logging in or signing up sexuality WoodRock Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 2492 Category: News & Reports.. License: All Rights Reserved Like it (1) Dislike it (0) Added: August 11, 2007 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Geriatric Sexuality: Geriatric Sexuality Older people were young once too! Outline: Outline Myths and expectations research- old and new what changes as we age film break!! Talking to older patients about sexuality specific topics The writer’s view: The writer’s view 'Wives are young men’s mistresses, companions for middle age and old men’s nurses.' Francis Bacon 'Sexuality in the elderly is a ‘dark continent’ that most people, including physicians, prefer not to think about.' J. LoPiccolo The writer’s view...: The writer’s view... 'Forty years of romance makes a woman look like a ruin, 40 years of marriage makes a woman look like a public building.' Oscar Wilde 'These people are just happy to be alive.' Anon What is sexuality?: What is sexuality? 'too often sexuality is equated with the ability to have or the frequency of intercourse' 'sexuality encompasses self, interactions with others, and many levels of expression and affection' What do you think of when you think of elderly & sex?: What do you think of when you think of elderly andamp; sex? ??? Beliefs about sex & aging: Beliefs about sex andamp; aging Current elderly were ‘Victorians’ when young sexual desire goes with age older women who enjoy sex were ‘nymphomaniacs’ when younger the ‘dirty old man’ elderly are not 'desirable, desirous, capable' More mythology & viewpoints...: More mythology andamp; viewpoints... Physiological changes = sexual dysfunction 'cute', 'disgusting', 'troublesome' physical illness obviates sex andamp; sexuality Viagra leads to divorces! How do older people view sexuality?: How do older people view sexuality? 'I was told nothing until my wedding night and my husband explained it.. For two solid weeks I was in a state of shock.' despite initial naivete women describe good early attitudes towards sex minimal change in attitude with aging Talking with older women...: Talking with older women... 'The longer you live you start to realize …life is too short… and sex is probably one of the last things to go.' 'You are always a sexual being, until you die.' 'You know, just because we are old doesn’t mean that when I see a nice grey-haired older man.. I take another look.' Apart from myths, what are other barriers: Apart from myths, what are other barriers Physiological changes lack of privacy illness andamp; impotence lack of a partner negative attitudes from staff andamp; physicians feeling of unattractiveness guilt andamp; 'widow’s syndrome Thinking about barriers: Thinking about barriers 'My husband got used to me after 50 years… if I was to start up with a new man now…if we could do it in the dark with our clothes on…' 'There are no single guys out there…not at our age.' Why do older people stop having sex?: Why do older people stop having sex? For the same reasons they stop riding a bicycle fear of falling off (ill health) afraid of looking ridiculous lack of a bicycle What research tells us...: What research tells us... The Kinsey report: general decline interest andamp; activity Mandamp;J: 'sharp decline in interest after age 60' other generally gloomy results Newer results...: Newer results... The Starr-Weiner report: 97% liked sex 91% approved of unmarried/widowed aged having sex quality more important than frequency! Women in survey had intercourse 1.4/week Even educated fleas do it...: Even educated fleas do it... Large proportion of seniors sexually active: 54% of married men andamp; women 65% of women over age 70 Netherlands: 34 % of women surveyed enjoy sexual activity most of time Vs. 70% of premenopausal women Defining sexuality more clearly than Clinton: Defining sexuality more clearly than Clinton Women age 80-102: 25% had regular partner touching and caressing 64% masturbation 40% intercourse 30% activities often dependent on older partner Physiology & the pleasure principle: Physiology andamp; the pleasure principle Women: reduced size of vagina andamp; vulva decreased vascularity andamp; secretions thinner, more lax vaginal walls atrophic vaginitis common libido declines but rarely disappears What problems may women report: What problems may women report 43% of older Swedes reported vaginal dryness 10% vaginal burning urinary incontinence may occur dyspareunia decreased orgasm (30%) How does the sexual cycle change?: How does the sexual cycle change? Excitement! Decreased