Q&A With Dr. Laurie: Aging & Sexuality

Lively libido at 80 Q: I have recently undergone a change of what I surmise is a change in my hormonal status. Considering my particular situation (I am near 80 y.o. , and have had a mild case of chronic Lymphocytic leukemia for more than 4 years and in a W&W status, and not having any medical treatment yet). Otherwise, I am in pretty good shape, my only symptom that I tire much quicker than before, so upon one of my periodic blood tests, I was told that my testosterone levels are below a 250 ml level but that it may be due to my age, along with the tiredness. I was told to concentrate on foods and beverage that may help increase testosterone content. The result is that my libido has increased in recent months, and I am certainly not complaining, but I would like to know if this is normal and not harmful. A: As an 80-year-old, it is perfectly normal that your testosterone levels have dropped and that you are experiencing more fatigue than in your younger years. Taking good care of yourself physically by exercising an eating well will increase your stamina, including your libido. A healthy libido is never “harmful”. People can and should continue sexual stimulation throughout the life cycle. In fact, it’s important to keep the blood flowing to your genitals to keep your penis healthy. Sexual dreams Q: I am a 68-year-old man. About 3 years ago I was put on a testosterone med Androgel). Since that time, two to three nights a week I have dreams of my wife having sex with other men (some we know). The sex is terrific, everything from oral to having sex in cars, hotels etc. When I have these dreams I usually wake up with terrific erections and sometime during the day we will have sex. I have tried talking to my wife about them but I cannot tell her everything that happens in them—in the dreams she is really having a good time. I have talked to my doctor about them and he asked if there was violence in them—there is none, just really good sex. He said to enjoy them. We are pretty active people and the testosterone med has worked wonders—I have a better libido and lots more energy. Can you explain these dreams? Is there a good way I can talk to my wife about them without me getting so embarrassed? I should point out that we have been married 47 years. THANKS! A: Your sexual dreams are perfectly normal and probably have been triggered by your increase in testosterone. Enjoy them, but don’t feel like you need to share them with your wife, who may not be comfortable hearing about them. Fantasies are personal, and if they help you get aroused, then that’s great. Sometimes sharing fantasies can be quite arousing as well, but both partners have to be into sharing and hearing. Erectile Dysfunction Q: I am 54 years old. For the past few years, I have been experiencing ED, flaccid penis, no erections at all. Have tried several drugs offered by many companies which included several supplements but no results till date. Have you any remedy to gain back my erections? Any effective remedy please. Thanks so much. A: Before a solution can be offered to you, we need to know the cause of your erectile dysfunction. Are you diabetic? Do you take any medication? How are your testosterone levels? How is your blood pressure? What about your cholesterol? Are you overweight? These and many more questions need to be answered. It is very important for any man who experiences consistent ED to consult with a medical doctor to see what is going on. Your doctor may send you to a specialist like a urologist to have a better look at the inside of your penis. The problem, given your age, could be a blood flow one, and thus it would be very important to check this as it may indicate a problem in some other area of your body like your other arteries. Please see your doctor. Sex with Multiple Sclerosis Q: I am still a virgin at 61 years old and I’m very horny. Everything works fine, but I have MS. I am one of the lucky ones, I’ve had MS since I was 17, and it’s still going okay. Do you think I could catch too many germs from sex and cause a flare-up of my MS? A: Is it your MS that has stopped you from seeking out a romantic/sexual partner? Even people with chronic conditions can have healthy sexuality—they just have to learn to adapt to the specific challenges that MS poses, like discomfort, loss of sensation, unpleasant feelings in the genitals or other parts of our body. Muscle spasms, impaired leg and/or arm function may also make sex less enjoyable and more laborious. There may be psychological factors that are stopping you from going ahead and finding a partner, like feeling unattractive, depression, worry and anxiety, and fears that sex will worsen the condition. If you want to have good sex it’s important to be able to have good communication. Be honest and share your feelings. Tell your partner what feels good and what doesn’t. You will also have to move past your comfort zone. Some other factors to consider if you are to maintain an active sex life include: Planning (vs. spontaneous) sexual activity (your best time of day, after a hot relaxing bath) Take pain medication prior Explore alternative positions Develop other forms of sexuality (outercourse: sensual massage, naked cuddling, kissing, manual stimulation) Masturbation Do Kegel exercises Use assistive devices (sex toys)