Senior sex: Tips for older men

Sex and the older man: What you can do to maintain a healthy and enjoyable sex life as you grow older.

Getting older changes sexual function and desire. Senior sex isn't the same as it was in your 20s — but it can still be satisfying. Contrary to common myths about sexuality and older adults, sex is not just for the young. Many seniors continue to enjoy their sexuality into their 80s and beyond.

A healthy sex life is not only fulfilling — but also good for other aspects of your life, including your physical health and self-esteem. Adapting to your changing body can help you maintain a healthy and satisfying sex life. But you may have to make a few changes, such as allowing yourself more time to become aroused and talking more openly with your partner.

Senior sex: What changes as men get older?

As men age, testosterone levels decline and changes in desire and sexual function are common. They include:

• Decreased sexual interest
  
• A need for more stimulation to achieve and maintain an erection and orgasm
  
• Shorter orgasms
  
• Less forceful ejaculation and less semen ejaculated
  
• Longer time needed to achieve another erection after ejaculation

Your health also can have a big impact on your sex life and sexual performance. If you or your partner is in poor health or has a chronic health condition such as heart disease or arthritis, sex and intimacy become more challenging.

Certain surgeries and many medications such as blood pressure medications, antihistamines, antidepressants and acid-blocking drugs can affect sexual function. But just because you aren't as spry as you once were doesn't mean you can't enjoy a healthy sex life. You need to adapt to your changing body and know your limitations. Focus on ways of being sexual and intimate that work for you and your partner. Talk with your doctor about your concerns.

Tips to maintain a healthy sex life later in life:

• Communicate with your partner. Open discussion of sex has become much more common in the last 40 years, but many older adults come from a generation where sex remains a taboo subject. But openly talking about your needs, desires and concerns with your partner can make you closer and help you both enjoy sex and intimacy more.

• Talk to your doctor. Talking about sexual issues with your doctor can help you maintain a healthy sex life as you get older. Your doctor can help you manage chronic conditions and medications that affect your sex life. Many older men have trouble maintaining an erection or reaching orgasm. Your doctor may be able to prescribe medications or other treatments for these problems.

• Expand your definition of sex. Intercourse is only one way to have fulfilling sex. Touching, kissing and other intimate sexual contact may be just as rewarding for both you and your partner. Realize that as you age, it is normal for you and your partner to have different sexual abilities and needs. Be open to finding new ways to enjoy sexual contact and intimacy.

• Change your routine. Simple changes can improve your sex life. Change the time of day when you have sex to a time when you have the most energy. Try the morning — when you're refreshed from a good night's sleep — rather than at the end of a long day. Because it might take longer for you or your partner to become aroused, take more time to set the stage for romance, such as a romantic dinner or an evening of dancing. Try a new sexual position or explore other new ways of connecting romantically and sexually.

• Seek a partner if you're single. It is never too late for romance. It can be difficult starting a relationship after the loss of a spouse or being single for a long time — but socializing is well worth the effort for many single seniors. No one ever outgrows the need for emotional closeness and intimate love. If you start a relationship with a new partner, be sure to practice safe sex. Many older adults are unaware that they are still at risk of sexually transmitted diseases such as AIDS

• Stay healthy. Eating regular nutritious meals, staying active, not drinking too much alcohol, and not smoking or using illegal drugs are important for your overall health — and it can help your sexual performance. Follow your doctor's instructions in taking medications and managing any chronic health conditions.

• Stay positive. The changes that come with aging — from health problems to changes in appearance and sexual performance — leave many men feeling less attractive or feeling they are less capable of enjoying or giving sexual pleasure. Discussing your feelings with your partner can help. Feeling angry, unhappy or depressed has a strong impact on your sex life. Professional counseling or other treatment can improve your sex life — and your well-being.

Sex may not be the same for you or your partner as it was when you were young. But by adapting to your changing body, sex and intimacy can continue to be a fulfilling and rewarding part of your life.

BROKEN BONES

Ever since Sir Isaac Newton figured out why apples fall down and not up, we've known the hard truths about gravity--and one of the hardest is that when you hit the ground, you can break a bone. With 206 bones in the human body, there's a lot of potential for breakage.