vasocongestion, lubrication, delayed arousal Plateau: expansion of vaginal ‘barrel’, orgasmic platform, clitoral retraction Cycle changes...: Cycle changes... Orgasm: shorter andamp; fewer contractions may be painful Resolution: more rapid reversion to pre-arousal state What changes for men?: What changes for men? Changed libido erectile function increased need for stimulation inadequate rigidity associated with risk factors decreased ejaculatory demand decreased ejaculatory power prolonged refractory stage (up to one week) Talking to your granny about SEX!: Talking to your granny about SEX! Important indicator of comorbidities if done appropriately, not offensive 91% over age 65 felt history-taking was appropriate remember that identification andamp; education very successful sexual abuse can still occur Hearing from the AARP’s: Hearing from the AARP’s Health-providers should help us feel comfortable talking about sex: don’t be afraid or embarrassed help us 'break the ice' offer permission to express feelings andamp; needs Suggestions to help talking about it: Suggestions to help talking about it … be open-minded and concerned: don’t assume there are no concerns ask direct questions about activity andamp; attitudes answer honestly don’t evade sexual concerns More from the AARP...: More from the AARP... …should treat older adults with respectful andamp; non-judgemental attitude see us as individuals with sexual needs accept us: gay, straight, bisexual …can provide advice andamp; suggestions: What did Kingston women have to say?: What did Kingston women have to say? 'So, how’s your sex life?' not a great line valid question if an explanation is given would talk to their MD if something specifically wrong layman’s terms, avoid making patient feel complaint insignificant Getting better informed about specific topics: Getting better informed about specific topics Menopause Viagra dementia sexual abuse chronic illnesses The myth of male menopause?: The myth of male menopause? Controversial but trendy! ?aging associated with lower sex steroid levels levels of binding globulin increases pituitary and testicular causes less dramatic andamp; less rapid than with women What might it mean?: What might it mean? Minimal change on reproductive function testosterone likely plays smaller role than other factors many men try androgens to help dysfunction frailty: osteoporosis, decreased muscle mass If it works for young men can it work for older men?: If it works for young men can it work for older men? Testosterone given IM to 13 men 57-76 years old with low serum testosterone increased lean body mass but no change in % body fat, grip strength, bone parameters increased PSA less clear benefit than in younger men How to answer patients’ questions?: How to answer patients’ questions? Consider screen for testosterone,highest level in AM if low, check FSH, LH, prolactin could consider Tx for libido problems not likely great for lost vigor and soft body! Tx options they might read about on the Internet?: Tx options they might read about on the Internet? Oral testosterone- serious hepatotoxicity parenteral- may cause fluctuation in levels transdermal- scrotal or non-scrotal more physiological levels scrotal patch causes high DHT If it’s not too effective, is it safe?: If it’s not too effective, is it safe? Weight gain, gynecomastia, sleep apnea MI, stroke altered lipids, ? Polycythemia prostate cancer? Menopause: just a few controversies: Menopause: just a few controversies Treatments: ERT education of woman andamp; partner ?testosterone lubricants education about male partner’s aging changes Viagra: an interesting sociological study: Viagra: an interesting sociological study Just a bit of hype Pfizer stock is a star! US army spending $$$ on it Listening to Viagra: Listening to Viagra 'Dr. Ian Osterloh may be one of the most important men in American history, if not world history' Viagra: medical information: Viagra: medical information Serendipitous discovery inhibits phosphodiesterase elevates serum levels of cyclic guanosine monophosphate effect is on erectile dysfunction not libido How to use it?: How to use it? Buy in the USA at @ $10 per pill taken orally 50 mg 1 hour before planned intercourse achieve erections in up to 85% of men be aware of safety concerns- good assessment of comorbidities Who to be cautious with: Who to be cautious with Active coronary ischemia active CHF hypotension/hypertension liver/renal failure interacts with cimetidine, erythromycin by August; 69 deaths of men using Viagra 12 had taken nitrates You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
