Concerns about declining in sexual performance

January 05, 2016

Dear Readers,

Trevor A., 62, writes from St Ann. He is concerned about a decline in his sexual performance over the past two years. He used to smoke and has diabetes, which is well controlled by medications that he takes. He has a new partner and is not performing as well as he used to. He asks Check Up if he can take Viagra.

Men's sexual peak usually occurs at about age 18 (believe it or not). It's usually slowly downhill after that. Some men will experience significant changes in their sexual performance from even in their late 20s. Symptoms that usually occur at this time are:

• Taking a longer time to achieve full erection

• A less firm erection

• Lower sex drive

• Less stamina

• Unsatisfactory ejaculation.

As men age, the production of sex hormones declines. The estimate is that for every year over age 40, men's testosterone declines by one per cent on average, so by age 60, there is a significant reduction in the male hormone, which will result in adverse performance issues.

Normal ageing brings significant changes in both men and women that can affect the enjoyment of sex. A woman may enjoy sex better once the threat of pregnancy has been removed after menopause. On the other hand, once female hormone levels fall, the vagina can become narrow, short, and dry. This is not conducive to comfortable sex, and natural vaginal moisture may need to be augmented with lubricants or by longer sexual foreplay. A lengthened sexual foreplay will also allow the male partner time for his erection to become firm enough to allow sexual enjoyment.

By age 65, 15-20 per cent of men experience an erection problem one in four times that they have sex.

Other health issues may complicate sexual performance:

• Arthritis: Pain and joint stiffness can hinder movement and decrease stamina during sexual intercourse.

• Diabetes and hypertension can diminish the necessary blood supply to the penis and hinder full erection and even sensation (especially diabetes). Diabetes can cause permanent impotence if not controlled properly before serious complications develop.

• Heart disease compromises blood flow to the male organ and is linked with stamina issues. Men with heart disease who use nitrates as part of their treatment cannot use drugs like Viagra or Cialis to assist their sexual function.

• Cigarette smoking

diminishes blood support for good erections, and cigarette smoking is a major cause of impotence.

• Alcohol consumption is linked with poor erectile outcomes.

• Loss of bladder tone causing stress incontinence, seen more commonly in older people, can cause people to avoid sex to prevent embarrassment.

• Strokes rarely inhibit the ability to have sex, although different positions may need to be used for sex because of muscle weakness.

• A mastectomy causes some women to lose interest in sex as their self-esteem may be diminished. Breast reconstruction might help this problem.

• A prostatectomy (surgery to remove an enlarged or cancerous prostate gland) can sometimes impair the nerves associated with an erection, and augmentation with Viagra or Cialis may be needed for proper sexual functioning.

• Some drugs used in the treatment of major health diseases can affect libido as well as erection and orgasmic ability. Some blood pressure medications, anti-histamines, anti-depressants, and tranquillisers may be culpable.

Sexuality is often a balance between physical and emotional issues. How a person sees himself often has a lot to do with influencing sexual health. A focus on youthful, physical beauty may hinder satisfactory sexual relations in older men and women.

Older couples not only face the stress of poor economic times, but they have less ability to compensate for it. Many persons in their mid-60s have retired and are on a pension or are only working part time. In addition to this are the illnesses associated with ageing. Stress can be a significant hindrance to

satisfying sex.

Older men and women should aim for a healthy, stress-free environment. Exercise, eat healthily, reduce alcoholic intake, eliminate cigarette smoking, get enough sleep at night, and obtain adequate management for any medical conditions. Drink plenty fluids and keep a positive outlook on life.

With these daily practices and augmentation with drugs like Viagra or Cialis, sexual health can be maintained and sex enjoyed for most of a person's lifetime.

Write to:

Check UP

PO Box 1731




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