Sex. Yes, Sex.

By Dr. Penny Stern

I recently came across an article about everyone's favorite topic: sex. It made me think about a few things that hadn't really crossed my mind til now. Yes, I know. It has been said that women think about sex ten times a day during their waking hours. But I can't really say that I think about sex for ninety six minutes each day. Even if you don't either, you probably wonder about a few things. Here are some nuggets that may reassure you--or surprise you!

First, did you know that scientists believe that women who frequently engage in sex are less likely to experience cognitive decline--that is, dementia? That was the conclusion of a 2018 study in the Journals of Gerontology. Seems like an excellent excuse to engage in a pleasurable activity, right? And in case you are thinking that older women are past the stage of having regular sex, here's another thought: as women get older their enjoyment of sexual activity actually increases. A survey conducted to assess the happiness of people over sixty found that the most sexually satisfied women are those over 66. (For those who are interested, for men the "age of satisfaction" was a similar 64.)

You probably do know that many women experience symptoms when they go through menopause that may cause problems during sexual activity. One common complaint revolves around the reduced amount of vaginal lubrication that accompanies menopause. Another stems from the fact that vaginal walls often thin following menopause, which can make intercourse not only less pleasurable but downright painful for some women. All of this is because with menopause comes a reduced supply of estrogen, an important female hormone. There are several solutions that may help, including lubricants and moisturizers, as well as short term use of HRT, hormone replacement therapy. Discuss them with your health care provider and see which might suit you best. 

Another common complaint of both women and men is the need to urinate, sometimes often, during the night. This can interfere with both sound sleep and great sex. This problem too may be associated with reduced estrogen in women. (In men, the issue is likely to be related to an enlarging prostate.) In some cases, the cause may be medications known as diuretics, or water pills, which can be prescribed as an effective component of high blood pressure management and other heart related diseases. Diuretics are designed to make us urinate, so taking them near bedtime can cause problems. Don't discontinue their use without discussing it with your doctor, but do talk to her if this is a problem.

Finally, some women find that their libido (sex drive) has diminished with age. Hate to sound like a broken record, but reduced estrogen may be partially to blame for this as well. Other factors may also contribute, such as stress or depression. So make sure your overall health is tip-top by having regular health maintenance checkups. 

Sex is good all through your life, so go ahead and enjoy it!

Dr. Penny Stern is a physician at Northwell Health, where she serves as Director, Preventative Medicine at the Katz Institute for Women's Health and the Department of Occupational Medicine, Epidemiology and Prevention.

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