Birds Do It; Bees Do It; and so Do Senior Citizens

With aging of the baby boomers, with their focus on health and wellness, and with increasing life expectancy for both men and women, it is natural and normal for our seniors to be sexually active. Many people want and need to be close to others as they grow older. This includes the desire to continue an active, satisfying sex life. But, with aging, there may be changes that can cause problems. This blog will discuss the normal changes that occur with aging and what can be done to add intimacy for both men and women.
Normal Changes With Aging
Normal aging brings physical changes in both men and women. These changes sometimes affect the ability to have and enjoy sex. A woman may notice changes in her vagina. As a woman ages, her vagina can shorten and narrow. Her vaginal walls can become thinner and also a little stiffer. Most women will have less vaginal lubrication. These changes could affect sexual function and/or pleasure. The solution to the vaginal dryness is easily resolved with the use of water soluble lubricant such as KY Jelly.
As men get older, impotence (also called erectile dysfunction–ED) becomes more common. ED is the loss of ability to have and keep an erection for sexual intercourse. ED may cause a man to take longer to have an erection. His erection may not be as firm or as large as it used to be. The loss of erection after orgasm may happen more quickly, or it may take longer before another erection is possible. ED is not a problem if it happens every now and then, but if it occurs often, a doctor can usually provide an effective solution.
What Causes Sexual Problems?
Some illnesses, disabilities, medi­cines, and surgeries can affect your ability to have and enjoy sex. Problems in your relationship can also affect your ability to enjoy sex.
Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Exercise, drugs, and possibly joint replacement surgery may relieve this pain. Rest, warm baths, and changing the position or timing of sexual activity can be helpful.
Chronic pain. Any constant pain can interfere with intimacy between older people. Chronic pain does not have to be part of growing older and can often be treated. But, some pain medicines can interfere with sexual function. You should always talk with your doctor if you have unwanted side effects from any medication.
Dementia. Some people with dementia show increased interest in sex and physical closeness, but they may not be able to judge what is appropriate sexual behavior. Those with severe dementia may not recognize their spouse but still seek sexual contact. This can be a confusing problem for the spouse. A doctor, nurse, or social worker with training in dementia care may be helpful.
Diabetes. This is one of the illnesses that can cause ED in some men. In most cases, medical treatment can help. Less is known about how diabetes affects sexuality in older women. Women with diabetes are more likely to have vaginal yeast infections, which can cause itching and irritation and make sex uncomfort­able or undesirable. Yeast infections can be treated.
Heart disease. Narrowing and hardening of the arteries can change blood vessels so that blood does not flow freely. As a result, men and women may have problems with orgasms, and men may have trouble with erections. People who have had a heart attack, or their partners, may be afraid that having sex will cause another attack. Even though sexual activity is generally safe, always follow your doctor’s advice. If your heart problems get worse and you have chest pain or shortness of breath even while resting, talk to your doctor. He or she may want to change your treatment plan.
Incontinence. Loss of bladder control or leaking of urine is more common as we grow older, especially in women. Extra pressure on the belly during sex can cause loss of urine, which may result in some people avoiding sex. This can be helped by a change in positions. The good news is that incontinence can usually be treated.
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.
Depression. Lack of interest in activities you used to enjoy, such as intimacy and sexual activity, can be a symptom of depression. It’s sometimes hard to know if you’re depressed. Talk with your doctor. Depression can be treated.
Surgery. Many of us worry about having any kind of surgery—it may be even more troubling when the breasts or genital area are involved. Most people do return to the kind of sex life they enjoyed before surgery.
Hysterectomy is surgery to remove a woman’s uterus. Often, when an older woman has a hysterectomy, the ovaries are also removed. The surgery can leave both women and men worried about their sex lives. If you’re afraid that a hysterectomy will change your sex life, talk with your gynecologist or surgeon.
Mastectomy is surgery to remove all or part of a woman’s breast. This surgery may cause some women to lose their sexual interest or their sense of being desired or feeling feminine. In addition to talking with your doctor, sometimes it is useful to talk with other women who have had this surgery. Programs like the American Cancer Society’s (ACS) “Reach to Recovery” can be helpful for both women and men. If you want your breast rebuilt (reconstruction), talk to your cancer doctor or surgeon.
Prostatectomy is surgery that removes all or part of a man’s prostate because of cancer or an enlarged prostate. It may cause urinary incontinence or ED. If removal of the prostate gland is needed, talk to your doctor before surgery about your concerns.
Medications. There are many drugs can cause sexual problems. These include some blood pressure medicines, antihistamines, antidepressants, tranquilizers, appetite suppressants, drugs for mental problems, and ulcer drugs. Some can lead to ED or make it hard for men to ejaculate. Some drugs can reduce a woman’s sexual desire or cause vaginal dryness or difficulty with arousal and orgasm. If the cause of a man or woman’s sexual problem is related to a medication, the doctor can usually reduce the dosage of the medication, change the medication that doesn’t have the side effect of sexual problems, or may even allow the patient to discontinue the medication for a short period of time, i.e., drug holiday, to allow the man or woman to enjoy intimacy without completely discontinuing the medication.
Alcohol. Too much alcohol can cause erection problems in men and delay orgasm in women.
Safe Sex Is For Seniors Too
Age does not protect you from sexually transmitted diseases. Older people who are sexually active may be at risk for diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis.
Almost anyone who is sexually active is also at risk of being infected with HIV, the virus that causes AIDS. The number of older people with HIV/AIDS is growing. You are at risk for HIV/AIDS if you or your partner has more than one sexual partner or if you are having unprotected sex. To protect yourself, always use a condom during sex. For women with vaginal dryness, lubricated condoms or a water-based lubricating jelly with condoms may be more comfortable. A man needs to have a full erection before putting on a condom.
Talk with your doctor about ways to protect yourself from all sexually transmitted diseases. Go for regular checkups and testing. Talk with your partner. You are never too old to be at risk.
What Can A Couple Do?
There are things you can do on your own for an active sexual life. Make your partner a high priority. Take time to enjoy each other and to understand the changes you both are facing. Try different positions and new times, like having sex in the morning when you both may be well-rested. Don’t hurry—you or your partner may need to spend more time touching to become fully aroused. Masturbation is a sexual activity that many older people, with and without a partner, find satisfying.
Don’t be afraid to talk with your doctor if you have a problem that affects your sex life. He or she may be able to suggest a treatment. For example, the most common sexual difficulty of older women is painful intercourse caused by vaginal dryness. Your doctor or a pharmacist can suggest over-the-counter vaginal lubricants or moisturizers to use. Water-based lubricants are helpful when needed to make sex more comfortable. Moisturizers are used on a regular basis, every 2 or 3 days. Or, your doctor might suggest a form of vaginal estrogen.
If ED is the problem, it can often be managed and perhaps even reversed. There are pills, Viagra, Levitra, Cialis, and now Stendra, that can help. They should not be used by men taking medicines containing nitrates, such as nitroglycerin. The pills do have possible side effects. Other available treatments include vacuum devices, self-injection of a drug, or penile implants.
Physical problems can change your sex life as you get older. But, you and your partner may discover you have a new closeness. Talk to your partner about your needs. You may find that affection—hugging, kissing, touching, and spending time together—can make a good beginning.
Bottom Line: Sex is good at 20-30, better at 30-40, and can be best of all after age 60. Intimacy is just as important as we age as when we were younger. Help is available; don’t be afraid to ask your doctor.

