1. Linda Weiner, LCSW 7396 Pershing Avenue St. Louis, MO 63130 314.588.8924 sextherapiststlouis@yahoo.com

2. ARE PEOPLE OVER 60 STILL SEXUALLY ACTIVE? ABSOLUTELY

3. TYPICAL CHANGES IN SEXUAL FUNCTION IN THE AGING POPULATION MEN May experience lower libido May be slower to gain erections and the erection may not be as full Getting an erection may require direct stimulation of the penis No driving need to ejaculate every time Ejaculation may be less copious and released under less pressure

4. TYPICAL CHANGES IN SEXUAL FUNCTION IN THE AGING POPULATION WOMEN May experience lower libido Post menopausal women w/o hormone use may experience vaginal dryness/atrophy Post menopausal women w/o hormone use may experience thinning and loss of elasticity of the vaginal walls leading to pain with insertion

5. ADDITIONAL CHALLENGES TO SEXUAL FUNCTIONING IN THE AGING POPULATION Sexual Myths Medical/Healthcare Manager’s Lack of information & comfort with Sexuality Issues Adult Children’s Discomfort with Parent’s Sexuality Lack of Privacy Lack of an interested and interesting sexual partner Medications which affect libido and sexual functioning Survivors of Cancers such as prostrate cancer, breast cancer, etc. where function is problematic due to artery or nerve damage, medications utilized or where body image and partner’s perception is affected Individuals with chronic diseases such as heart disease, MS, Diabetes, Parkinson’s, Dementia

6. INTERVENTIONS Ask about sexual concerns “Good Enough” model of Sex Use of Vaginal Lubrication Use of localized estrogen creams with medical approval Use of Testosterone for men and women Availability of penile pumps/ medications such as Viagra where indicated Teaching shifting of focus to other erotic or pleasurable sensations Kegels Relationship Counseling Body Image Counseling Grief Counseling General Exercise Self Stimulation Use of vibrators Medication adjustments Creation of Private Rooms at Facilities Use of condoms