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Sexuality is often a delicate balance of emotional
and physical issues. How we feel may affect what we are able to
do. For example, worrying about impotence can create enough stress
to cause it. As a woman ages, she may become more anxious about
her appearance. This emphasis on youthful physical beauty can interfere
with a woman's ability to enjoy sex. Older couples may have the
same problems that affect people of any age. They may also have
the added concerns of age, retirement and other lifestyle changes,
and illness. These problems can cause sexual difficulties. Talk
openly with your doctor about this. Remember that there is no such
thing as a 'normal' sex life. The important thing is for both members
of a couple to find what makes them both happy.
Sex and aging process
Most of the older people want and are able to enjoy an active,
satisfying sex life. However, over time, you may notice a slowing
of response.
This is part of the normal aging process.
What changes do men experience ?
Men often notice more distinct changes. It may take longer to get
an erection or the erection may not be as firm as in earlier years.
The feeling that an ejaculation is about to happen may be shorter.
The loss of erection after orgasm may be more rapid or it may take
longer before an erection is again possible. Some men may find that
they need more stimulation to become aroused.
Older men and impotence
As men get older, impotence - the loss of ability to achieve and
maintain an erection hard enough for sexual intercourse - seems
to increase, especially in men with heart disease, hypertension
and diabetic complications. For many men, impotence can be managed
and perhaps even reversed.
Effects of illness or disability.
Although illness or disability can affect sexuality, even the most
serious conditions shouldn't stop you from having a satisfying sex
life.
| How
an Erection Occurs? |
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The interior of the penis contains 3 cylindrical-shaped
structures, 2 called the corpora cavernosa which are responsible
for erection and rigidity, and the 3rd called the corpus spongiosum
which contains the urethra (the tube that carries urine and sperm
out of the body). The corpora cavernosa contain a maze of blood
vessels shaped as cavernous spaces (like a sponge). Erection occurs
when these spaces dilate (open up) and blood rushes to fill these
dilated spaces and then gets trapped under high pressure creating
rigidity. Flaccidity (not erect) occurs when these spaces are constricted
and empty.
During sexual arousal, nerve messages begin to stimulate the penis.
Sexual function, including erectile function, originates in the
brain. Nerve signals are then transmitted through the spinal cord
and subsequently through peripheral nerves to the penis where the
nerve endings give orders to the blood vessels to dilate and fill
the spaces of the corpora cavernosa with blood; thus, resulting
in an erection. The transmission of signals from the nerves to the
smooth muscle cells that surround the cavernous spaces involves
chemicals that cause dilation of the blood vessels. As the chambers
fill with blood, they expand and exert strong pressure against the
veins that normally drain blood from the penis. This pressure closes
the veins, trapping blood in the penis. With more blood flowing
in and less blood flowing out, the penis hardens, producing an erection.
After a man climaxes, the erection quickly subsides. The penis becomes
flaccid again. It is important to note that an erection is a complex
chain of events, involving the brain, blood vessels, nerves, and
smooth muscles inside the penis. If any of these systems do not
work properly, a man may not be able to get an erection.
The sex hormone testosterone is also essential to generate sexual
desire (libido) at the brain centre as well as to help expand the
spongy tissue of the penis. For the common people this desire or
instinct is related to the mind. Any problem at the desire or the
mind level or at the penis level is responsible for the problem
of erection called impotence. Testosterone levels decline gradually
after the age 40 to 50, and may cause impotence.
Commonly known as impotence, it is inability
of a person to either achieve or maintain the penile erection till
desired time duration during a sexual intercourse.
