Meston C M
Reproductive and Sexual Medicine Clinic, University of Washington School of Medicine, Seattle 98105, USA.
West J Med. 1997 Oct;167(4):285-90.
Recent research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-related physiological changes do not render a meaningful sexual relationship impossible or even necessarily difficult. In men, greater physical stimulation is required to attain and maintain erections, and orgasms are less intense. In women, menopause terminates fertility and produces changes stemming from estrogen deficiency. The extent to which aging affects sexual function depends largely on psychological, pharmacological, and illness-related factors. In this article I review the physiological sex-related changes that occur as part of the normal aging process in men and women. I also summarize the effects on sexual function of age-related psychological issues, illness factors, and medication use. An understanding of the sexual changes that accompany normal aging may help physicians give patients realistic and encouraging advice on sexuality. Although it is important that older men and women not fall into the psychosocial trap of expecting (or worse, trying to force) the kind and degree of sexual response characteristic of their youth, it is equally as important that they not fall prey to the negative folklore according to which decreased physical intimacy is an inevitable consequence of the passage of time.
近期研究表明，很大一部分男性和女性在晚年仍保持性活跃，这驳斥了普遍存在的一种误解，即衰老与性功能障碍必然相关。与年龄相关的生理变化并不会使有意义的性关系变得不可能，甚至不一定困难。对男性而言，勃起需要更强的身体刺激，且性高潮没那么强烈。对女性来说，绝经会终止生育能力，并引发因雌激素缺乏而产生的变化。衰老对性功能的影响程度在很大程度上取决于心理、药理及与疾病相关的因素。在本文中，我将回顾作为男性和女性正常衰老过程一部分而发生的与性相关的生理变化。我还将总结与年龄相关的心理问题、疾病因素及药物使用对性功能的影响。了解正常衰老过程中伴随的性变化，可能有助于医生就性问题给予患者现实且鼓舞人心的建议。虽然重要的是，老年男性和女性不要陷入期待（或更糟的是，试图强迫）他们年轻时那种性反应的类型和程度的心理社会陷阱，但同样重要的是，他们不要轻信那种负面的观念，即身体亲密程度降低是时间流逝的必然结果。
