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Better Sex At Our Age! Oh, Why Not?

Better Sex At Our Age! Oh, Why Not?. James White Professor Emeritus University California San Diego 2004 JIMWHITE@UCSD.EDU. Sexuality Is Intensely Personal. All material provided by James White, Ph.D. is provided for educational purposes only.

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Better Sex At Our Age! Oh, Why Not?

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  1. Better Sex At Our Age!Oh, Why Not? James White Professor Emeritus University California San Diego 2004 JIMWHITE@UCSD.EDU

  2. Sexuality Is Intensely Personal All material provided by James White, Ph.D. is provided for educational purposes only. Consult an appropriate physician regarding the applicability of opinions or recommendations with respect to your specific situation or medical condition.

  3. UCSD Human Sexuality Study1978 - 2004 • Hypotheses: Instituting exercise, diet, weight loss, tobacco avoidance will enhance bodily function, androgens production and sexuality. • Purpose: To determine the effects of 9 months of exercise, nutrition and lifestyle changes on the sexual behavior of older men and women.

  4. 263 Of 320 Subjects (82%) CompletedThe 9-Month Study All subjects: healthy, non-exercising and co-habiting with a heterosexual partner: 152 men Ave. age 52 ±13 (range 20-69) 64 Women Ave. age 48 ±11 (range 36-71) 47 controls Ave. age 50 ±12) (range 20-69) (50% gender split)

  5. Medical And Physical Evaluation Profile to Prescribe Program

  6. Program Based On Results Of Tests, each subject was randomly assigned to exercise or control group: Classes Held Daily, All Kept Daily Diary: • Exercise (jogging in class + extra sessions), Wt. train… • Food intake (West Analysis). • Drug, alcohol, tobacco use. • Sexual activities for 28 days before, at mid-term and during the 9th month.

  7. Data Analysis Change scores, i.e., final minus initial results, were compared (Student’s t test). Correlations between exercisers’ individual improvements in fitness and reported changes in their sexual activity.

  8. Physiological Changes Following 9 Months Of Exercise And Diet

  9. Physiological Changes Aerobic Fitness:BeforeAfter mlO2/kg-min: Women 23 ±6.9 33 ±6.4 ( 30%) Men 30 ±7.4 41 ±7.1 ( 27%) Blood Lipids(mg%): LDL/HDL: BeforeAfter Women 121/58 (2.1) 92/71 (1.3) Men 136/34 (4.0) 112/48 (2.3)

  10. Cardiovascular Changes Blood Pressure: (mmHg): BeforeAfter Women 128/78 111/68 ( 13%/13%) Men 146/88 129/77 ( 13%/13%) Blood Volume : . Takashi, Med. Sci. Sports Exerc., Vol. 33, No. 3, 2002. BeforeAfter (L) Women 4 ± 1.3 5 ± 1.3 ( 20%) Men 5 ± 1.5 6 ± 1.6 ( 17%)

  11. Body Composition Changes Weight: Before After Women 151 ±13.8 132 ±9.4 ( 13%) Men 187 ± 9.9 164 ±6.2 ( 12%) Body Fat (%):BeforeAfter Women 33 ±6.7 27 ±5.9 ( 18%) Men 27 ±4.5 19 ±3.6 ( 30%)

  12. Sexuality Changes Following 9 Months Of Exercise And Diet

  13. Visual And Limbic Sensory Occurrence Of Major Sexual Fantasies/week: BeforeAfter Women 10 ±6.6 13 ± 8.1 (23%) Men 8 ±5.3 15 ± 10 (47%)

  14. Intimacy Desire To Kiss and Caress/week: BeforeAfter Women 7.3 ±4.2 8.9 ±4.1 (18%) Men 3.6 ±3.4 4.4 ±2.5 (18%) Frequency Of Kissing & Caressing/week: BeforeAfter Women 6.5 ±2.8 8.4 ±2.1 (23%) Men 4.4 ±2.5 5.2 ±2.5 (15%)

  15. Sexuality Desire To Have Intercourse/week: BeforeAfter Women 3.1 ±2.1 3.8 ±2.1 (18%) Men 3.6 ±2.5 4.5 ±2.5 (20%) Frequency Of Intercourse/week BeforeAfter Women 2.5 ±1.7 3.2 ± 1.7 (18%) Men 2.8 ±1.5 3.7 ± 1.5 (24%)

  16. Orgasmic Response Desire To Have An Orgasm/week: BeforeAfter Women 3.8 ±2.1 4.5 ±2.1 (18%) Men 3.6 ±2.5 4.5 ±2.5 (20%) Frequency Of Orgasm/week: BeforeAfter Women 2.1 ±1.7 3.2 ± 1.7 (18%) Men 2.9 ±1.5 4.1 ± 1.5 (24%)

  17. Sexual Dysfunction Difficulty Achieving an Erection or Lubrication or Becoming Sexually Aroused* (% of time) BeforeAfter Women 22 ±17 16 ± 12 (27%) Men 13 ±18 5.5 ± 9.2 (58%) * With out aid of Viagra or a lubricating lotion

  18. Frequency Of All Sexual Activities/Week – 1109 Women Age

  19. Frequency Of All Sexual Activities/WeekMen Initiated Exercise Age 52 ----- Age

  20. Minutes Of Exercise/week And Orgasms/week (152 Males Age 52, 64 Females Age 58)

  21. Smoking Habits Effects Number Of Orgasms/Week 23 Women/36 Men, Age 55-71 (Mean = 59 yrs.)

  22. One Reason For Increased Sexual Activity In Women and Men - Testosterone

  23. Testosterone – Steroid Hormone Responsible For Libido • Produced in testes/ovaries and elsewhere. • Stimulates release of nitric oxide (NO) and cGNP > smooth muscle relaxation > male erection and assists in female lubrication. • Promotes aggressive sexual behavior. • Higher levels promote more sexual activity. • Hastens arousal,  intensity,  sensation… • Shortens time to achieve erection, lubrication and orgasm.