Most men will experience impotence - failure to achieve or maintain
an erection - at some time in their lives. This is usually a temporary
experience, often due to anxiety or too much alcohol. For many men
impotence, also called erectile dysfunction (ED), is a persistent,
chronic problem causing much anxiety, stress and unhappiness for
them and their partners. Erections occur with increased amounts
of blood flowing into the penis and remaining 'trapped' there. Many
factors combine to make this happen. It used to be thought that
impotence was mainly a psychological (mental) problem, related to
stress, fear of failure and relationship problems. However, modern
medicine has shown that about half of these problems are due to
physical causes. Many of these causes can be treated and are reversible.
Impotence can be caused by
- Medical problems such as·
- Diabetic complications
- Poor circulation due to narrowed arteries
- Nerve damage
- Hormone problems, such as lack of adequate amount of testosterone·
- Overuse of alcohol and tobacco
- Chronic disease of the liver and kidneys
- Some of the medications (prescription drugs) that may cause
impotence such as sedatives, tranquilizers, blood pressure medications
and diuretics.
- The problem can also occur following surgery to the bladder,
prostate gland, lower bowel and spine, which might damage the
nerves supplying to penis thus causing erectile dysfunction.
- Psychological causes could be feeling stress over a recent
life event or a change in lifestyle. Psychological causes account
for about 15% of impotence cases, but there is often a psychological
contribution to impotence that has a physical cause.
Treatments include psychotherapy, drug therapy, vaccum devices and
surgery.
| Premature ejaculation
|
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Premature ejaculation describes the condition
where a man ejaculates (or comes) too soon. Sometimes this happens
even before any direct stimulation of the penis occurs. Just thinking
about a sexually stimulating situation can trigger ejaculation.
However it is more common for ejaculation to occur either during
or very soon after penetration.
Premature ejaculation is one of the most common sexual problems
affecting men. Most men will experience premature ejaculation
at some time. It can become a problem when this situation is repeated
in most sexual situations. Studies have shown that it is highly
prevalent across all socio-economic groups
What causes premature ejaculation?
There are some conditions
that may interfere with the ejaculatory process, such as changes
in the prostate gland, arteriosclerosis, diabetes and neurological
disorders, but most cases are caused by failure to control the
ejaculatory response. Early pioneers of sexuality studies believed
early sexual experiences were important in the shaping of future
ejaculatory habits. They thought that because of initial nervousness
and haste, unsatisfactory early sexual experiences would 'programme'
a pattern of learned rapid ejaculation later on (a form of negative
conditioning). Inappropriate venues and circumstances e.g., backseats
of cars, fear of discovery and one-night stands may contribute
to establishing a pattern of rapid ejaculation.
Psychosocial events that may contribute to premature ejaculation
include:
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Partner's illness
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Occupational stress/financial
stress/shift work
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Family problems/elderly
relatives/bereavement/children
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Guilt/Sexual orientation
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Lack of experience
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Performance anxiety/fear
of failure/expectations
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Lack of sexual/interpersonal
skills
A common reason for premature ejaculation
is relationship disorders. Some of the components of relationship
distress are: sexually demanding partners, unrealistic expectations,
discrepant needs and desires in a relationship, dissatisfaction,
lack of communication and trust, and affairs, partners who also
have a sexual dysfunction, and an excessive desire to please a
partner. Derogatory remarks made at the time tend to make matters
worse and can lead to a cycle of failure and anxiety.
What treatments are available ?
Often, the problem of premature ejaculation diminishes, as you become
more secure with your partner or the circumstances in which you're
having sex. However, a counselor or therapist will be able to show
you and your partner techniques to help delay ejaculation. One type
of behavior therapy, known as the stop-and-start technique, allows
your partner to stimulate your penis until you feel you are about
to ejaculate. On your signal, your partner stops stimulation, waits
for 20 or 30 seconds and then begins stimulation again. Over time,
and with practice, this technique has been shown to help more than
95 per cent of men to control their ejaculation for up to 10 minutes
or longer. For persistent cases of premature ejaculation, your doctor
may prescribe medication, such as a selective serotonin reuptake inhibitor
(SSRI, a type of antidepressant), which may help delay ejaculation.
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