If you're on the mend from a fracture, there are some ways you can speed healing and make yourself more comfortable.

Butt out.

Smoking can delay the healing of bones--up to five months longer for serious fractures and less for minor breaks, says orthopedic surgeon George Cierny III, M.D., of Atlanta. He has shown experimentally that nicotine and other substances in cigarette smoke reduce the amount of oxygen reaching bone tissue, causing the delay in healing. So if you're a smoker, expect a longer-than- average healing time.

Watch what you drink.

It's still unknown what effect alcohol and caffeine have on healing, but researchers know that people who consume beverages containing these two substances are more likely to endure fractures. That's because caffeine and alcohol affect bone mass and interfere with calcium absorption, which builds stronger bones.

"In our study, there was an increased risk of getting fractures in those who drank more than four cups of coffee daily or about two glasses of alcohol--wine, beer or a highball," says Graham A. Colditz, M.D., a researcher at Harvard Medical School in Boston.

When to See the Doctor

The most important thing you should know about broken bones is that they require immediate medical attention. If you even suspect a fracture, have a doctor check it out. Otherwise, you may further damage the broken bone. There's also risk of infection and delayed healing.

Use Gravity to Stop Itchy Casts

Bothered by that annoying itch from inside a cast? Don't try to scratch it with a ruler, clothes hanger or other device--you' ll just get more itching from the tiny cuts caused by your scratching.

"Instead, simply elevate the fractured area so that it's above the level of your heart," suggests Philip Sanfilippo, D.P.M., a San Francisco podiatrist who specializes in sports injuries and treatment. "By doing that, you'll diminish blood flow to the area and reduce swelling. Often that's enough to relieve the itching."

RICE is nice.

On the first-aid front, most experts suggest some big chill-even after your doctor has treated you. The acronym RICE--rest, ice, compression and elevation-describes the best way to hasten healing and prevent further damage. If you have a minor fracture that's protected by an air cast or soft cast, your doctor might let you remove the cast now and then to apply ice directly.

"Put a bag of frozen vegetables on the fracture for about 20 minutes, then remove it for 10," suggests Steven Subotnick, D.P.M., a sports podiatrist in Hayward, California, and author of Sports and Exercise Injuries. "But make sure you put a washcloth between your skin and the ice bag to prevent an ice burn." Since you want to avoid pressure on the area, the cold compress should be applied lightly.

Even if you can't take off a soft cast, you can apply ice to the outside of the cast, and it will help chill the area underneath.

STUTTERING

We all get a kick out of watching Porky Pig's animated arsenal of sputters, misfires and f-f-f-false starts. But if you, your spouse or your child is among the millions of Americans whose speech is laden with hesitations, prolongations, repetitions and blockages, then you know firsthand that stuttering is not as amusing as a Looney Tunes cartoon.

About 4 percent of all children between the ages of two and seven will develop a stutter--but there will be far more boys than girls. Although most of the children who stutter will outgrow the problem by puberty, a small percentage (less than 1 percent) carry it into adulthood.

As yet, no one knows what causes stuttering, and there is no cure. "Our best guess is that it is due to a combination of psychological, neurological and genetic factors," says Barry Guitar, Ph.D., professor of communication science and disorders at the University of Vermont in Burlington. But they do know that it is habit forming and is usually related to stress, according to Martin F. Schwartz, Ph.D., executive director of the National Center for Stuttering in New York City.

When a child is learning, to speak, or when an adult has to speak in stressful situations (before a large audience, for instance), that stress focuses tension on the vocal cords, closing and locking them. The person struggles to speak but can't do so easily: The struggle becomes a stutter. "If the vocal cords can be kept open and relaxed, however, the stuttering can be stopped immediately, " says Dr. Schwartz.

If you or your child does stutter, try these techniques.

Pause a second.

If you're stuttering, maybe it's because you're trying to speak as fast as or faster than others--and you just don't need to. "Slow down to a normal rate and set your own relaxed pace," says Edward G. Conture, Ph.D., chairman of the Program of Communication Sciences and Disorders at Syracuse University in Syracuse, New York. "When someone asks you a question, pause one to two seconds before responding, then answer at a rate that is comfortable for you."