Screen Tests Are Not Just For Male Movies Stars

Getting the right screening test at the right time is one of the most important things a man can do for his health. Screenings find diseases early, before you have symptoms, when they’re easier to treat. Early colon cancer can be nipped in the bud. Finding diabetes early may help prevent complications such as vision loss and impotence. The tests you need are based on your age and your risk factors.

Prostate Cancer
Prostate cancer is the most common cancer found in American men after skin cancer. It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer. Screening tests can find the disease early, sometimes before symptoms develop, when treatments are most effective.
Screenings for healthy men may include both a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test. The American Cancer Society advises men to talk with a doctor about the risks and limitations of PSA screening as well as its possible benefits. Discussions should begin at:
• 50 for average-risk men
• 45 for men at high risk. This includes African-Americans.
• 40 for men with a strong family history of prostate cancer
The American Urological Association recommends a first-time PSA test at age 40, with follow-ups per doctor’s orders.

Testicular Cancer
This uncommon cancer develops in a man’s testicles, the reproductive glands that produce sperm. Most cases occur between ages 20 and 54. The American Cancer Society recommends that all men have a testicular exam when they see a doctor for a routine physical. Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. I suggest that most men learn how to do a self-examination. You can gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes. If you find an abnormality, contact your doctor. For more information on testis self-examination, please go to my website: http://www.neilbaum.com/testes-self-examination-tse.html

Colorectal Cancer
Colorectal cancer is the second most common cause of death from cancer. Men have a slightly higher risk of developing it than women. The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon. After cancer develops it can invade or spread to other parts of the body. The way to prevent colon cancer is to find and remove colon polyps before they turn cancerous.
Screening begins at age 50 in average-risk adults. A colonoscopy is a common test for detecting polyps and colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon. Some patients opt for a virtual colonoscopy — a CT scan — or double contrast barium enema — a special X-ray — although if polyps are detected, an actual colonoscopy is needed to remove them.

