Sexual health

Where libido is concerned, it really is good to talk! No matter what teenagers think, sex is NOT exclusively the property of the under 25s!
No matter what teenagers think, sex is NOT exclusively the property of the under 25s! More and more of us are enjoying an active life in the bedroom into our 60s and beyond. But as you get more mature, you may have to overcome a few barriers to keep your romantic life healthy.

Erectile dysfunction

Erectile dysfunction or ED used to be called impotence, and it affects an astonishing two out of five men over 40. It does get more common as you get older, but it isn't inevitable and it is almost always treatable.

Unfortunately, a few (or even one) episodes of ED can knock a man's confidence in his performance. This can raise his anxiety levels, which in turn make it much harder to get an erection. If this happens to your partner, before you know it, you're sleeping in separate rooms. That's a tragedy, because there are such effective treatments available.

ED can be an indicator of underlying medical conditions including diabetes or furring up of the arteries. If your partner suffers from ED, it's essential that you persuade (or cajole or even bully!) him into visiting his GP to get himself checked out for these conditions.

ED can also be caused by some tablets, especially blood pressure treatments. Even if there is no treatable physical cause, his GP can help with effective treatment options. The most common is the group of tablets in the Viagra© family, which also include Cialis© and Levitra©.

Vaginal dryness

This is a hugely common problem after the menopause, when your levels of the female hormone oestrogen drop. Unlike hot flushes, vaginal dryness doesn't go away.

Fortunately, there are effective treatments. HRT, or hormone replacement therapy, has become less popular in recent years because of worries about an increased risk of breast cancer if you use it long-term.

Topical HRT (in the form of vaginal cream, pessaries etc) doesn't carry the same risks, although you should stop it every few months to check you still need it. Replens© is a non- hormonal vaginal moisturiser that you use every three days. It is often as good as HRT and is available from your pharmacist or on prescription.

Loss of sex drive

Libido, or sex drive, is hugely complicated. It can be affected by:

  • Changes in your hormone levels - most commonly around the menopause or if you are using hormonal contraception such as the contraceptive pill
  • Problems in your relationship
  • Overwork, tiredness, anxiety or depression
  • Medicines, especially tablets used to treat high blood pressure or depression
  • Drinking too much alcohol

Sometimes physical problems, like ED or vaginal dryness, can make sex uncomfortable or awkward. This in turn can mean that subconsciously you worry about it, which may put you off. You may not be in the mood for sex if your relationship is less than ideal. But equally, difficulties in the bedroom can put a strain on any relationship.

Where libido is concerned, it really is good to talk! Your partner may be worried it's his fault - discussing it openly can often mean you make time for each other, which may be all that's needed. Otherwise, talk to your GP.

Preventing sexually transmitted infections (STIs)

With more and more people finding love second time around - let's celebrate! But a word of caution - the last 20 years has seen a huge rise in the number of over 40s being diagnosed with STIs. These aren't just a worry for the young - STIs can cause painful long-term symptoms, as well as infertility. What's more, some infections like chlamydia can cause complications, even without short- term symptoms like vaginal or penile discharge.

So be a grown-up - get yourself and your partner checked out (completely confidentially) at your GP or local sexual health clinic, and use condoms until you both have the all-clear. If you're really too embarrassed to attend, you can buy an accurate do-it-yourself chlamydia test called Clamelle© from pharmacies.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.