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By shifting your focus away from your perceived flaws to your attributes — for example, your eyes or your hair — you can boost your self-esteem and establish your own standards for attractiveness. Also, try directing your attention to the experience of giving and receiving pleasure during sex. This can help you find the confidence to give yourself over to the experience.

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Great sex is often the outgrowth of a deep emotional connection — something that's not guaranteed by having a perfect body. A negative self-image isn't always rooted in your appearance. Career setbacks or other disappointments can lead to feelings of failure and depression, both of which sap desire. For men, episodes of impotence can undercut confidence in their manhood. No matter what its cause, a poor self-image can take a toll on your sex life. When performance anxiety develops as a result, it can spark a downward spiral of repeated sexual failure and diminishing self-esteem.

Correcting this problem demands serious attention to its origin. Because feelings of low self-worth are a symptom of depression, you should talk to a doctor if the problem persists. For example, women and men — particularly those who came of age before the so-called sexual revolution in the '60s — may cling to the notion that it is improper for "nice girls" to enjoy sex. This belief can be damaging for both partners. A woman who has merely acquiesced to sex as a duty to her husband or as a necessary step in childbearing may feel uncomfortable seeking sexual pleasure.

Her partner may interpret this lack of enthusiasm as a reflection of her feelings about him. Inexperience and embarrassment over discussing sexual matters may hamper people from fully expressing themselves sexually. For example, intercourse alone does not give many women the kind of stimulation they need for fulfilling sex, and uneasiness about discussing the problem prevents some couples from developing techniques that could offer the woman greater pleasure. Compounding the problem, childhood taboos against masturbation may prevent a woman from ever discovering the means to her sexual pleasure, so she's unable to direct her partner in this regard.

It may be more comfortable for a woman to forgo her own pleasure than to confront these matters.

She may ultimately resort to faking orgasms rather than risk asking for a different approach to lovemaking. When this pattern exists for years, revealing the truth would mean admitting to a longstanding deception, which could shake the trust in the relationship and injure her partner's self-esteem. Alternately, a man may feel his self-worth depends on his ability to please his partner.

His focus during sex, therefore, is on performing rather than succumbing to pleasure. If his partner doesn't immediately respond to his efforts, feelings of inadequacy can pervade the relationship, eroding the couple's bond. This dynamic can ultimately lead to performance anxiety and related sexual problems. During the early years of a couple's relationship, such missed connections are often masked by priorities outside the bedroom, such as building a marriage, raising a family, and launching a career.

However, midlife may prove to be a turning point. Upon reaching menopause, the long-unsatisfied woman might greet the physical changes in her body as a sign that her sexual duties are fulfilled. If her husband is still interested in sex, a conflict is likely to erupt. A much more hopeful scenario is also possible. Midlife and later may be a time when a woman's sexuality blossoms. Menopause means that women no longer have to worry about pregnancy. Often, children are grown and family responsibilities have eased, allowing a couple to engage in more relaxed and spontaneous lovemaking.

In addition, the changes a man is experiencing during these years, such as slower erections and longer time before ejaculation, lend themselves to the kind of pleasurable play that a woman may have been missing out on before. For a couple wishing to embark on the more positive course, the key is to begin to unravel negative patterns. To do this, you must open up a dialogue.

It's also important to resist succumbing to unproductive beliefs about aging and sex. Stress and fatigue are major libido sappers. During midlife, stress can hit from any direction and take any form. Challenging teenagers, financial worries, aging parents, and career woes are common. Concern over your own health or that of a loved one, or general anxiety about aging can also weigh heavily.

With so many demands on your time and attention, you and your partner may neglect to nurture your relationship. This inattention can cause your sexual connection to fray as well. Sheer lack of time is often a major factor. The physical changes in sexual response that occur in both men and women as they age mean that it will take you and your partner more time to become aroused and reach orgasm than it did in your younger years. You may find it hard to squeeze an extended lovemaking session into an already packed day.

If a couple typically waits until bedtime to have sex, exhaustion also can become an obstacle.

Stress has a particularly deleterious effect on libido, especially in women. Whereas men can sometimes use sex to relax, women more often need to be relaxed in order to enjoy sex. This mismatch can create conflict for a couple. Sexual issues brought on solely by stress and fatigue often can be remedied simply by taking a vacation.

If you and your partner are able to resume pleasurable lovemaking in a pressure-free environment, you'll be reassured that the underpinnings of your sexual relationship are sound. Midlife and after is also a time when profound lifestyle changes take place. Events such as retirement and children leaving home can upset decades-long patterns in a couple's life. For example, many couples go through a period of adjustment when they retire. If a woman is used to having the house to herself, her feeling of control over her domain can be threatened by her husband's constant presence.

If both partners worked outside the home, they must each adapt to having more time together at home. One bonus is that retirement may allow you and your partner the opportunity to engage in leisurely lovemaking — something you may have lacked for many years. One danger, however, is that couples who begin spending a lot of time together may stop making an effort to include romance in their relationship.

Chronic illness also affects many couples' sexual relationships during this stage of life.

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People who are ill may find that a condition or its treatment causes sexual difficulties, while healthy partners may worry that sexual activity will make their loved one's condition worse. The fatigue and stress of the caretaker role may also dampen desire.

During this time, many people also experience the loss of someone close — parents, friends, or siblings. Grieving may make it difficult to enjoy anything pleasurable, including sex. The physical transformations your body undergoes as you age can have a major influence on your sexuality. By understanding the crucial physical and emotional elements that underlie satisfying sex, you can better navigate problems if they arise. The Sexuality in Midlife and Beyond Report is an essential tool that can help you remain active, vibrant and vital as you age.

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Attitudes about sexuality and aging Updated: March 17, Published: June, E-mail Address. First Name Optional. By the numbers: Statistics on sexuality and sexual satisfaction In , Modern Maturity magazine and the AARP foundation polled 1, adults age 45 and older about the role sex played in their lives. The importance of sex Over all, the majority of men In a subsequent meeting, organized by PAHO and the World Association for Sexual Health WAS , a number of sexual health concerns were addressed with respect to body integrity, sexual safety, eroticism, gender, sexual orientation, emotional attachment and reproduction.

Sex refers to the biological characteristics that define humans as female or male. While these sets of biological characteristics are not mutually exclusive, as there are individuals who possess both, they tend to differentiate humans as males and females. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.

For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. Sexual health cannot be defined, understood or made operational without a broad consideration of sexuality, which underlies important behaviours and outcomes related to sexual health.

The working definition of sexuality is:. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. Halperin, The lesbian and gay studies reader pp.

What is sexuality and sexual orientation?

New York: Routledge. Original work published Faderman, L. Odd girls and twilight lovers: A history of lesbian life in twentieth-century America. New York: Columbia University Press.

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Gay rights, patient rights: The implications of sexual orientation conversion therapy. Professional Psychology: Research and Practice, 33 3 , Drescher, J. Drescher, A. Schroeder Eds. Kinsey, A.. Sexual behavior in the human male. Carter, D. Stonewall: The riots that sparked the gay revolution. New York: St. Silverstein, C. Letter: The implications of removing homosexuality from the DSM as a mental disorder. Archives of Sexual Behavior, 38 2 , The practice and ethics of sexual orientation conversion therapy.

Journal of Consulting and Clinical Psychology, 62 2 , American Psychiatric Association. Diagnostic and statistical manual of mental disorders 4th ed.

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Arlington, VA: Author. Wingerson, L. Gender identity disorder: Has accepted practice caused harm? Psychiatric Times.