-life issues can cause the candle to either burn brightly or fizzle out. Here are some matters you need to be aware of.

Pay Attention to Attraction

No one likes the changes that come with ageing. Wrinkles and pigmentation, grey hair and hair loss and the dreaded weight gain make many women (and men) feel less attractive and desirable. Women may be juggling the needs of husbands, children, home life, work, elderly parents and other commitments. It’s exhausting just reading that list, and easy to see how the desire to be intimate can retreat.Embracing seniors

What is normal? Research has found that it is quite common for intimacy to extend into one’s 80’s if that is what both partners wish. What if intimacy derails? While it is not an issue for some couples, others are affected. Like my patient commented last week, “Not only have I lost the physical side of our relationship, but the emotional bond is slipping away.”

Don’t settle for a loss of intimacy because you are “too old”. Many couples find that their sex lives peak in mid-life through years of practice perfecting techniques, time to enjoy each other’s company and bolstered by a deep love brought on by shared experiences and mutual respect.

Manage the Menopause

Along with ageing, women experience the menopause, usually around the age of 50 years. The accompanying hormonal fluctuations and eventual fall in hormones give rise to hot flushes, night sweats, sleep disturbance, fatigue, joint and muscle pains, breast shrinkage, vaginal dryness and sexual discomfort, to name just a few symptoms. These don’t exactly promote confidence or encourage a rip-roaring sex life!

If you are adversely affected, seek help. There are many things that can help vaginal dryness. Water-based lubricants are widely available from pharmacies and supermarkets, while silicone-based preparations are available online or from sex shops. Vaginal oestrogen is even better, but is available only on prescription. Research has shown that hormone replacement therapy (HRT) can potentially have wide-ranging health benefits when taken early in the menopause. Speak to your family doctor or gynaecologist for advice.

Mediating Medical Conditions

Medical conditions become more common over 40 years of age. Issues such as incontinence, prolapse, thyroid and heart problems, diabetes, arthritis and depression can affect intimacy. Your condition may affect your ability to “get in the mood” or to “perform”. Sex, however, isn’t just about penetration or orgasms. Even those with physical disabilities can enjoy emotional closeness and intimacy. Take time, increase both emotional and physical stimulation and find new ways to enjoy closeness.

Similarly, medications commonly used to treat high blood pressure, depression, high cholesterol, stomach problems and many others can affect sex drive, erections and the ability to orgasm. Speak to your doctor to see if a drug you or your partner is taking could be contributing to the problem. Often, an alternative can be used.

Untitled-1Surprise! It’s the Stork

Most likely your family is complete, or you have decided against having children. How would you feel about an unplanned pregnancy? Many women in their 40’s erroneously believe that pregnancy is impossible. While it is true that women have a lower fertility from their mid-30’s, those with normal fertility can still get pregnant in their 40’s.

Long-acting reversible contraception in the form of injections, implants, intra-uterine devices (“the coil”) and intra-uterine system all work as well or better than female sterilization, and often have gynaecological benefits. There is also emergency contraception (the “morning after” pill) which can be used up to five days after an episode of unprotected sex. Keep contraception going until the menopause has been confirmed or age 54, when most women are menopausal.

Relationships and Risks

You may be contemplating a new partner after divorce or the death of a partner. Intimacy with a new partner is both exciting and scary.  Even in the throes of passion, remember to protect yourself. Sexually transmitted infections are potential risks but shouldn’t put you off seeking a new relationship.

Use condoms to prevent sexually transmitted diseases like chlamydia, gonorrhoea, syphilis and HIV. Insist on their use until you have both been tested.

In a Sex Slump?

Finally, what if you want to keep the intimacy going but feel that you are “in a rut”? Now is the time to put that creativity that you harness for work, hobbies and managing your home, into your sex life. Book an “appointment” with your partner and explore new ways to connect intimately. Quality is more important than quantity, and penetration does not always have to occur.

My biggest tip for a healthy sex life is communication. Unfortunately, many adults still think that talking about sex is off limits.  The more you talk, the easier it gets, and open discussions can bring you closer. If there are still issues despite talking openly, or if that is just too difficult, please seek professional help.

You are never too old to keep your sexual health in shape and enjoy the health benefits of improved relaxation, the release of natural painkillers, increased blood flow and circulation and improved self-esteem, confidence and well-being. Now, that’s something to celebrate!

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Dr Susan Logan is a Consultant in the Department of Obstetrics and Gynaecology, National University Hospital, Singapore. She sub-specialises in sexual and reproductive care and has a special interest in menopause and sexual problems.
Posted by ezyhealth on Feb 3 2015. Filed under Regulars. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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