Does Sexuality Have a Time Limit

Using the assigned readings and information from the literature, compose a response to the following:

The question ‘Does sexuality have a time limit?’ is addressed in the following article.

Katz, A. (2012). Sex, health and aging. Nursing for Women’s Health, 15(6), 519-521.

After reading the article by Katz, initiate a discussion that addresses reproductive health across the life span. Describe what impact, if any, age, economics, health and lifestyle, society and culture may have on a person’s perception of their own sexuality. How do these factors affect your role as a registered nurse working in a family health clinic?

assigned reading:
Sex, Health and Aging
What Women Need to Know
ANNE KATZ, PhD, RN
Is there a time limit on sexuality? Do we ever
get too old to have sex or to be seen by our-
selves and others as sexual beings? In part this
depends on perspective; society and individuals
have diff
ering attitudes on this topic. If you be-
lieve what the media presents, then sex is for the
young and “sexy”; older adults, especially the
very old (age 75 and above), are not portrayed
as sexual beings at all. Many of us may hold the
same attitudes; just think for a moment about
your own parents having an active and satisfy-
ing sex life and most of us will fi
nd our faces
crinkling in horror at worst or confusion at best.
Gender Differences
But what do we really know about sexuality in
the very old? Lindau and Gavrilova (2010) ana-
lyzed data from 3,005 adults ages 57 to 85 in
the National Social life, Health and Aging Proj-
ect (NSHAP); this included 1,550 women and
1,455 men from the later life cohort (ages 75 to
85). Th
ey found that older adults remain sexu-
ally active and happy well into older adulthood;
however, gender diff
erences increased with age
At 75
Anne Katz, PhD, RN, is
a clinical nurse specialist
and sexuality counselor
at the Prostate Centre of
CancerCare in Winnipeg,
Manitoba, and she is
the editor of
Nursing for
Wo m e n’s H e a l t h
. Address
correspondence to: anne.
katz@cancercare.mb.ca.
DOI: 10.1111/j.1751-486X.2011.01683.x
520
Nursing for Women’s Health
Volume 15 Issue 6
and were most pronounced in those ages 75 to
85. In this group, more men were sexually ac-
tive than women (38.9 percent vs. 16.8 percent)
and of those men and women who were sexu-
ally active, men reported greater quality of sex
life (70.8 percent) than women (50.9 percent).
Men tend to die earlier than their female part-
ners, so there are oft
en more women than men
in this age group. Th
is allows for men to have
more freedom in choosing a new partner, and
men also have the added advantage of being
able to date younger women. Women were less
likely to be interested in sex (11.4 percent) than
men (41.2 percent). Th
is may be, in part, adap-
tive—if you don’t have a partner or your partner
is not physically able to be sexual, then perhaps
you stop thinking about it and/or stop wanting
to be sexual.
Presence or Absence
of a Partner
When we look at women in this older age group,
38.5 percent are living with a partner; this is a
major contributor to continued sexual activity
in old age (DeLameter & Sill, 2005). For women,
the absence or ill health of a partner has a direct
eff
ect on sexuality. For those living with a part-
ner, 41 percent report sexual activity in the past
12 months; this drops to under 2 percent for
women who do not live with a partner. And the
absence of a partner leads to a decrease in inter-
est in sex (7 percent) from 18 percent for those
who have a partner.
Physical Changes
What else infl
uences sexuality in older women?
We know that many older women experience
pain with sexual intercourse; this is almost al-
ways associated with urogenital atrophy (Lindau
et al., 2007) and leads to decreased sexual satis-
faction (Carpenter, Nathanson, & Kim, 2009).
We do know that good health is associated with
sexual activity and satisfaction.
Tools for Providers
We know little about the eff
ects of illness and
medications on older women because there
seems to be little impetus (or funding) to ex-
plore this. And health care providers are oft
en
reluctant to explore sexual issues with their pa-
tients, particularly if they are elderly (Yee, 2010).
Many common medical conditions (diabetes,
cardiovascular disease, obesity) are associated
with sexual problems (Camacho & Reyes-Ortiz,
2005), but ongoing chronic disease management
aff
ords health care providers multiple opportu-
nities to assess sexual functioning. Examples of
questions to assess this important aspect of life
are included in Box 1. Another way of assessing
sexual functioning is to follow the four steps of
the PLISSIT model (Annon, 1974) that are pre-
sented with examples in Box 2.
