Dr. Ruth and Sexual Medicine Experts Discuss Sex After 50 and Beyond

Dr. Ruth on Sex After 50

• 💡 Dr. Ruth Westheimer, nearing her 80th birthday, discusses the evolving perception of sex after 50, noting that sexual activity in later years is becoming more common and accepted.
• 💬 Her book, "Sex After 50," addresses common questions about relationships and specific sexual issues, emphasizing that vocabulary around sex has changed due to media influence.
• ⚠️ A key message is that men and women need to understand that physical stimulation may become necessary for erections in older men, and lubricants are important for women experiencing painful intercourse due to menopause.

Understanding Female Sexual Dysfunction (FSD)

• 🎯 Sue Goldstein, co-author of "When Sex Isn't Good," highlights common FSD complaints: low sexual interest and lack of sexual fulfillment or orgasm.
• 🔬 Dr. Irwin Goldstein, a sexual medicine expert, identifies low sexual desire (HSDD) and painful sex as the most frequent issues, followed by difficulty achieving orgasm.
• 💊 For orgasmic difficulties, treatments can include androgens, dopamine agonists like bupropion, and alpha-2 receptor blockers such as yohimbine.
• 💡 Sue Goldstein shares her personal experience with FSD, emphasizing the importance of recognizing biological changes and seeking help, leading to a fulfilling sex life after treatment.

Biological and Psychological Factors in Sexual Health

• 🧠 Dr. Goldstein explains that sexual dysfunction can stem from both biological and psychological factors, with the biological often being the primary cause that leads to psychological distress.
• 💊 Medications like SSRIs (e.g., Prozac) can inhibit sexual activity by increasing serotonin levels, while other drugs can interfere with libido and blood flow.
• ⚖️ For couples facing sexual issues, a joint evaluation is recommended to address both partners' concerns, whether it's erectile dysfunction, premature ejaculation, or differing libidos.

Emerging Treatments and Future Directions

• 🚀 A new drug, flibanserin, is being developed to treat low sexual desire in premenopausal women by acting on the central nervous system to balance neurotransmitters like serotonin, dopamine, and norepinephrine.
• 💡 Persistent Sexual Arousal Syndrome (PSAS) is discussed as a condition of constant biological arousal without desire, treated through various methods including addressing physical causes, medication adjustments, and sometimes experimental treatments like dopamine receptor blockers (Chantix) or opioid receptor blockers (Ultram).
• 📈 Thyroid imbalances (hypo- and hyperthyroidism) can significantly impact sexual interest and function, and correcting these can restore sexual health.
• ❤️ Oxytocin, administered nasally, is being explored as a novel treatment to help individuals achieve orgasm, particularly those with anorgasmia.
• 💬 Open communication between partners and seeking professional help from sexual medicine specialists are crucial for addressing sexual health concerns effectively.