Sexuality

What are the different options of penile implants?

DEAR DOCTOR K: Can you discuss penile implants? I haven't had success with other treatments for erectile dysfunction.

DEAR READER: Medications, injectable drugs and devices such as vacuum pumps can effectively help most men who cannot get or maintain an erection. In particular, the three different pills for erectile dysfunction (ED) are effective about 70 percent of the time. Have you talked with your doctor about increasing the dose of the medicines you have taken? And has your doctor done tests to determine the cause of your erectile dysfunction?

I’m a woman in my 50s with a diminishing sex drive — what could be the cause?

DEAR DOCTOR K: I'm a woman in my 50s. I've always had a healthy sex drive, but lately it's gone bye-bye. What could be wrong?

DEAR READER: There aren't a lot of people with a take-it-or-leave-it attitude about sex. We are sexual creatures, and for most of our lives, we are well aware of having sexual desire. So when you notice that it's just not there, it is upsetting.

Which age-related sexual changes in men are normal?

DEAR DOCTOR K: I'm a man in my 70s. I still enjoy sex, but it's different than when I was younger. What changes are normal?

DEAR READER: As a man in the last half of his life, I would like to be able to tell you that nothing changes. However, even in healthy men, sexuality changes over time.

Questions and answers about low testosterone

The following Q&A is excerpted from “Testosterone for Life,” written by my colleague Abraham Morgentaler, M.D., and published by Harvard Medical School. For more on low testosterone, read my column from October 10, 2012, “Could I have low testosterone?“ Q. Is it true that if a person has a normal sex drive, then he must have […]

Can I do anything about painful sex after menopause?

DEAR DOCTOR K: Ever since I went through menopause, sex has become painful. My doctor says this is because of vaginal atrophy. Is there anything I can do?

DEAR READER: Pain that occurs before, during or after sex is a common problem for many women following menopause. Most often, the cause is vaginal atrophy, but there are other causes, too. The pain can range from mild to excruciating.

Can lifestyle changes help with erectile dysfunction?

DEAR DOCTOR K: I'm a man in my mid-60s. Lately I've been unable to perform sexually. Are there non-drug strategies I can try before turning to medication?

DEAR READER: Even if you'd prefer to handle this drug-free, start with a trip to your doctor. There may be a straightforward explanation for your erectile dysfunction (ED), such as a side effect of medication. If this is the case, maybe the drug can be discontinued or a new one substituted that is less likely to produce ED.

Do older adults need to practice safe sex?

DEAR DOCTOR K: I'm a single, postmenopausal woman in my 50s. Do I still need to worry about "safe" sex?

DEAR READER: I'm surprised by how often my patients ask me the same question. "Safe" sex means using what doctors call "barrier protection" — male or female condoms. It is true that menopause brings freedom from worries about pregnancy (if your doctor is sure you have entered menopause). But menopause doesn't change at all your need to practice safe sex. That's particularly true if you're entering into a new relationship or have multiple sexual partners.