Conclusion
Sexual functioning for women over the age
of 75 can be seen in either a positive or nega-
tive light. For some readers, these statistics may
point to the end of sex for older women, while
for others, it may off
er great hope. Up to half
(39.1 percent to 53.4 percent) of the partnered
women in Lindau’s study were sexually active in
the past year and an average of 22.9 percent of
them were having sex once a week or more. Sev-
enty-eight percent of these women report high-
quality sex lives and the same proportion report positive emotional quality of their sex lives. Th
at
is good news indeed!
So a woman’s sex life does not have to end in
old age. Th
is is in part up to her, but also in large
part related to her relationship status as well as
her health status. For some this will provide evi-
dence that sex is for the young and not some-
thing to be bothered with as old age approach-
es. For many of us this will provide hope that an
important and pleasurable activity will continue
for many years, bringing with it satisfaction and
joy.
NWH
Box 1.
Assessment Questions
•
How has your sexuality (body image,
sexual feelings, sexual activity)
changed as you have grown older?
•
Does this change concern you?
•
Have you tried to do anything about
it? What would you like to do about
it?
•
Have these changes made a dif-
ference in your primary or intimate
relationship?
•
How has your partner’s health
affected your sex life? Has he/she
expressed concern about this?
•
What difference has this made in the
way you think about yourself? How
about how you feel about your body?
When we look at women in this older
age group, 38.5 percent are living with
a partner; this is a major contributor to
continued sexual activity in old age
Box 2.
PLISSIT Model
Permission
All nurses should be able to function at this level.
An example of this level would be to include a general statement that normalizes the
topic, such as, “As women age, they often experience changes in sexual functioning and
feelings. Is this something that you have noticed as you have aged?”
Limited Information
Most nurses should be able to give this kind of information.
Example: “Vaginal dryness can cause pain with sexual touch and intercourse. There are
some strategies that can help with this.”
Specifi
c Suggestion
This level of the model requires a deeper level of expertise on the part of the nurse. Infor-
mation at this level often includes anticipatory guidance related to possible sexual conse-
quences of medications and other treatments.
Example: “Antidepressants such as the one prescribed for you are known to cause some
problems with sexual functioning. In particular, they interfere with ability to have an
orgasm.”
Intensive Therapy
This level of the model usually requires a referral to a sex therapist or specially trained
counselor. Nurses should know where to refer patients when problems or issues are dis-
closed that are beyond the scope of practice or expertise of the nurse.
Example: “It sounds like things have really changed for you since your husband’s diagno-
sis with Alzheimer disease. We have a social worker who can provide you with more infor-
mation and support; would you like me to make an appointment for you to see her?
At 75
December 2011
|
January 2012
Nursing for Women’s Health
521
sexual satisfaction in midlife.
Archives of Sexual
Behavior, 38
, 87–107.
DeLameter, J., & Sill, M. (2005). Sexual desire
in later life.
Journal of Sex Research, 42
(2),
138–149.
Lindau, S., & Gavrilova, N. (2010). Sex, health, and
years of sexually active life gained due to good
health: evidence from two US population based
cross sectional surveys of ageing.
British Medical
Journal, 340
, c810. doi:10.1136/bmj.c810
Lindau, S., Schumm, P., Laumann, E., Levinson,
W., O’Muircheartaigh, C., & Waite, L. (2007).
A national study of sexuality and health among
older adults in the US.
New England Journal of
Medicine, 357
, 22–34.
Yee, L. (2010). Aging and sexuality.
Australian
Family Physician, 49
(10), 718–721.
positive emotional quality of their sex lives. Th
at
is good news indeed!
So a woman’s sex life does not have to end in
old age. Th
is is in part up to her, but also in large
part related to her relationship status as well as
her health status. For some this will provide evi-
dence that sex is for the young and not some-
thing to be bothered with as old age approach-
es. For many of us this will provide hope that an
important and pleasurable activity will continue
for many years, bringing with it satisfaction and
joy.
NWH
References
Annon, J. (1974).
The behavioral treatment of
sexual problems
. Honolulu: Enabling Systems.
Camacho, M., & Reyes-Ortiz, C. (2005). Sexual
dysfunction in the elderly: Age or disease?
International Journal of Impotence Research, 17
