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      Seeking Medical Help for Sexual Concerns in Mid- and Later Life: A Review of the Literature

      1 , 2

      The Journal of Sex Research

      Informa UK Limited

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          Abstract

          Research consistently reports that older people tend not to seek medical help for sexual concerns or difficulties. This article reviews the literature to examine help-seeking for, and doctor-patient interactions about, sexual problems in the middle and later life age groups. Twenty-five articles from 1999 to 2010 were identified and analyzed. Significant barriers to seeking medical help included psychosocial factors relating to the patient, such as thinking that sexual changes were "normal with ageing," and also to the doctor-for example, assuming that sex was less important to older patients than it was to their younger patients. Inadequate training at medical school for health care professionals (HCPs) was also identified as a barrier. People were more likely to seek help if their doctor had asked about sexual function during a routine visit sometime during the previous three years. However, doctors tended not to take a proactive approach to sexual health management, and indeed often had limited knowledge of later-life sexuality issues. There are clear implications for sexual well-being if the doctor does not ask and the patient does not tell. Providing education about later-life sexuality for HCPs is crucial if we are to meet the needs of older patients in useful and effective ways.

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          Most cited references 62

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          Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study

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            Epidemiology of erectile dysfunction: results of the 'Cologne Male Survey'.

            The last few decades have seen a marked increase in mean life expectancy in Central Europe. This has made elderly people and their quality of life a matter of ever-increasing medical concern. Available data from the United States and Scandinavia relating to erectile dysfunction (ED) do not enable us to draw valid conclusions about the current situation in Germany. The aim of the present study was to evaluate the epidemiology of male sexuality in Germany, and the proportion of men who need medical treatment because of increased suffering from this.A newly developed and validated questionnaire on male erectile dysfunction was mailed to a representative population sample of 8000 men, 30-80 y of age in the Cologne urban district. The response included 4489 evaluable replies (56.1%). The response rates in different age groups ranged from 49.2% to 68.4%. Regular sexual activity was reported by 96.0% (youngest age group) to 71.3% (oldest group). There were 31.5%-44% of responders who were dissatisfied with their current sex life. The prevalence of ED was 19.2%, with a steep age-related increase (2.3-53.4%) and a high co-morbidity of ED with hypertension, diabetes, pelvic surgery and 'lower urinary tract symptoms'. When treatment need was defined by co-occurrence of ED and dissatisfaction with sex life, 6.9% men required treatment for ED. Oral treatment of ED was preferred by 73.8% of respondents. There were 46.2% respondents who were willing to contribute more than DM 50 (25 Euro) per month for ED treatment. We conclude that regular sexual activity is a normal finding in advanced age. ED is a frequent disorder, contributing to dissatisfaction with sex life in a considerable proportion of men. The high burden of ED is reflected in willingness to pay for treatment. ED is frequently associated with chronic diseases. Therefore adequate diagnostic workup is essential, to offer patients individually adapted treatment. General non-reimbursability of treatment for ED appears to be unacceptable.
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              Sexual desire in later life.

               M W Sill,  J DeLamater (2005)
              The has been relatively little research on sexuality in later life, particularly among persons over 60 years of age. The existing literature consists of studies of small samples, much of it from a biomedical perspective. This literature suggests that age, hormone levels, specific illnesses, and various medications negatively affect sexual functioning in older persons. The study reports results from a survey of a large sample (N=1,384) of persons age 45 and older that included measures of a variety of biological, psychological and social factors that potentially influence sexual functioning. We report bivariate and multivariate analysis conducted separately for women and men. We find that the principal influences on strength of sexual desire among women are age, the importance of sex to the person, and education. In this sample of the population of older persons, attitudes are more significant influences on sexual desire than biomedical factors.
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                Author and article information

                Journal
                The Journal of Sex Research
                The Journal of Sex Research
                Informa UK Limited
                0022-4499
                1559-8519
                February 28 2011
                March 15 2011
                February 28 2011
                : 48
                : 2-3
                : 106-117
                Affiliations
                [1 ] a School of Nursing and Midwifery, University of Sheffield
                [2 ] b School of Nursing, University of Auckland
                Article
                10.1080/00224499.2010.548610
                21409708
                1ecce6de-d793-4e5d-af78-000c38653d59
                © 2011

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