Skin Cancer
The most dangerous form of skin cancer is melanoma (shown here). It begins in specialized cells called melanocytes that produce skin color. Older men are twice as likely to develop melanoma as women of the same age. Men are also 2-3 times more likely to get non-melanoma basal cell and squamous cell skin cancers than women are. Your risk increases as lifetime exposure to sun and/or tanning beds accumulates; sunburns accelerate risk.
The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine cancer checkup. Treatments for skin cancer are more effective and less disfiguring when it’s found early.

High Blood Pressure (Hypertension)
Your risk for high blood pressure increases with age. It’s also related to your weight and lifestyle. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm — dangerous ballooning of an artery. But it can be treated. When it is, you may reduce your risk for heart disease, stroke, and kidney failure. The bottom line: Know your blood pressure. If it’s high, work with your doctor to manage it.
Blood pressure readings give two numbers. The first (systolic) is the pressure in your arteries when the heart beats. The second (diastolic) is the pressure between beats. Normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher, and in between those two is prehypertension — a major milestone on the road to high blood pressure. How often blood pressure should be checked depends on how high it is and what other risk factors you have.

Cholesterol Levels
A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of your arteries (seen here in orange). This increases your risk of heart disease. Atherosclerosis — hardening and narrowing of the arteries — can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Lifestyle changes and medications can reduce this “bad” cholesterol and lower your risk of cardiovascular disease.
The fasting blood lipid panel is a blood test that tells you your levels of total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, and triglycerides (blood fat). The results tell you and your doctor a lot about what you need to do to reduce your risk of heart disease, stroke, and diabetes. Men 20 years and older should have a new panel done at least every five years. Starting at 35, men need regular cholesterol testing.

Type 2 Diabetes
One-third of Americans with diabetes don’t know they have it. Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), nerve damage, and impotence. This doesn’t have to happen. Especially when found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss, and medications.
A fasting plasma glucose test is most often used to screen for diabetes. More and more doctors are turning to the A1C test, which tells how well your body has controlled blood sugar over time. Healthy adults should have the test every three years starting at age 45. If you have a higher risk, including high cholesterol or blood pressure, you may start testing earlier and more frequently.

Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It’s in the blood and other body secretions of infected individuals, even when there are no symptoms. It spreads from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. Modern treatments can keep HIV infection from becoming AIDS, but these medications can have serious side effects.
HIV-infected individuals can remain symptom-free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It’s possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you were recently infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.
Most newly infected individuals test positive by two months after infection. But up to 5% are still negative after six months. Safe sex — abstinence or always using latex barriers such as a condom or a dental dam — is necessary to avoid getting HIV and other sexually transmitted infections. If you have HIV and are pregnant, talk with your doctor about what needs to be done to reduce the risk of HIV infection in your unborn child. Drug users should not share needles.

Glaucoma
This group of eye diseases gradually damages the optic nerve and may lead to blindness — and significant, irreversible vision loss can occur before people with glaucoma notice any symptoms. Screening tests look for abnormally high pressure within the eye, to catch and treat the condition before damage to the optic nerve.
Glaucoma Screening
Eye tests for glaucoma are based on age and personal risk:
• Under 40: Every 2-4 years
• 40-54: Every 1-3 years
• 55-64: Every 1-2 years
• 65 up: Every 6-12 months
Talk with a doctor about earlier, more frequent glaucoma screening, if you fall in a high-risk group: African-Americans, those with a family history of glaucoma, previous eye injury, or use of steroid medications.

Bottom Line: There’s a saying New Orleans that if ain’t broke, don’t fix it. Well that doesn’t apply to maintaining your car and it certainly doesn’t apply to your health and well-being. Men need to have screening tests in order to detect disease states early when they are treatable and curable.

Safe Sex For Seniors

The days of the dirty old man are over. Let the truth be told; older men and women want to remain sexually active. Seniors have more open attitudes toward sexuality, better health among seniors, the option for Internet dating, and the availability of medications like Viagra, Levitra, and Cialis, many older adults are remaining sexually active. It is important to emphasize that seniors are also vulnerable to sexually transmitted diseases (STDs) just as younger adults. Therefore it is important that seniors make certain that they are practicing safe sex. This article will provide suggestions for safe sex for seniors.

