No doubt about it, sexual desire and function slow down as we get older. What doesn’t change, however, is our lifelong need for intimacy. For many people, that includes satisfying sexual relations. It’s important for men and women to understand the challenges they and their partners face during this time of transition—and to be aware of therapies that enhance libido and performance in both sexes.

Good Health = Good Sex
You can’t expect to have topnotch sexual function if you have poor overall health. Hypertension, cardiovascular disease, uncontrolled diabetes, and other disorders involving impaired circulation are commonly linked with sexual dysfunction. That’s because optimal blood flow is required to produce erections in men and clitoral engorgement in women. Other conditions that can affect interest in sex and the ability to act on that interest include anxiety, depression, hormonal imbalances, chronic pain, and neurological problems. Once these health issues are tackled, desire and function often return.

Prescription Drugs Can Interfere With Performance
Problem is, some of the medications used to treat these diseases make things even worse. For example, psychotropic drugs are notorious for causing significant sexual dysfunction. Studies suggest that up to 60 percent of the men and women taking Prozac and related SSRI antidepressants have difficulty achieving orgasm. Also problematic are some blood pressure–lowering drugs (especially beta blockers), stimulants, narcotics, antihistamines, sleeping pills, and peptic ulcer and heart meds—more than 130 prescription drugs in all!

Recently, I heard from a subscriber whose husband had been taking a number of drugs that robbed him of his sex drive. It was very frustrating for both of them. He finally got so fed up with feeling lousy on all of his medications that he replaced them with CoQ10, L-arginine, and other nutritional supplements. Now his libido is back and their sex life is “fantastic.”

Maintain a Healthy Lifestyle
Harvard researchers have found that men who eat a good diet, exercise regularly, and maintain their optimal weight are able to delay age-associated erectile dysfunction by about 10 years! Among the bad habits that contribute to sexual problems are drinking too much alcohol, overeating (obesity), and smoking. As you can see, anything you can do to improve your overall health will also improve your sexual function.

HRT to the Rescue
A hallmark of getting older—and what many experts believe to be an underlying cause of aging—is declining levels of hormones. As a woman’s production of estrogen gears down and her monthly cycles cease, the vagina loses elasticity and becomes drier, which makes intercourse difficult and uncomfortable. No wonder some women lose interest in sex! Men, you’re not off the hook either. As testosterone levels fall, erections take longer and are less firm, and libido may take a hit as well.

Fortunately, there’s a solution: hormone replacement therapy. Estrogen can be a lifesaver for women during and after menopause. It relieves hot flashes, improves vaginal tone and dryness, and lifts mood, which often translates into better sexual function. Suffice it to say that bioidentical hormones—exactly like those produced in your body—can be a godsend at this time of life. Bioidentical hormone replacement therapy requires a prescription and must be ordered from a compounding pharmacy. To locate such a pharmacy, contact the International Academy of Compounding Pharmacists (IACP) at (800) 927-4227 or iacprx.org.

Testosterone for Men…
I have one thing to say to men who are having sexual difficulties: Give supplemental testosterone a try. Although men don’t experience a defining “event” such as menopause, testosterone production tapers off throughout adulthood. This decline is linked not only with sexual problems but also with increased risk of obesity, loss of muscle and bone mass, heart disease, diabetes, and even death. Supplemental testosterone is an amazing libido lifter. If lack of interest is your problem, I can almost guarantee it will work. But sexual desire isn’t the main problem for most men—it’s erectile dysfunction (ED). And testosterone can also improve function. Given its many benefits, I recommend it as a first-line therapy for this condition.

…and Women
Women who want a libido booster should also talk to their doctors about testosterone. Testosterone is the hormone of desire for women as well as men. A small amount of weak testosterone cream, applied to the skin daily, is the best therapy I know for restoring female sexual desire.

Nonprescription Options
Nonprescription options are also available. One of my favorites for men is the amino acid L-arginine, which is the direct precursor to nitric oxide, a vasodilator that relaxes the arteries and improves blood flow to the penis. For women, I suggest trying DHEA, a hormone that converts into testosterone in the body. Although results aren’t as predictable as with the drugs, supplemental arginine and DHEA have been shown to improve sexual function in several clinical trials—and they don’t require a prescription.

I recognize that sexual problems are a sensitive topic, and there’s no single solution that works for everyone. The good news is, you do have several options. I sincerely hope that these suggestions will help you and your partner enjoy a lifetime of intimacy.