Using the assigned readings and information from the literature, compose a response to the following:
The question Does sexuality have a time limit? is addressed in the following article.
Katz, A. (2012). Sex, health and aging. Nursing for Womens Health, 15(6), 519-521.
After reading the article by Katz, initiate a discussion that addresses reproductive health across the life span. Describe what impact, if any, age, economics, health and lifestyle, society and culture may have on a person’s perception of their own sexuality. How do these factors affect your role as a registered nurse working in a family health clinic?
Assigned reading: Sex, Health and Aging What Women Need to Know ANNE KATZ, PhD, RN Is there a time limit on sexuality? Do we ever get too old to have sex or to be seen by ourselves and others as sexual beings? In part this depends on perspective; society and individuals have differing attitudes on this topic. If you believe what the media presents, then sex is for the young and sexy; older adults, especially the very old (age 75 and above), are not portrayed as sexual beings at all. Many of us may hold the same attitudes; just think for a moment about your own parents having an active and satisfying sex life and most of us will find our faces crinkling in horror at worst or confusion at best.
Gender Differences But what do we really know about sexuality in the very old? Lindau and Gavrilova (2010) analyzed data from 3,005 adults ages 57 to 85 in the National Social life, Health and Aging Project (NSHAP); this included 1,550 women and 1,455 men from the later life cohort (ages 75 to 85). They found that older adults remain sexually active and happy well into older adulthood; however, gender differences increased with age. At 75, Anne Katz, PhD, RN, is a clinical nurse specialist and sexuality counselor at the Prostate Centre of CancerCare in Winnipeg, Manitoba, and she is the editor of Nursing for Womens Health. Address correspondence to: anne.katz@cancercare.mb.ca.DOI: 10.1111/j.1751 486X.2011.01683.x 520 Nursing for Womens Health Volume 15 Issue 6 and were most pronounced in those ages 75 to 85. In this group, more men were sexually active than women (38.9 percent vs. 16.8 percent) and of those men and women who were sexually active, men reported greater quality of sex life (70.8 percent) than women (50.9 percent).
Men tend to die earlier than their female partners, so there are often more women than men in this age group. This allows for men to have more freedom in choosing a new partner, and men also have the added advantage of being able to date younger women. Women were less likely to be interested in sex (11.4 percent) than men (41.2 percent). This may be, in part, adaptive if you don’t have a partner or your partner is not physically able to be sexual, then perhaps you stop thinking about it and/or stop wanting to be sexual.
Presence or Absence of a Partner
When we look at women in this older age group, 38.5 percent are living with a partner; this is a major contributor to continued sexual activity in old age (DeLameter & Sill, 2005). For women, the absence or ill health of a partner has a direct effect on sexuality. For those living with a partner, 41 percent report sexual activity in the past 12 months; this drops to under 2 percent for women who do not live with a partner. And the absence of a partner leads to a decrease in interest in sex (7 percent) from 18 percent for those who have a partner.
Physical Changes
What else influences sexuality in older women? We know that many older women experience pain with sexual intercourse; this is almost always associated with urogenital atrophy (Lindau et al., 2007) and leads to decreased sexual satisfaction (Carpenter, Nathanson, & Kim, 2009). We do know that good health is associated with sexual activity and satisfaction.
Tools for Providers
We know little about the effects of illness and medications on older women because there seems to be little impetus (or funding) to explore this. And health care providers are often reluctant to explore sexual issues with their patients, particularly if they are elderly (Yee, 2010). Many common medical conditions (diabetes, cardiovascular disease, obesity) are associated with sexual problems (Camacho & Reyes-Ortiz, 2005), but ongoing chronic disease management affords health care providers multiple opportunities to assess sexual functioning. Examples of questions to assess this important aspect of life are included in Box 1. Another way of assessing sexual functioning is to follow the four steps of the PLISSIT model (Annon, 1974) that are presented with examples in Box 2.
Conclusion
Sexual functioning for women over the age of 75 can be seen in either a positive or negative light. For some readers, these statistics may point to the end of sex for older women, while for others, it may offer great hope. Up to half (39.1 percent to 53.4 percent) of the partnered women in Lindau’s study were sexually active in the past year and an average of 22.9 percent of them were having sex once a week or more. Seventy-eight percent of these women report high-quality sex lives and the same proportion report positive emotional quality of their sex lives. That is good news indeed!
So a woman’s sex life does not have to end in old age. This is in part up to her, but also in large part related to her relationship status as well as her health status. For some this will provide evidence that sex is for the young and not something to be bothered with as old age approaches. For many of us this will provide hope that an important and pleasurable activity will continue for many years, bringing with it satisfaction and joy.
NWH References Annon, J. (1974). The behavioral treatment of sexual problems. Honolulu: Enabling Systems.
Camacho, M., & Reyes-Ortiz, C. (2005). Sexual dysfunction in the elderly: Age or disease? International Journal of Impotence Research, 17, S52-S56.
Carpenter, L., Nathanson, C., & Kim, Y. (2009). Physical women, emotional men: Gender and
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