281022 What causes sexual problems?
The following comes from https://www.nia.nih.gov/health/sexuality-and-intimacy-older-adults
Sexuality is the way we experience and express ourselves sexually. It involves feelings, desires, actions, and identity, and can include many different types of physical touch or stimulation. Intimacy is a feeling of closeness and connectedness in a relationship that can occur with or without a physical component.
Some illnesses, disabilities, medicines, and surgeries can affect your ability to have and enjoy sex.
Alcohol. Too much alcohol can cause erection problems in men and delay orgasm in women.
Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Exercise, drugs, and possibly joint replacement surgery may help relieve this pain. Rest, warm baths, and changing the position or timing of sexual activity can be helpful.
Chronic pain. Pain can interfere with intimacy. It can also cause tiredness and exhaustion, leaving little energy or interest in sex. Chronic pain does not have to be part of growing older and can often be treated. But, some pain medicines have effects on sexual function. Always talk with your health care provider if you have side effects from any medication.
Dementia. People with some forms of dementia may show an increased interest in sex and physical closeness, but they may not be able to judge what is appropriate sexual behavior. People with severe dementia may not recognize their spouse or partner but may still desire sexual contact. They may sometimes even seek this with someone else. It can be confusing and difficult to know how to handle this situation. Talking with a doctor, nurse, or social worker with training in dementia care may be helpful.
Depression. Lack of interest in activities you used to enjoy, such as intimacy and sexual activity, can be a symptom of depression. If you think you’re depressed, talk with your health care provider about possible treatments that will not further interfere with desire.
Diabetes. This is one of the illnesses that can cause ED. In most cases, medical treatment can help. When not well controlled, diabetes can lead to yeast infections, which can cause itching and irritation and make sex uncomfortable or undesirable.
Heart disease. Narrowing and hardening of the arteries can change blood vessels so that blood does not flow freely. For some, it may take longer to become aroused, and it may be difficult to have or maintain an erection. As a result, this can make it difficult to achieve an orgasm. People who have had a heart attack, or their partners, may be afraid that having sex will cause another cardiovascular incident. Even though sexual activity is generally safe, always follow your doctor’s advice.
Incontinence. Loss of bladder control or leaking of urine is more common as people grow older. Extra pressure on the belly during sex can cause urine to leak. This can be helped by changing positions or by emptying the bladder before and after sex. The good news is that incontinence may be treated with medical treatments, bladder control training, and behavioral and lifestyle changes.
Medications. Some drugs can cause side effects that interfere with sex, such as ED, difficulty ejaculating, difficulty with arousal and orgasm, reduced sexual desire, and vaginal dryness. Drugs that can cause these problems include some blood pressure medicines, antihistamines, antidepressants and drugs for other mental health conditions, sedatives, medications for Parkinson’s disease or cancer, appetite suppressants, and anti-ulcer drugs. If you experience any of these side effects, check with your health care provider to see if there is a different drug you could take.
Obesity. Adults with overweight or obesity have an increased risk of erection problems.
Peyronie’s disease. This is a disorder in which scar tissue forms under the skin of the penis and pulls on the surrounding tissues, causing the penis to curve or bend, usually during an erection. Curves in the penis can make erections painful and may make sexual intercourse painful, difficult, or impossible. If you are affected by Peyronie’s disease, discuss treatment options with a doctor.
Stroke. The ability to have sex is sometimes affected by a stroke. A change in positions or medical devices may help people with ongoing weakness or paralysis to have sex. Some people with paralysis from the waist down are still able to experience orgasm and pleasure.
Surgery. Any kind of surgery can cause worry, and this can be even more troubling when the breasts or genital areas are involved, such as with the surgeries listed below. Most people are able to return to the kind of sex life they enjoyed before surgery. For some, these types of surgeries may even help them to increase their sex life options.
- Hysterectomy is a surgery performed to remove the uterus because of pain, bleeding, fibroids, or other reasons. Often, when the person is older, the ovaries are also removed during this procedure. Deciding whether to have this surgery can leave both women and their partners worried about their future sex life. If you’re concerned about any changes you might experience with hysterectomy, talk with your gynecologist or surgeon. You may also wish to talk with other people who have had this procedure.
- Mastectomy is the removal of all or part of a breast, often because of breast cancer or cancer prevention. This surgery may cause some people to lose their sexual interest, or it may leave them feeling less desirable or attractive. If you are considering breast reconstruction, you can discuss this with your cancer health care provider or surgeon. In addition to talking with your doctor, sometimes it is useful to talk with other people who have had this surgery.
- Prostatectomy is surgery that removes all or part of the prostate, commonly because of cancer or an enlarged prostate. It may cause urinary incontinence or ED. If you need this operation, talk with your health care provider before surgery about your concerns.
For some people, talking with their health care provider about sexual problems may feel uncomfortable. It’s important to remember that these are topics your doctor needs to hear about to treat you most effectively. You may also consider speaking with other physical and mental health professionals, such as a nurse or therapist. Many health care providers now use online patient portals through which people may feel more comfortable opening a discussion with their health care team.
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