SEX IN THE MIDDLE YEARS

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In both men and women, there is good evidence that there is a decline—but not a termination—of sex-hormone production in the forties and fifties and later. This does not mean, however, that there is an accompanying decline in sexual activity. Sexual function depends only partly on the level of hormone production, and is probably influenced mainly by emotional factors such as psychological make-up, marital relationship, and previous satisfactory or unsatisfactory sexual experiences. On the other hand, some diminution in sexual drive and capacity can be expected in the middle years, but not sufficient to preclude an active sex life.

Some women may manifest an increase in sexual activities in the late forties and early fifties. This may be related to release from fear of pregnancy or a searching for outlets of energy formerly expended in raising and caring for children. Other women may be plagued by unsatisfactory sexual relations to an ever-increasing extent in these years. Most often, this is a manifestation of previously unresolved inner conflicts regarding sexuality. Such problems are best handled by a qualified physician such as a gynaecologist or a psychiatrist. In general, sexual interest and satisfaction is more likely to continue for many years beyond the menopause in those who have had a happy, well-adjusted marriage with a healthy attitude towards sex.

Sexual inadequacy in men takes a sharp upturn after the age of 50. However, according to recent findings, it need not do so. Many cases of impotence can be treated successfully through good guidance in sexual practices. Given reasonable health, men can enjoy adequate sexual performance into the seventies and eighties—as can women. What is needed to maintain effective sexuality in the ageing male is a constant interest in sex and active sexual expression.

There are several factors that tend to inhibit sexual responsiveness in men. Over-indulging in food and drink can lead to a transitory diminution of intensity of sexual tension and desire; alcohol, in particular, can cause an inability to maintain an erection.

Concern with job performance can lead to encroachment on the time available for sexual relations and a breakdown in communication with the marriage partner. Bad days at the office may bring a decreased interest in sexual activity and performance.

The types of physical, activity that have an unfavourable effect on male sexuality are usually associated with excess strain or fatigue, such as weekend sports. Being in good physical condition helps prevent the letdown in sexual tension associated with physical fatigue.

Mental fatigue has a greater detrimental influence on sexual interest than physical fatigue. Whether it be a strenuous day at the office or family or financial emergencies, the expenditure of energy on such concerns lessens the energy available for sexual responsiveness— often for days beyond the immediate emergency. This sensitivity of sexual tension to mental strain is a significant difference between middle-aged and older men as compared to young men.

Sexual capacity and performance can be affected either transiently or for long periods of time by physical illness. But heart disease, for example, need not mean an end to sexual relations. Medical guidance as to how and when to have sexual relations after any kind of serious illness is important and should be discussed frankly with the physician.

Do not be afraid to discuss sexual problems with your physician. He can often give you good advice or refer you to a specialist.

The key to sexual responsiveness in the middle years lies in regularity of sexual expression. Lack of sexual performance leads to a reduction in sexual tension, while maintained sexual expression combined with adequate physical health and a positive attitude towards the changes of the middle years can provide satisfying sexuality into the later years of life.