,
S52–S56.
Carpenter, L., Nathanson, C., & Kim, Y. (2009).
Physical women, emotional men: Gender and
Box 2.
PLISSIT Model
Permission
All nurses should be able to function at this level.
An example of this level would be to include a general statement that normalizes the
topic, such as, “As women age, they often experience changes in sexual functioning and
feelings. Is this something that you have noticed as you have aged?”
Limited Information
Most nurses should be able to give this kind of information.
Example: “Vaginal dryness can cause pain with sexual touch and intercourse. There are
some strategies that can help with this.”
Specifi
c Suggestion
This level of the model requires a deeper level of expertise on the part of the nurse. Infor-
mation at this level often includes anticipatory guidance related to possible sexual conse-
quences of medications and other treatments.
Example: “Antidepressants such as the one prescribed for you are known to cause some
problems with sexual functioning. In particular, they interfere with ability to have an
orgasm.”
Intensive Therapy
This level of the model usually requires a referral to a sex therapist or specially trained
counselor. Nurses should know where to refer patients when problems or issues are dis-
closed that are beyond the scope of practice or expertise of the nurse.
Example: “It sounds like things have really changed for you since your husband’s diagno-
sis with Alzheimer disease. We have a social worker who can provide you with more infor-
mation and support; would you like me to make an appointment for you to see her?”
At 75
December 2011
|
January 2012
Nursing for Women’s Health
521
sexual satisfaction in midlife.
Archives of Sexual
Behavior, 38
, 87–107.
DeLameter, J., & Sill, M. (2005). Sexual desire
in later life.
Journal of Sex Research, 42
(2),
138–149.
Lindau, S., & Gavrilova, N. (2010). Sex, health, and
years of sexually active life gained due to good
health: evidence from two US population based
cross sectional surveys of ageing.
British Medical
Journal, 340
, c810. doi:10.1136/bmj.c810
Lindau, S., Schumm, P., Laumann, E., Levinson,
W., O’Muircheartaigh, C., & Waite, L. (2007).
A national study of sexuality and health among
older adults in the US.
New England Journal of
Medicine, 357
, 22–34.
Yee, L. (2010). Aging and sexuality.
Australian
Family Physician, 49
(10), 718–721.
positive emotional quality of their sex lives. Th
at
is good news indeed!
So a woman’s sex life does not have to end in
old age. Th
is is in part up to her, but also in large
part related to her relationship status as well as
her health status. For some this will provide evi-
dence that sex is for the young and not some-
thing to be bothered with as old age approach-
es. For many of us this will provide hope that an
important and pleasurable activity will continue
for many years, bringing with it satisfaction and
joy.
NWH
References
Annon, J. (1974).
The behavioral treatment of
sexual problems
. Honolulu: Enabling Systems.
Camacho, M., & Reyes-Ortiz, C. (2005). Sexual
dysfunction in the elderly: Age or disease?
International Journal of Impotence Research, 17
,
S52–S56.
Carpenter, L., Nathanson, C., & Kim, Y. (2009).
Physical women, emotional men: Gender and
Box 2.
PLISSIT Model
Permission
All nurses should be able to function at this level.
An example of this level would be to include a general statement that normalizes the
topic, such as, “As women age, they often experience changes in sexual functioning and
feelings. Is this something that you have noticed as you have aged?”
Limited Information
Most nurses should be able to give this kind of information.
Example: “Vaginal dryness can cause pain with sexual touch and intercourse. There are
some strategies that can help with this.”
Specifi
c Suggestion
This level of the model requires a deeper level of expertise on the part of the nurse. Infor-
mation at this level often includes anticipatory guidance related to possible sexual conse-
quences of medications and other treatments.
Example: “Antidepressants such as the one prescribed for you are known to cause some
problems with sexual functioning. In particular, they interfere with ability to have an
orgasm.”
Intensive Therapy
This level of the model usually requires a referral to a sex therapist or specially trained
counselor. Nurses should know where to refer patients when problems or issues are dis-
closed that are beyond the scope of practice or expertise of the nurse.
Example: “It sounds like things have really changed for you since your husband’s diagno-
sis with Alzheimer disease. We have a social worker who can provide you with more infor-
mation and support; would you like me to make an appointment for you to see her?