7 Embarrassing Questions About Older People And Sex, Answered

Our expert, Dr. Donnica Moore, answers the sex questions you were afraid to ask, from leakage to penis sensitivity to the easiest positions on your joints.
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Q: I have occasional leakage during sex. What can I do?

Dr. Donnica: [Whether you’re male or female,] my answer is the same: Make an appointment to see your doctor and get evaluated. The most likely causes will differ based on your gender, but the incidence increases in men and women as we age. Many causes of incontinence are medically treatable and as with most medical conditions, the sooner the better.
Until your doctor’s appointment, you can also make sure to void immediately before sex, decrease or eliminate caffeine intake, and limit intake of all beverages three hours before bedtime.

Q: My husband’s penis is becoming less sensitive as we age. Can we do something?

Dr. Donnica: Many men may be surprised to know that penile sensitivity decreases with aging starting at 25, but the most rapid decline occurs between 65 and 75. There are many factors which contribute to this including obesity, cardiovascular disease, diabetes, prolonged sitting or biking, penile damage from trauma or circumcision, prostate surgery, or spinal injuries. The best ways to improve the situation are to optimize his health: Address all medical issues, stop smoking, decrease alcohol intake, and maintain a healthy weight.
There is also a condition called RPS, or Reduced Penis Sensation, which is diagnosed when a man has normal erectile function and sex drive, but difficulty becoming sufficiently aroused to reach orgasm. For men with RPS, visual imagery or sex therapy may be helpful. And some men swear by Man 1 Man Oil, a topical moisturizer and penile vitamin formula, but conclusive medical studies are lacking.

Q: Is anal sex more dangerous for older people?

Dr. Donnica: Anal sex carries health risks for people of all ages, but yes, it becomes increasingly risky as we age because of thinning of the tissue inside the anus. This makes it more vulnerable to tearing, which allows bacteria and viruses to enter the bloodstream, thus spreading infection. As we age, we are also more likely to have hemorrhoids, which may bleed during anal intercourse.

Q: Sex takes a long time lately, and it gets painful. How can I ease the pain on my joints and, frankly, my vagina?

Dr. Donnica: There are many reasons that sex may be painful for your vagina, but within reason, duration shouldn’t be one of them. The most common reason for postmenopausal women is vaginal atrophy, or thinning of the vaginal tissues associated with decreased vaginal lubrication. While over-the-counter lubricants may help, you should also discuss this with your gynecologist, as there are several prescription medicines which may help as well.
As for your joints, experiment withdifferent positions and the use of pillows for support or cushioning. Finally, if your partner is using medication for erectile dysfunction, this may be a factor.

Q: Am I crazy, or does my partner taste different as we age?

Dr. Donnica: Young adults have about 9,000 taste buds, but the number decreases with aging. In addition, the size of each remaining taste bud shrinks. After age 60, sensitivity to the five tastes (sweet, sour, salty, bitter & umami) declines. In addition, your mouth produces less saliva, causing dry mouth, which can also alter tastes. Your sense of smell diminishes with aging as well, but particularly after age 70. This is attributed to lost nerve endings and less mucus production in the nose. Other factors that can alter tastes and smells as we age include diseases, smoking, medications, and environmental exposures.

Q: Should we avoid certain positions or kinds of sex because of heart problems?

Dr. Donnica: This depends upon what kind of heart problem you have had and what your doctor has advised you. Many doctors forget to offer this advice, so don’t be shy about asking! In general, you should avoid sex:
  • within three hours of a heavy meal
  • if you’ve been drinking heavily
  • if you get short of breath walking up one flight of stairs
Sexual positions that require less exertion (and may therefore be more comfortable) include lying side to side or with the heart patient on the bottom. If you have more than usual shortness of breath, an irregular heart beat or any chest pain while having sex, stop and call 911 if it doesn’t resolve after rest.

Q: Do I need to worry about birth control in my late 40s and early 50s, immediately before and after menopause?

Dr. Donnica: You don’t need to ‘worry’ about it, but you do need to use it until you are officially in menopause. This means that you have not had a menstrual period for 12 months (and aren’t pregnant or breast-feeding). While it is very unusual for women in their 50s to conceive naturally, it can happen.
Dr. Donnica Moore is highly regarded as a women’s health expert and advocate, as a physician educator, and as a media commentator. She is the Founder and President ofDrDonnica.com, a popular women’s health website, and Founder and President of Sapphire Women’s Health Group LLC, a multimedia women’s health education and communications firm. She is also a founding co-chair of the annual national Congress on Women’s Health. Dr. Donnica has been interviewed more than 375 times on programs like The Oprah Winfrey Show, The View, and Good Morning America.
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