  24. Testosterone Levels ng/mL Non-exercising Men and Women Age

  25. Testosterone Levels ng/mL Non-exercising & Exercising Women Age

  26. Testosterone Levels ng/mL Non-exercising & Exercising Men Age

  27. Testosterone Levels ng/mL Obese And Exercising Men Age

  28. Summary • Exercise, proper diet and avoiding tobacco • Improves fitness, CHD risk factors, LDL/HDL ratio, body fat, blood volume, androgens… • Enhances desire: touching, kissing, caressing, all sexual activities, intercourse and orgasms • Increases frequency of touching, kissing, caressing, intercourse and orgasms • High r. indicates the higher the fitness, lower the body fatness, lower the LDL/HDL ratio and higher testosterone the greater the sexual activity, pleasure, satisfaction, andreducesoccurrence of sexual dysfunction, failure...

  29. Questions???

  30. VIAGRA -- EIGHT YEARS LATER For Men With Sexual Dysfunction Or For Healthy Men Wishing To Achieve A Recreation Erection?

  31. SILDENAFIL CITRATE (VIAGRA) - PRONUNCIATION: Sil - DEHN - A - Fil • Blue Pill: 25, 50 or 100 mg taken by mouth with 8 oz. water or with a low fat meal, but never with grapefruit -- in any form.

  32. SILDENAFIL CITRATE (VIAGRA) • Take once daily as needed - ½ to 4 four hours before sexual activity. • One hour before is most generally recommended.

  33. SILDENAFIL CITRATE (VIAGRA) • Works with sexual stimulation to help achieve and maintain an erection. • Does not produce sexual arousal – up to you.

  34. Non-Aroused State Limbic Center PDE5 (-)

  35. Sexual Arousal

  36. Sexual Arousal Parasympathetic Nerves Release ACh (+) ACh Activates NO & cGMP (+) PDE5 (-)

  37. HOW VIAGRA WORKS • 1. Parasympathetic nerves release ACh which enables Nitric Oxide (NO) and Guanosine Monophosphate (cGMP) to relax smooth muscle - allows inflow of blood leading to the erection. • 2. An enzyme, PDE5 hinders the action of cGMP - causes loss of the erection. • 3. Viagra inhibits PDE5, allowing both NO and cGMP to function more effectively.

  38. How Well Does Viagra Work In The Absence Of Pathology? • 67%-82.5% with sexual dysfunction report improved erections. • 64% are able to complete sexual intercourse attempts. • 69% increase sexualsatisfaction. • 75% showed improved self-esteem, relationship, and confidence.

  39. Viagra For Women? • Viagra increases vaginal engorgement and lubrication during erotic stimulus. No effect on sexual arousal, length of plateau, orgasm or multiple orgasms. • Viagra is not recommended for women. • Normal sexual function involves successful integration of biological, psychological, tactile and interpersonal influences. • Improvement of sexual function was reported following Tibolone use.

  40. Pharmacological Agent Tibolone Treats Female Sexual Dysfunction

  41. Pharmacological Agent Tibolone Treats Female Sexual Dysfunction

  42. Pharmacological Agent Tibolone Treats Female Sexual DysfunctionPalacios & Juradp 2002 Maturitos 1995

  43. Food Proportions Recommended • 60% COH • 20% Fat • 20% Protein

  44. Antioxidants Slow Aging • All Cells use Oxygen - metabolism • A byproduct – O2 Free Radicals. • Free Radicals attack Protein. Collagen (cement that holds all tissue cells firmly together)and destroys Cell Membrane… • Premature Skin Aging, Heart, Lung, & Artery Destruction.

  45. Stop Those Free Radicals – How? Antioxidants (in diet) first disable and then escort Free Radicals away from cell membranes - protect lungs, heart, brain, arteries, all organ and skin, thus keeping them younger and safer. Where can I find my favorite antioxidants?

  46. Antioxidant Food & Supplements VitaminC(RDA 60 mg.) 1000 mg Citrus, Papaya, Cranberry or Grapejuice, Cherries, Strawberries,Melon, Beets,Fresh corn,Tomatoes, Green leafy vegetables, Peppers, Beans/peas, Potatoes… Vitamin E Margarine/most oils, Green leafy vegetables. Asparagus…

  47. Antioxidant Food & Supplements • Selenium(50 mcg.): Seafood, Meat, Grains. • Calcium (RDA 800-2400* mg/day) Non/Low-fat Dairy , Salmon, Green leafy vegetables

  48. Antioxidant Food & Supplements • Vitamin Dneededto absorb Ca: Sunlight, Tuna or Salmon, Milk, Egg, Liver… Potassium: (RDA 1.9—5.6 gm/day) Not in once-a-day multivitamin pills. Meat/fish, Nonfat Milk/Yogurt (not cheese), Banana, Cantaloupe, Dates, Oranges, Apricots, Green leafy vegetables…

  49. fin

  50. If you want printed information: JIMWHITE@UCSD.EDU In the message: Be Specific! State what material would you like?

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