Sexual Function in Older Women and the Role of Physical Therapy | Heather Lane

Sexual Function in Older Women and the Role of Physical Therapy

Sexual Function in Older Women and the Role of Physical Therapy

Every aging woman who has experienced menopause knows that it changes her body, from bone loss and a higher risk of heart disease to bladder leakage, also known as urinary incontinence. Menopause can change your body’s ability to function sexually as well, including your level of sexual desire.

Physical changes that affect sex

Some of the physical changes that make sex difficult are predictable and typically occur post-menopause. Being aware means that you can plan for these changes and address them so you can continue to enjoy sex long after menopause has brought you to a new stage of life.

Common predictable changes include:

  • Vaginal atrophy. The walls of the vagina become thinner and drier, making them more prone to inflammation. This can make sex painful.
  • Urinary tract symptoms. Some women get more urinary tract infections after menopause (which can be brought on by sex), while others feel the urge to urinate at inopportune moments (such as during intercourse). You may also get up to urinate multiple times each night, which can make you too tired to want to have sex.
  • Diminished sexual interest. The hormones that spark sexual desire change as we age. This makes it harder to get aroused or even think about wanting sex.

Individual influences on sexual function

In addition to the barriers that women generally can expect to occur with aging, any individual can experience conditions that further disrupt sexual function or just change the way you experience sex as you age.

Factors proven to influence older women’s sexual activity and attitudes toward sex include:

  • Depression and anxiety
  • Medication for depression and anxiety
  • Amount and quality of sleep
  • Level of alcohol consumption
  • Socioeconomic status

Solutions for Improving Sexual Function as Women Age

When it comes to dealing with the predictable barriers, you have a lot of options for handling the issues that come up. You could try physical therapy for urinary issues. The therapist will likely work with you to strengthen your pelvic floor so you will have fewer urinary tract problems.

Solutions for sexual function include finding a lubrication option that works for you to combat vaginal dryness. Even if you are enjoying sex, there are measures you can take to try to improve improve sexual function:

  • Sleeping 7-8 hours each night
  • Avoiding alcohol
  • Exercising 30 minutes at least 3 times a week

If you’re still struggling, further options include estrogen supplementation, vaginal estrogen suppositories, testosterone supplements and more. Each of these options should be overseen by a doctor. Seek out your primary care physician or your OB-GYN, who can help you find and implement a solution or a combination of solutions that will make sex fun again.

Women can and should enjoy sex for as long as they want to. Knowing your body and when to talk to a doctor will help extend the longevity of your sexual life.

Citations
Avis NE, Zhao X, Johannes CB, Ory M, Brockwell S, Greendale GA. Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2005 Jul-Aug;12(4):385-98. Epub 2005 Jul 21. PubMed PMID: 16037753.

Caruso S, Rapisarda AM, Cianci S. Sexuality in menopausal women. Curr Opin Psychiatry. 2016 Nov;29(6):323-30. doi: 10.1097/YCO.0000000000000280. Review. PubMed PMID: 27584710.

Kashanian M, Ali SS, Nazemi M, Bahasadri S. Evaluation of the effect of pelvic floor muscle training (PFMT or Kegel exercise) and assisted pelvic floor muscle training (APFMT) by a resistance device (Kegelmaster device) on the urinary incontinence in women: a randomized trial. Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):218-23. doi: 10.1016/j.ejogrb.2011.06.037. Epub 2011 Jul 7. PubMed PMID: 21741151.

Kingsberg SA, Woodard T. Female sexual dysfunction: focus on low desire.
Obstet Gynecol. 2015 Feb;125(2):477-86. doi: 10.1097/AOG.0000000000000620. Review. PubMed PMID: 25569014.

Prairie BA, Wisniewski SR, Luther J, Hess R, Thurston RC, Wisner KL, Bromberger JT. Symptoms of depressed mood, disturbed sleep, and sexual problems in midlife women: cross-sectional data from the Study of Women’s Health Across the Nation. J Womens Health (Larchmt). 2015 Feb;24(2):119-26. doi: 10.1089/jwh.2014.4798. Epub 2015 Jan 26. PubMed PMID: 25621768; PubMed Central PMCID: PMC4326025.

Worsley R, Bell RJ, Gartoulla P, Davis SR. Prevalence and Predictors of Low Sexual Desire, Sexually Related Personal Distress, and Hypoactive Sexual Desire Dysfunction in a Community-Based Sample of Midlife Women. J Sex Med. 2017 May;14(5):675-686. doi: 10.1016/j.jsxm.2017.03.254. PubMed PMID: 28499520.

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