Geriatric Sexuality Lecture Powerpoint Flashcards
Barriers to sexuality in geriatric patients (5)
- lack of partner***
- ageism
- adult children’s attitude regarding new relationships
- erectile dysfunction
- disease/iatrogenic
Drugs that can cause sexual dysfunction in geriatric populations (3)
- B blockers (antihypertensives, ED)
- antidepressants (TCA’s or SSRI - sertaline, ED, low libido)
- H2 blockers (cimetidine,
The aging female sexual characteristics (3)
- Vaginal wall dryness (atrophic vaginitis)
- shrinking of the vulva and vagina
- shorter less intense but more painful orgasms (still retain multiorgasmic response)
Post menopausalestrogen deficiency
Decreased vaginal lubrication and elasticity with age, treated with continued usage/stimulation as preventative (if you don’t use it you lose it) as well as topical estrogens (premarin cream - low risk compared to systemic)
Flibanserin (addyi) function (geriatric sexual activity)
Unknown mech of action to treat premenopausal women with hypoactive sexual desire disorder, black box warning with interactions with alcohol
The aging male sexual characteristics (4)
- reduced penile sensitivity
- reduced volume of ejaculation and force
- refractory period longer
- FERTILITY RETAINED**
Erectile dysfunction and aging
More common as men age but NOT a normal response to aging, needs to be worked up
Erectile dysfunction work up (5)
- total serum testosterone level
- urinalysis
- TSH
- A1C
- injection study
Erectile function treatment options (4)
- sexual counseling
- decrease or discontinue drugs contributing
- PDE5 inhibitors
- testosterone replacement IN hypogonadism only either injection or penile suppository, intracavernosal injection, penile vacuum pump
Sex and long term care
Restricted in long term care such as nursing home or homes with adult children but is least restricted in senior living centers or own home
