The Hormone Equation

His Symptoms The ability to concentrate and plan is altered by dropping testosterone levels, says Dr. Jack Barkin, a Toronto urologist, and visual stimuli may be less effective: "Looking at a sexy picture may not stimulate a sex response anymore." Sexual function is also more strongly affected now by psychological stress. And because after age 50 testosterone levels decline by one per cent a year, this also causes decreased desire, a reduction in muscle mass and an increase in body fat. Erections take longer and are less rigid. (Ejaculation may take longer, too, which can be fun.) Erections may come and go several times during sexual activity.

The Solution Play along. "Penis-in-vagina intercourse doesn't have to be the be-all and end-all," Paulsen says. "Sex can mean whatever the couple wants it to mean, as long as they're both comfortable and willing." For men who are having trouble getting erections, possible therapies include PDE5 inhibitors (Viagra and friends), injections or vacuum devices. Try talking to your family doctor or urologist. "Men still don't want to talk about their problems, even though we [doctors] can help them and they want help," says Barkin. "We can't reverse the aging process but we can definitely provide options, whether they be medical, physical or emotional, to help them have a satisfying sexual activity."

Her Symptoms Estrogen production drops off at menopause. Vaginal tissues become thinner and more easily irritated and produce less lubrication. The vagina becomes less expandable. Although sexual desire is influenced by multiple factors, there's also a natural decline from aging and menopause, says Dr. Wendy Wolfman, director of the Menopause Clinic at Mount Sinai Hospital in Toronto. (Drugs to address this are currently in trials.)

The Solution Make up the estrogen you've lost. "It can restore some of the moisture and elasticity," says Wolfman. "Since the vagina is exquisitely sensitive to estrogen, it will respond to safe, local low-dose estrogen therapy via a low-dose tablet, cream or ring—or when systemic estrogens via pills, gels or patches are used." Help your skin by wearing breathable cotton underwear (go commando at night) and wash both your undies and your lady parts with mild, fragrance-free soap. Vaginal gels containing hyaluronic acid can help with dryness. Some women use coconut oil or even Crisco shortening. For sex, learn to love lube. (Lubricant will also protect your condom from breaking—you are using condoms to prevent STIs, right?)

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