Nip stutter starters in the bud.

The moment before a stutter begins, you may grimace, twist your face or purse your lips without being conscious of these movements. R. Gregory Nunn, Ph.D., a clinical psychologist and president of R. G. Nunn and Associates, a private clinic in San Diego, suggests using competing behaviors when you feel these stuttering precursors come on.

When muscles tense up, for instance, let your arms, shoulders, chest and stomach slump and relax. If your lips are pursed, open them slightly. Or loosen your tight throat by letting out a little air through your mouth before saying just one word per breath, gradually increasing the number until you feel comfortable.

Record your stuttering.

Keep a personal log of all your stuttering episodes, noting what takes place prior to and during the stutter, says Dr. Nunn. "When you become aware of situations and behaviors that contribute to your stuttering, you can catch them in advance and prevent stuttering before it starts." If you always stutter on the phone, for instance, be prepared to use some competing behavior techniques even before you dial.

Practice natural breathing.

"A stutterer tries to superimpose speech over short, rapid, uneven breaths or speak while holding his breath," explains Dr. Nunn. "We want him to get used to natural speech breathing." Take a relaxed breath through the mouth, filling your lungs with a comfortable amount of air, and let it out slowly and easily, producing a deep, hollow sound. Practice this breathing pattern daily. Then try to maintain the deep breathing while you speak, letting the words come out easily as the smooth, even breath is being exhaled.

Synchronize your airflow.

Dr. Schwartz recommends the following method to take tension off the vocal cords. First relax. Take a short, easy breath through your mouth. just before speaking, let the air flow passively through your mouth, opening up the locked cords. Slow the first word a bit, easing into the first syllable, gliding to the next. Then proceed at a comfortable pace. Do this with each sentence, stopping and starting at natural pause points. Stuttering should stop right away. Practice this technique for 15 minutes three times a day, and try to integrate it into all your conversation. Four months of daily practice should make this behavior a habit.

Nix cola and coffee.

Caffeine, sugar and other stimulants encourage muscle and vocal tension, says Dr. Schwartz. They should be eliminated or greatly reduced.

When to See the Doctor

How do you know whether to help a stuttering child at home or to see a speech specialist? Martin F. Schwartz, Ph.D., executive director of the National Center for Stuttering in New York City, provides these guidelines.

If you are the parent of a child who stutters and someone in the immediate family also stutters, there's a chance your child's habit may continue into adulthood. Note whether there's a lot of struggling with words or at midsentence and also whether the stutter occurs every day and the child reacts by acting unhappy or refusing to speak. When stuttering is this persistent, you should definitely go to a speech specialist.

By adulthood, the habit is ingrained, and a good bit of one-on-one counseling may be needed to overcome it. The help of a licensed speech therapist may be necessary before you can change the habit.

Also, if stuttering should develop for the first time in adulthood or very suddenly in an older, normally fluent child, it may be the result of a neurological condition, a head injury or an event that has been very upsetting. See a doctor immediately.

Skip the sweets.

Sugar reduction alone has completely eliminated stuttering in some children, says Dr. Schwartz. You may observe rapid improvement in your child's speech simply by decreasing his consumption of cakes, cookies, candy and soda.

Set the pace.

"When kids try to speak as fast as or faster than adults, they often stutter," says Dr. Conture. "If you speak slowly and evenly to your child, he'll soon get the picture and slow down naturally." Other pacemaking tips from Dr. Conture: Pause one to two seconds before responding to your child's questions. Try not to finish the child's sentences, talk over him or interrupt. And don't tell him to speak slowly while you proceed rapidly.

Take a listening break.

A fast-paced, hectic environment where it is difficult to speak and be heard may increase stuttering in children, says Dr. Conture. When talking with a child who stutters, turn off the TV and radio as often as possible, or keep the volume low, so the child doesn't have to verbally compete with background talking. It's ideal if you can set aside time for family discussions and then give everyone a chance to speak in turn without undue interruption. And if your child talks to you while you are doing things that require your concentration, take a time-out. "Assure him you are listening and then do listen," says Dr. Conture.