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What Causes Sexual Problems?

Some illnesses, disabilities, medicines, and surgeries can affect your ability to have and enjoy sex. Problems in your relationship can also affect your ability to enjoy sex.

Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Joint replacement surgery and drugs may relieve this pain. Exercise, rest, warm baths, and changing the position or timing of sexual activity can be helpful.

Chronic pain. Any constant pain can interfere with intimacy between older people. Chronic pain does not have to be part of growing older and can often be treated. But, some pain medicines can interfere with sexual function. You should always talk with your doctor if you have unwanted side effects from any medication.

Diabetes. This is one of the illnesses that can cause ED in some men. In most cases, medical treatment can help. Less is known about how diabetes affects sexuality in older women. Women with diabetes are more likely to have vaginal yeast infections, which can cause itching and irritation and make sex uncomfortable or undesirable.

Heart disease. Narrowing and hardening of the arteries can change blood vessels so that blood does not flow freely. As a result, men and women may have problems with orgasms, and men may have trouble with erections. People who have had a heart attack, or their partners, may be afraid that having sex will cause another attack. Sexual activity is often safe. Always follow your doctor’s advice.

Incontinence. Loss of bladder control or leaking of urine is more common as we grow older, especially in women. Extra pressure on the belly during sex can cause loss of urine, which may result in some people avoiding sex. This can be helped by a change in positions. The good news is that incontinence can usually be treated.

Stroke. The ability to have sex is sometimes affected by a stroke. A change in positions or medical devices may help people with ongoing weakness or paralysis to have sex. Some people with paralysis from the waist down are still able to experience orgasm and pleasure.

Dementia. Some people with dementia show increased interest in sex and physical closeness, but they may not be able to judge what is appropriate sexual behavior. Those with severe dementia may not recognize their spouse, but still seek sexual contact. This can be a confusing problem for the spouse. A doctor, nurse, or social worker with training in dementia care may be helpful.

What Disrupts Sleep?

Many factors can prevent a good sleep. These factors range from well-known stimulants, such as coffee, to certain pain relievers, decongestants and other culprits. Many people depend on the caffeine in coffee, soft drinks (for example, colas) or tea to wake up in the morning or to stay awake. Caffeine is blocks the cell receptors that adenosine uses to trigger its sleep-inducing signals. In this way, caffeine fools the body into thinking it is not tired. It can take up to eight hours for the effects of caffeine to wear off completely. Drinking a cup of coffee in the late after­noon consequently may prevent a person from falling asleep at night.
Nicotine is another stimulant that can keep a person awake. Nicotine also leads to lighter than normal sleep. Heavy smokers also tend to wake up too early because of nicotine withdrawal. Although alco­hol is a sedative that makes it easier to fall asleep, it prevents deep sleep and REM sleep, allowing only the lighter stages of sleep. People who drink alcohol also tend to wake up in the middle of the night when the effects of an alcoholic "nightcap" wear off.
Certain common prescription and over-the-counter medicines contain ingredients that can keep people awake. Many pain relievers contain caffeine. Heart and blood pressure med­ications known as "beta blockers" can cause difficulty falling asleep and increase the number of awakenings during the night. People who have chronic asthma or bronchitis also have more problems falling asleep and staying asleep than healthy people, either because of breathing difficulties or because of medicines. Other chronic painful or uncomfortable conditions, such as arthritis, congestive heart failure and sickle cell anemia, can disrupt sleep, too.
A number of psychological disorders, including schizophrenia, bipolar disorder and anxiety disorders, disrupt­ sleep. Depression often leads to insomnia and insomnia can cause depression. Some of these psychological disorders are more likely to disrupt REM sleep. Psychological stress also takes its toll on sleep, making it more difficult to fall asleep or stay asleep. People who feel stressed also tend to spend less time in deep sleep and REM sleep. Many people report having difficulties sleeping after having recently lost a loved one, are undergoing a divorce or are under stress at work.
Menstrual cycle hormones can affect how well women sleep. Progesterone is known to induce sleep and circulates in greater concentrations in the second half of the menstrual cycle. For this reason, women may sleep better during this phase of their menstrual cycle, but many women report trouble sleeping the night before their menstrual bleeding starts. This sleep disruption probably relates to the abrupt drop in progesterone levels in the bodies just before the period begins.
Certain lifestyle factors may also deprive a person of needed sleep. Large meals or exercise just before bedtime can make it harder to fall asleep. Studies show that exercise in the evening delays the extra release of melatonin at night that helps the body fall asleep. Exercise in the daytime, on the other hand, is linked to improved nighttime sleep.
Most people report that it is easier to fall asleep after having time to wind down into a less active state before sleeping. Relaxing in a hot bath before bedtime may help a person fall asleep. Body temperature also drops after a hot bath in a way that mimics, in part, what happens as the falls asleep. Probably for both these reasons, many people report that falling asleep more easily after a hot bath.
Sleeping environment also can affect sleep. Clear the bedroom of any potential sleep distractions, such as noises, bright lights, a television or computer. Having a comfortable mattress and pillow can help promote a good sleep. People also sleep better if the temperature in the bedroom is on the cool side.