Some couples are lucky and never have sex problems. But in reality, the passing years can have an effect on what goes on between the sheets. Here are the 5 most common sex problems for the over-forties that Dr Rosemary Leonard encounters in her surgery.
Sex problem 1: When sex doesn’t feel the same
What I’m talking about here is everything – and yes, I mean everything – moving south. Not just your boobs and tummy, but your intimate parts as well. The ligaments that support the womb become more lax, along with the walls of the vagina. This can mean the vaginal walls sag a little, with the cervix positioned lower than before, especially if you have given birth to several large babies.
The result is a generallack of sensation for both of you, along with some occasional discomfort, especially if he penetrates you too deeply in different positions.
Doing pelvic-floor exercises can help to tighten up the entrance to the vagina and many women report that this can improve sensation around their G-spot (which is usually in the front lower wall). But don’t expect instant results – daily exercise for weeks is required. Prolapse of the upper vaginal walls and the womb itself is best dealt with by surgery. See your GP for referral to an gynaecologist.
Sex problem 2: Erectile dysfunction
Most men have occasions when either tiredness or too much alcohol means they cannot perform as they wish. Even experienced men can suffer ‘performance anxiety’ at the start of a relationship, which means their penis does not behave as they would like.
Persistent erectile dysfunction may have a psychological cause and reflect difficulties in your relationship or other stresses. But it can also be an indicator of health problems, notably narrowed arteries (which can put a man at risk of heart disease) or diabetes.
So the answer is not to buy viagra online, but for him to have a medical check-up.
Sex problem 3: Troublesome bleeding
There is no medical reason why you shouldn’t have sex while you are having a period, but it isn’t something all couples enjoy. Abstaining for a few days may not be a problem, but bleeding for several days or even weeks can affect romance.
The erratic behaviour of the ovaries in the run-up to the menopause is usally to blame, with wildly varying hormone levels (which can trigger mood swings as well). However, it’s wise to have an ultrasound scan of the pelvis to exclude other causes, such as the thickening of the womb lining or fibroids – balls of fibrous tissue within the womb lining, which occur in at least 30 per cent of women over 40.
The way bleeding problems are tackled depends on the underlying cause, but hormone treatment or having a Mirena IUD fitted can help. And apart from the effect that it has on your sex life, prolonged bleeding is a common cause of anaemia – so see your GP.
Sex problem 4: Vaginal dryness
Oestrogen plays an important role in keeping the tissues of the genital area most and plump – low levels after the menopause can cause itching and dryness during sex, which may make intercourse impossible.
Oestrogen cream (available on prescription) can make an enormous difference and intermittent treatment can help maintain the effect. Alternatively, creams such as ReplensMD and Multi-Gyn Actigel are available from chemists and can make lovemaking more comfortable for you.
Sex problem 5: Low libido
Surveys suggest that most couples in their forties have sex on average twice a week and sliightly more at the start of a new relationship. Of course, sex drives vary enormously and some couples are perfectly happy with more or less. But it’s not normal to go off sex completely if your relationship is otherwise good.
The cause of low libido in both men and women can be linked to lifestyle – when you’re overworked, overtired, stressed and worn out, along with drinking too much alcohol – and tackling these nearly always has benefits that go beyond improving your libido. Boredom may also be a contributing factor so investing in a sex manual (yes, really!) to spice things up can pay off.
Testosterone is vital for a good sex drive in women as well as men. The ovaries produce testosterone as well as oestrogen and levels can plummet after the menopause. Testosterone levels in men do fall naturally with age, but if he is tired, irritable, shaving less often and no longer has spontaneous erections, then it’s worthwhile for him to have a blood test to check testosterone level. Replacement therapy is available for both sexes and can be very helpful – again, see your GP to find out more about it.
Want more? Read 20 ways to improve your love life