sexuality WoodRock Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 2492 Category: News & Reports.. License: All Rights Reserved Like it (1) Dislike it (0) Added: August 11, 2007 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Geriatric Sexuality: Geriatric Sexuality Older people were young once too! Outline: Outline Myths and expectations research- old and new what changes as we age film break!! Talking to older patients about sexuality specific topics The writer’s view: The writer’s view 'Wives are young men’s mistresses, companions for middle age and old men’s nurses.' Francis Bacon 'Sexuality in the elderly is a ‘dark continent’ that most people, including physicians, prefer not to think about.' J. LoPiccolo The writer’s view...: The writer’s view... 'Forty years of romance makes a woman look like a ruin, 40 years of marriage makes a woman look like a public building.' Oscar Wilde 'These people are just happy to be alive.' Anon What is sexuality?: What is sexuality? 'too often sexuality is equated with the ability to have or the frequency of intercourse' 'sexuality encompasses self, interactions with others, and many levels of expression and affection' What do you think of when you think of elderly & sex?: What do you think of when you think of elderly andamp; sex? ??? Beliefs about sex & aging: Beliefs about sex andamp; aging Current elderly were ‘Victorians’ when young sexual desire goes with age older women who enjoy sex were ‘nymphomaniacs’ when younger the ‘dirty old man’ elderly are not 'desirable, desirous, capable' More mythology & viewpoints...: More mythology andamp; viewpoints... Physiological changes = sexual dysfunction 'cute', 'disgusting', 'troublesome' physical illness obviates sex andamp; sexuality Viagra leads to divorces! How do older people view sexuality?: How do older people view sexuality? 'I was told nothing until my wedding night and my husband explained it.. For two solid weeks I was in a state of shock.' despite initial naivete women describe good early attitudes towards sex minimal change in attitude with aging Talking with older women...: Talking with older women... 'The longer you live you start to realize …life is too short… and sex is probably one of the last things to go.' 'You are always a sexual being, until you die.' 'You know, just because we are old doesn’t mean that when I see a nice grey-haired older man.. I take another look.' Apart from myths, what are other barriers: Apart from myths, what are other barriers Physiological changes lack of privacy illness andamp; impotence lack of a partner negative attitudes from staff andamp; physicians feeling of unattractiveness guilt andamp; 'widow’s syndrome Thinking about barriers: Thinking about barriers 'My husband got used to me after 50 years… if I was to start up with a new man now…if we could do it in the dark with our clothes on…' 'There are no single guys out there…not at our age.' Why do older people stop having sex?: Why do older people stop having sex? For the same reasons they stop riding a bicycle fear of falling off (ill health) afraid of looking ridiculous lack of a bicycle What research tells us...: What research tells us... The Kinsey report: general decline interest andamp; activity Mandamp;J: 'sharp decline in interest after age 60' other generally gloomy results Newer results...: Newer results... The Starr-Weiner report: 97% liked sex 91% approved of unmarried/widowed aged having sex quality more important than frequency! Women in survey had intercourse 1.4/week Even educated fleas do it...: Even educated fleas do it... Large proportion of seniors sexually active: 54% of married men andamp; women 65% of women over age 70 Netherlands: 34 % of women surveyed enjoy sexual activity most of time Vs. 70% of premenopausal women Defining sexuality more clearly than Clinton: Defining sexuality more clearly than Clinton Women age 80-102: 25% had regular partner touching and caressing 64% masturbation 40% intercourse 30% activities often dependent on older partner Physiology & the pleasure principle: Physiology andamp; the pleasure principle Women: reduced size of vagina andamp; vulva decreased vascularity andamp; secretions thinner, more lax vaginal walls atrophic vaginitis common libido declines but rarely disappears What problems may women report: What problems may women report 43% of older Swedes reported vaginal dryness 10% vaginal burning urinary incontinence may occur dyspareunia decreased orgasm (30%) How does the sexual cycle change?: How does the sexual cycle