As we grow older, our sexual prowess declines, but a  loving spouse can do wonders to maintain an exciting, emotional and  physical relationship. Many married couples who, as they age, make  marvelous adaptations to the changes in their sexuality. But others may  need a little help.
                                
                                  After  the age of fifty, changes that may be expected in women are reduced  lubrication and lessened vaginal elasticity. Men may expect delayed and  partial (less high) erections, reduced fluid and force of ejaculation,  more rapid detumescence after orgasm, and longer refractory period  before the next capability.
                                
 
                                  Studies showed that 70% of 68 year old men and 25% of men in their  eighties regularly had intercourse. So did the majority of women in  their seventies, if they had an active partner. The normal sexual  decline in men can be with more prolonged foreplay and genital  caressing. Women with reduced lubrication may benefit from hormones or  bland vaginal lubricants.
                                
                                  Sexual feelings for many elderly men and women endure despite all the  family and cultural negatives and may continue into the nursing home  (old age home). There are also a variety of constructive approaches  that can help with sexual performance in the presence of arthritis,  alcoholism, cardiac disease and stroke. Even in the presence of  diabetes and its organic changes, sexual therapy has helped reverse  impotence. Some drugs may be an obstacle to sexual performance. Also,  some tranquillizers and hypnotics may cause partial erections, delayed  ejaculations or impotence.
                                
                                  
                                    
                                      |  | 1.  BE  REALISTIC |   | 
                                  
                                  
                                  The keys to a happy and successful sexual life in  the later years are realistic expectations and a sound personal  philosophy of the sexual relationship. It is most important to think  preeminently of quality, not quantity. There seems very little merit  in the man who is a sexual acrobat, capable of considerable sexual  feats, especially when his wife tells him that he wears her out or,  worse, is not loving. Men who have intercourse with their wives at far  less frequent intervals but who are warm and affectionate, both in and  out of bed, have a far better sex life, than the former.
                                  
                                    At any age, sex is an interaction that mirrors the underlying relation,  not an isolated event occurring without any context. Great sex can  occur once a week — or even far less often — yet be full of tenderness  and sweetness. Routine sex, on the other hand, though performed more  often, may remain devoid of the necessary emotional charge.
                                  
                                    The quantitative decline of sex with aging will not always be  accompanied by those additional qualities that infuse good sexuality.  It is the higher sexual pathway that originates in the brain in  response to all the meanings of a good relationship that is important.  Interestingly, the emotional component as reported by many couples may  make for better erections and much more satisfying intercourse. The  sexuality of the real world flows from a hug, a kiss, a flood of  memories and feelings. These are the essence of love at all ages. They  charge up the sexual act, and they transcend the confines of the  laboratory experiments.
                                  
                                    
                                      |  | 2.  SEXUAL CHANGES IN WOMEN |   | 
                                  
                                                                      The menopause, of course, is clear-cut and unmistakable. Monthly  periods cease, and there may be a succession of uncomfortable changes  associated with it, such as the familiar hot flushes, sweats, and  sometimes minor depression and nervousness.
                                  
                                    Because the female hormones tend to plump up the skin and produce some  water retention in it, loss of the hormones following menopause may  make some women's skin look older. Another common complaint is of  increasing vaginal dryness and a decreased capacity to lubricate with  sexual stimulation.
                                  
                                  In  addition, the passage of the years may produce some atrophy of the  vaginal lining, as it becomes thinner and more delicate. Where hormone  deprivation in the vagina is maximum, all the structures, including the  vaginal outlet, seem to shrink and Contract. Fortunately, however, we  have a quick and reliable answer to all this: The female sexual  hormones, available in a variety of pills and in various combinations,  prevent all these changes.
                                  
                                    
                                      |  | 3. SEXUAL CHANGES IN MEN |   | 
                                  
                                  
                                    The male sexual capacity, as determined by the number of ejaculations  over a defined time period, peaks in the mid- to late teens. This  ability starts declining in the twenties and thirties and goes down to  virtually zero in the eighties and nineties. There is no decline in the  blood levels of testosterone (male hormone) over this time period,  though studies have shown decline with aging. There are slight changes  in the semen from youth to old age, but these are not major, and old  men are therefore capable of becoming fathers.
                                  
                                    The manufacture of testosterone and of sperm is governed by the  pituitary gland at the base of the brain. There seem to be mo  significant changes in the hormone from the pituitary, which governs  the making of testosterone, or in the follicle stimulating hormone  (FSH), which governs sperm production.
                                    These findings may be contrasted with those for females who experience  ovarian failure that leads to menopause. This event produces a large  rise in the FSH, which soars to fifteen times the normal level and  which is associated with the characteristic hot flush.
                                  
                                    
                                      |  | 4. MALE  SEXUAL FUNCTION AS RELATED TO                  AGING |   | 
                                  
                                  The  male requires a longer time to reach erection and may require greater  stimulation, such as manual stimulation.
                                  - Once  response to stimuli has occurred, the erection may be somewhat less rigid.
- The  erection may start to wilt earlier than has been customary with that  individual.
- The  spurts of semen produced in the orgasm diminish.
- The  latency period, which is the time from orgasm to the next erection, may  be much prolonged in the aging male. Many hours may go by in which even  maximum stimulation will not produce an erection.
5. CAUSES OF IMPOTENCY  WITH MEN 
                                  
                                    
                                      - Aging.
- Depression.
- Drugs.
- Diabetes.
- Endocrine  disorders.
- Vascular  and neural impairment.
- Chronic,  progressive or wasting diseases.