Transcript Physiology and Sexuality in Aging

Physiology and Sexuality in Aging
Gerontology 410
Jan 2008
Introduction
• Physiological changes in the human are gradual and
the body acomodates them. The potential for sexual
expression lasts well into the eighties and nineties
and we are not clear how the physiological changes
occur at these ages.
• We must look back to the middle years to see where
these changes begin. First, body appearance begins
to change. Breasts may sag, the abdomen become
more creased, fatty tissues around the vulva become
displaced.
Physiological change
• The ovaries and the uterus begin to shrink. The
vaginal walls become thinner and less elastic. This
loss of elasticity occurs throughout the whole body
and it is noticed over the whole of the climateric
change. It can start with the cessation of menses and
the loss of fertility and then extend into old age. As
menopause proceeds there is a gradual loss of
estrogen and progesterone. This results in the
decrease in the synthesis of proteins, a decrease in
fatty tissue synthesis in the genital tissues.
Physiological change
• What does not decrease is the sense of libido,
however more time is needed for stimulation and
lubrication. This change in the responsivity time is
often co-related to the time it now takes the man to
reach and sustain and erection. With the loss of
estrogen there is drying of mucus membranes
throughout the body and therefore there is less
lubrication in the vaginal linings.
• Examining the four stages of the sexual act we
observe the following
Physiological change
• In the excitement phase-Masters and Johnson
described this as follows: increases in heart rate,
breathing rate, nipples become erect, sexual flush,
muscle tone changes, contractions occur in the anal
sphincter, clitoris swells, vaginal walls become
lubricated, uterus elevates, penis become erect,
testicles are drawn up into the body, the labia flatten
and become thinner and increase in size, and the
vagina stretches.
Physiology of sex
• Plateau Phase: Continued increase in heart rate and
muscle tension. The urinary bladder closes and
muscles at the base of the penis begin rythmic
contractions. There is some secretion of seminal fluid
and the testicles continue to withdraw into the body.
The areola and the labia increase in size and the
clitoris withdraws. The Bartholin glands produce
further lubrication and an orgasmic platform
develops as the vagina opening decreases in size.
There may be vocalizations occurring at this time.
Physiology of Sex
• Orgasmic phase: A release of sexual tension, male
and female cycles of muscle contraction in the anus
and in the women in her lower pelvic muscles,
uterine and vaginal contractions. Males ejaculate 25ml of semen. There are other involuntary actions
and euphoric sensations. There is a perceived
tiredness due to endorphin release and a general
feeling of relaxation and drowsiness.
Physiology of Sex
Resolution Phase: Muscles relax and BP drops. There is
a refractory period and the penis returns to a flaccid
state. Females who are multi-orgasmic may not
immediately go to a resolution stage and will become
further stimulated. The cervix opens and there is a
blood flow reduction to the genitals and nipples. For
some women, stimulation at this stage may in fact be
painful.
Physiology
• For the aging male and female subtle changes are
recorded. Sex flush decreases and is of shorter
duration. In the plateau phase an extension of the
excitement period may be longer. There may be
reduced contractions in orgasm, which may be
sporadic rather than regular. Resolution is faster.
Men do not have menopause but their physiology
also changes. They have viable sperm but less in
quantity, muscles sag, the testes are more flaccid,
the prostate may increase in size, the penis stays
essentially the same
Physiology
• Older males take longer to achieve erection, but
erection can be maintained longer. The decrease in
ejaculatory inevitability is a plus of aging. Some of
the phases in the older male may run together or
lose some of their clear descriptive boundaries. At
orgasm the amount of ejaculate is less and the
resolution phase happens more quickly.
• Many older males voluntarily withdraw from sexual
behavior for no apparent reason from a physiological
standpoint
Physiology
• There are of course many physical illnesses that
impact the physiology of the aging person.
Cardiovascular disease, respiratory disease, diabetes,
hemotological disease can affect sexual desire and
function. Many prescribed medications have a direct
effect on capacity and interest in sexual expression.
Mood elevators, hypnotics, anxiolytics and a wide
range of psychotropics have a direct impact on libido
and function.
• Sex education is essential for a continued satisfactory
sex-life into old age.