change? Excitement! Decreased vasocongestion, lubrication, delayed arousal Plateau: expansion of vaginal ‘barrel’, orgasmic platform, clitoral retraction Cycle changes...: Cycle changes... Orgasm: shorter andamp; fewer contractions may be painful Resolution: more rapid reversion to pre-arousal state What changes for men?: What changes for men? Changed libido erectile function increased need for stimulation inadequate rigidity associated with risk factors decreased ejaculatory demand decreased ejaculatory power prolonged refractory stage (up to one week) Talking to your granny about SEX!: Talking to your granny about SEX! Important indicator of comorbidities if done appropriately, not offensive 91% over age 65 felt history-taking was appropriate remember that identification andamp; education very successful sexual abuse can still occur Hearing from the AARP’s: Hearing from the AARP’s Health-providers should help us feel comfortable talking about sex: don’t be afraid or embarrassed help us 'break the ice' offer permission to express feelings andamp; needs Suggestions to help talking about it: Suggestions to help talking about it … be open-minded and concerned: don’t assume there are no concerns ask direct questions about activity andamp; attitudes answer honestly don’t evade sexual concerns More from the AARP...: More from the AARP... …should treat older adults with respectful andamp; non-judgemental attitude see us as individuals with sexual needs accept us: gay, straight, bisexual …can provide advice andamp; suggestions: What did Kingston women have to say?: What did Kingston women have to say? 'So, how’s your sex life?' not a great line valid question if an explanation is given would talk to their MD if something specifically wrong layman’s terms, avoid making patient feel complaint insignificant Getting better informed about specific topics: Getting better informed about specific topics Menopause Viagra dementia sexual abuse chronic illnesses The myth of male menopause?: The myth of male menopause? Controversial but trendy! ?aging associated with lower sex steroid levels levels of binding globulin increases pituitary and testicular causes less dramatic andamp; less rapid than with women What might it mean?: What might it mean? Minimal change on reproductive function testosterone likely plays smaller role than other factors many men try androgens to help dysfunction frailty: osteoporosis, decreased muscle mass If it works for young men can it work for older men?: If it works for young men can it work for older men? Testosterone given IM to 13 men 57-76 years old with low serum testosterone increased lean body mass but no change in % body fat, grip strength, bone parameters increased PSA less clear benefit than in younger men How to answer patients’ questions?: How to answer patients’ questions? Consider screen for testosterone,highest level in AM if low, check FSH, LH, prolactin could consider Tx for libido problems not likely great for lost vigor and soft body! Tx options they might read about on the Internet?: Tx options they might read about on the Internet? Oral testosterone- serious hepatotoxicity parenteral- may cause fluctuation in levels transdermal- scrotal or non-scrotal more physiological levels scrotal patch causes high DHT If it’s not too effective, is it safe?: If it’s not too effective, is it safe? Weight gain, gynecomastia, sleep apnea MI, stroke altered lipids, ? Polycythemia prostate cancer? Menopause: just a few controversies: Menopause: just a few controversies Treatments: ERT education of woman andamp; partner ?testosterone lubricants education about male partner’s aging changes Viagra: an interesting sociological study: Viagra: an interesting sociological study Just a bit of hype Pfizer stock is a star! US army spending $$$ on it Listening to Viagra: Listening to Viagra 'Dr. Ian Osterloh may be one of the most important men in American history, if not world history' Viagra: medical information: Viagra: medical information Serendipitous discovery inhibits phosphodiesterase elevates serum levels of cyclic guanosine monophosphate effect is on erectile dysfunction not libido How to use it?: How to use it? Buy in the USA at @ $10 per pill taken orally 50 mg 1 hour before planned intercourse achieve erections in up to 85% of men be aware of safety concerns- good assessment of comorbidities Who to be cautious with: Who to be cautious with Active coronary ischemia active CHF hypotension/hypertension liver/renal failure interacts with cimetidine, erythromycin by August; 69 deaths of men using Viagra 12 had taken nitrates