性行為的發展

正如我們反復指出的那樣，人體的性反應會隨著年歲的增長而開始減弱。尤其對大多數男性更是如此，他們的性能力、性動機和性行動在50歲後顯著地降低或減少。這種衰退在女性不那麼明顯，她們的性行動水準通常從未達到男性本來所達到的程度。然而，兩性如果摒棄不現實的期待，如果放棄人的性的早期、中期和末期的所謂“適當的”舊腳本，他們都能夠一直得到令人滿意的性行為。

對於女性，絕經期並不必定意味著性活動的終止。正相反，許多女性從此後變得更為活躍，因為她們不再需要擔憂懷孕及其避免懷孕的方法。從生理上來說，老年婦女的陰道壁會變薄，陰道分泌液相應地會減少。這些症狀可以通過局部使用激素藥膏而改善。（在其它方面，健康的男女的全身激素替代療法並不總是明智的。也許對一些案例是有用的，但是對其它的案例則證明是使用不當。）一些婦女，可能也存在環繞陰道的肌肉軟弱無力，使陰道鬆弛。通過練習恥骨尾骨肌可以使這種“寬鬆的”陰道縮緊。當然，男性也可以利用這種練習來改善自己的性反應。不過，年長的男性可能會要較長時間才能達到陰莖勃起，而且也不能像先前一樣的強硬。另一方面，達到性高潮和射精的需要通常變得不怎麼緊迫，因而也許能夠持續進行比年輕時更久的性交。無論如何，只要一對夫妻保持實實在在的親昵接觸和一直全神貫注的交流，相對較為微弱的性反應並不會以任何方式損害他們的性關係。反之，則正好相反。

Stages of Development: Old Age

Sexual Response 1

As repeatedly pointed out, the human sexual response becomes weaker with advancing age. This is especially true for most males, whose sexual capacity, motivation, and performance noticeably diminish after the age of fifty. The decline is less obvious in females, whose performance levels, as a rule, never reach those of the males to begin with. Nevertheless, both sexes can continue to have satisfying sexual intercourse if they abandon unrealistic expectations and obsolete scripts about its “proper” beginning, middle, and end.
For a woman, the menopause does not have to mean the end of her sexual activity. On the contrary, many women become more active, because they no longer need to be concerned about pregnancies and the means to prevent them. Physiologically, older women experience a thinning of the vaginal walls and a corresponding reduction of vaginal fluid. These conditions can be treated by locally applied hormonal medications. (A more general hormone replacement in otherwise healthy females and males is not always advisable. It may be useful in some cases, but contraindicated in others.) In some women, there may also be a weakening of the muscles surrounding the vagina, making it less tight. Such a “loose” vagina can be tightened by exercising the PC muscle. Indeed, men can also use these exercises to improve their own sexual response. Nevertheless, older men may take longer to achieve an erection of the penis, and it may not be as firm as before. On the other hand, the need to reach orgasm and ejaculate usually becomes less pressing, and thus, the man may be able to continue coitus for a longer time than in his younger years. In any case, as long as a couple remains truly intimate and continues its full communication, a weaker sexual response need not impair their erotic relationship in any way, On the contrary.