Do your homework. Seniors need to know your partner’s sexual background before having sex. This includes oral sex, anal sex, as well as vaginal sex. All types of sexual intimacy can spread STDs. It is important for seniors to talk about their sexual histories, and tell one another whether they have recently been tested for STDs and share with each other the results of those tests. It is also important to ask if there has ever been a history of injecting illegal drugs. HIV/AIDS can also be spread via a shared hypodermic needles though the most common risk factor for older women is sex with an infected man.

Make sure you can pass this test! The best way to protect yourself and your partner is for both partners to get tested for HIV and other STDs before starting to have sex. If one of the partners has not been tested, then it is imperative that the tested partner encourage the other partner to obtain testing. Remember that STDs don’t always cause obvious symptoms such as a rash, discharge, fever, or urinary symptoms. Also, some symptoms of STDs or HIV, such as fatigue, can be mistaken for age-related health problems such as low testosterone levels in men.

Condoms count. I suggest that seniors use a condom as well as a lubricant every time you have sex until you are in a monogamous relationship and your know your partner’s sexual history and HIV status. Lubricants such as KY Jelly are important because they can lower the odds of getting a sore or a tiny cut on the penis or inside the vagina. These sores or cuts can significantly increase the risk of getting STDs.

Bring your doctor into the equation. Your doctor can offer additional advice about protecting yourself from STDs. He or she can also recommend treatments for common sexual problems such as vaginal dryness and erectile dysfunction (ED).

It is quote common for senior women to have vaginal dryness as a result of estrogen deficiency. Vaginal dryness results in discomfort when a woman engages in sexual intercourse and can make for an uncomfortable experience. Solutions range from over the counter moisturizers and lubricants or the use of supplemental estrogen prescribed by your doctor. Estrogen can be given by pills, topical vaginal creams and estrogen impregnated rings that are inserted into the vagina.

Though ED is more common with age, it isn’t an inevitable part of the aging process. ED is often due to an underlying medical condition such as heart disease, diabetes, or the side effects of medication. As a result there is a likelihood of nervousness with the onset of a new relationship. Since ED may be the first sign of an underlying medical condition, it’s particularly important to speak with your doctor if you are having difficulty obtaining or holding an erection adequate for sexual intimacy.

It is not uncommon for seniors to have lost a partner and to go without sexual intimacy for months or years after losing a spouse. Consequently, there is anxiety associated with embarking on a new sexual relationship. Occasionally, counseling is in order to help the seniors jump start their sex lives.

There are numerous medications for ED, which are not recommended for men who use any form of nitroglycerin. Other treatments for ED include testosterone replacement therapy for men who have symptoms of decreased libido, lethargy, and falling asleep after meals. Finally, there are operations which includes penile implants for men where oral medications are not effective.

Bottom Line: It is acceptable and even normal of seniors to engage in sexual intimacy. If a man and women are healthy, are free of STDs, and wish to be sexually intimate, they can plan to successfully engage in sexual intimacy. In 2012, no one needs to suffer the tragedy of the bedroom.

Safe Sex May Be Just A Spray Away!-Spray On Condoms

Good news for men whose penises are either so large or so small that they can’t find a condom to fit them: A German inventor has come up with a sprayed-to-measure system that should ensure a snug fit for even the most unusual sizes.

A German condom expert has developed a “spray-on condom” system in the form of a pump that squirts out liquid latex that cover the erect penis with a latex sheath.  If you go into a drug store to buy condoms, the ones they sell are mainly suited to men with the average penis length of 5.5 inches, but a lot of people have penises that are smaller or larger than that. Jan Krause, director of the Institute for Condom Consultancy, thought developing a condom that fits the man rather than the man fitting the condom.

The system works a bit like a car wash. The man put his penis in a chamber and presses a button to start the jets of liquid latex. A puff of latex is delivered to the penis forming a condom around the penis that is form-fitting and customized exactly for the man.  The rubber dries in seconds and is later rolled off and discarded like a conventional condom.

The spray-on condom will be more expensive than conventional ones. The cost is around €1 or $1.39 per condom, compared with around 50 cents per conventional sheath.

The condoms will be available in red, green, yellow and transparent, but they won’t come in different flavors!

Bottom Line: The spray on condom gives new meaning to “Puff the Magic Dragon”!