physical health issues – Dr. Vandita Dubey

physical problems affecting sex in midlife marriage

marriage midlife physical health issues • sex July 27, 2018 By Dr Dubey 0 Comments

Mind-body issues affecting sex in midlife marriages – Part 1

Sex is an integral part of life. Even in midlife. However, for many married couples sex is riddled with difficulties. For some, the difficulties are long – standing: Sex was never fun enough. For others, sex becomes unsexy in midlife. Either ways, this is a problem that needs to be addressed.

Midlife, for many adults, is a time of reflection, reprioritization, reorganisation and discovery. And, amongst the many dimensions of their lives that many men and women re-examine is sexuality.

Some couples realize that the sex life they had in their younger years is a thing of the past. Some middle aged men realize that their sexual drive is lower now. Some middle aged women, on the other hand, feel that they are more comfortable exploring and expressing their sexuality.

Some middle aged women or men may also realize that they have not had great sex so far in their relationship and feel a need to fix this problem.

Now, there is no “normal” when it comes to sex. In fact, researchers at the Kinsey Institute have found that there is no common definition of sex. It means different things to different people. For example, some couples consider manually stimulating each other’s sex organs as sex, others only consider intercourse as sex.

For a couple who is on the same page as far as expectations from sex is concerned, there are usually no problems. But, if there is a mis-match of expectations between the partners, that often spells trouble for the relationship.

The mis-match around sex involves two main aspects – desire or the frequency of sex, and satisfaction or the quality of sex. When there is a discrepancy of desire, one partner wants sex less often and the other wants it more often. When there is a discrepancy of satisfaction with sex, two more aspects are involved. One aspect is orgasm – one partner experiences orgasm and the other does not. The other aspect is experiencing the feelings of love and connectedness during sex. These feelings get created through a range of intimate physical behaviours, such as kissing, caressing, etc.

So, how can couples bridge the sex gap? Well, the first step is figuring out what is getting in the way. Based on my work with Indian couples, which is corroborated by western research, there seem to be three body and six mind related reasons that affect couple’s sex life in midlife. The fact that six out of the nine factors are mind related shows that sexual satisfaction is not purely about the physical act.

Let’s first talk about the physical or body related factors that affect sex in midlife marriages:

– Figuring out the mechanics of satisfying sex

Male orgasm is quite well understood but female orgasm is even now shrouded in mystery. Many women believe that they are incapable of achieving orgasm. However, experts believe that every woman, including women in midlife, can experience orgasm.

The problem is that even in today’s day and age, the female sexual anatomy is not widely understood. Most women do not know that the clitoris is the sex organ that is involved in women’s orgasm. But, for many women, the clitoris does not automatically get stimulated during vaginal penetration. Hence, they do not experience orgasm during sexual intercourse. Therefore, other ways of stimulating the clitoris have to be explored.

The good news is that researchers have found that women’s ability to achieve orgasm through clitoral stimulation is not affected by age. In fact, women are equipped to experience multiple orgasms with continued stimulation. Therefore, there is a simple solution to this problem – explore and experiment with sexual touch and sexual positions to find what works.

– Physical wellbeing

Chronic illness often affects how people view themselves, their bodies, and their relationships. Research has shown that women in midlife who are suffering from a chronic illness have many concerns. They are bothered by the changes their body is undergoing, worried about meeting the needs of others, and concerned about expressing their sexual needs and desires. Hence, it is difficult to engage in sex or enjoy sex when one is preoccupied, worried, or feeling negatively about oneself.

Physical illnesses, such as multiple sclerosis (MS) or cancer, are sometimes accompanied by sexual problems. However, researchers have found that couples who have had problems in their relationship or experienced sexual difficulties before the illness, are more likely to face sexual issues after the illness is diagnosed.

Sometimes, the illness itself can create sexual dysfunction when none existed earlier. For example, MS can cause sexual issues that the male partner experiences, such as, erection or ejaculation related problems. Or, the female partner may begin to experience discomfort or pain during sexual intercourse.

Common midlife health conditions, such as diabetes and high blood pressure, can also cause sexual dysfunctions. These dysfunctions are primarily experienced by men and include conditions, such as, erectile disorder.

If your sex life is being affected by a chronic illness or health condition, get help. Talk to your doctor about the impact your condition is having on your sex life. And, check out the additional resources given below that give suggestions about dealing with problems, such as, painful intercourse or erectile dysfunction. Also, seek help from a psychotherapist/psychologist to work through your relationship issues or individual issues related to the illness.

– Hormonal issues

Sex hormones play a role in men and women having satisfactory sex. A change in the level of these hormones, therefore, can take one from good sex to bad sex.

Menopause is a reality for women in midlife. Menopause, as a normal part of growing older, leads to reduced levels of the sex hormone, oestradiol (oestrogen). This sometimes affects women’s ability in midlife to experience arousal, sexual pleasure and orgasm.

Women who enter into menopause at a younger age because their ovaries have been surgically removed may also experience sexual issues. For women undergoing treatment for breast cancer, chemotherapy can also induce menopause and sexual problems.

The normal process of ageing for most men in midlife involves a reduction in the levels of testosterone. But this decline in testosterone levels that begins around age 40 occurs at a very, very slow rate. Its impact on men is, therefore, not as dramatic or significant as the impact of menopause on women.

However, for men, too, endocrine problems can lead to significantly lower levels of testosterone, which may cause sexual problems.

Please look at the additional resources section at the end of this aricle for suggestions on how to deal with sexual issues. Please also speak to your gynaecologist, if you are a woman, or urologist, if you are a man. Or, speak to an endocrinologist to figure out ways to deal with hormonal issues that may be messing up your sex life.

Physical health problems that affect one’s sex life in midlife have many solutions offered by the medical profession. Some solutions are well tested while others may be somewhat experimental. There may be pluses and minuses to the different treatment options.But, getting your sex life sorted is worth the effort.

Coming up: Part 2 of this article where the mind related issues that affect sex in midlife marriages are discussed.