Mens Health Blog. Medical Blog

Those elderly people who are not forced to live in institutions because of illness or destitution have, at some stage, to make a decision about where they will spend their remaining years of life. Should they choose to live in the house or flat they have occupied for years, or move to a smaller house within the community? Should they seek to live in a ‘retirement village’ or complex? Should the concept of ‘almshouses’ be revived?

Whatever decision is made, it is important that the old person makes the choice and that it is not dictated by others. If the choice is to continue to live in the general community, in the person’s own home, or in a flat, the community needs to be pressured to provide appropriate facilities, such as social clubs, access to shops, and community helping organizations, and efforts need to be made to provide the old person with an occupation. A retirement village is usually expensive and only the well-to-do can afford it. The advantage of such places is that services are readily available; illness is not as great a problem, because of the facilities provided; and the environment encourages group activity, giving a much-needed sense of purpose to life. A disadvantage of many retirement villages is that they are relatively isolated and the inhabitants may find it difficult to go into the town centre or to visit friends, without seeking the charity of someone to take them. This can promote a feeling of being cut off from real life and create an artificial, unhealthy way of living. The old idea of almshouses, situated in the town itself, has attractions as these can provide independence for the old person and, at the same time, the facilities and services needed for the person to enjoy his independence without fear of accident, illness, or incapacity.

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Escape from the crisis of middle age is well advanced when the man accepts that he needs help. With help, he can escape from the dull routine of work, he can widen the range of his activities, he can change direction, and he can have a stimulating sex life. He needs to see that he must talk about his problem. He needs to see that соoperation and sharing are more important than acquisitiveness and competition. He needs help to build up his self-esteem. He needs to see through his dissembling, his fantasies, his deceptions (about himself and about others), and his delusions. He needs to learn about his strengths and to accept his weaknesses.

If he is overweight, he will feel better if he loses some weight. If he drinks heavily, he will feel more awake if he drinks less. If he is slothful, he will become healthier if he takes more exercise – not competitive exercise to ‘beat’ someone, or ‘duty’ exercise to keep himself fit for work, but an active pursuit he enjoys.

These two infections more commonly infect a woman’s vagina, but can spread to her partner’s penis. Both cause a vaginal discharge which is usually itchy and may smell. Trichomoniasis is the name of the infection caused by a tiny animal (a flagellate) which infests the vagina of 10 to 20 per cent of sexually active women, but only causes symptoms in a few. Candidosis (or monilia) is caused by a fungus and infects about 25 per cent of sexually active women, but only produces symptoms in about 5 per cent.

If a man’s partner is diagnosed as having trichomoniasis he should take a course of tablets and should wear a condom when they have sex, until they have both been cured. One course of tablets for 7 to 10 days usually does this. The preferred drugs are metroni-dozole and tinidazole. Recently research has shown that a single large dose is almost as effective as the seven-day course.

If the woman has candidosis, the man may get an itchy penis. Should this happen, treatment with an ointment called nystatin, which kills the fungus, is available.

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An impotent man who is unable to get an erection may believe that his sexual partner, who is usually his wife, is disgusted with his diminished masculinity, talks about his masculine inadequacy to her friends, may seek sexual release with other men, and generally belittles him. The vicious circle of failure to achieve an erection causes anxiety, which is increased the harder he tries, and the harder he tries the more he fails.

A number of men become impotent because of illness or because of the treatment required for an illness. Diabetes often causes impotence, and certain drug treatments for high blood pressure may produce impotence. Alcohol, taken excessively over the years, is often associated with impotence. The reason for this is not clear, but it may be because of liver damage.

A question which many couples would like to ask, but are often too shy to ask, is when can sexual relations resume after childbirth. A couple could and should cuddle immediately after childbirth, and on return home one or other partner may wish to be stimulated sexually by fondling or petting. Sexual intercourse can begin as soon as the woman wishes. Usually a couple of weeks pass after childbirth, because sexual intercourse would be painful or messy before this. During this time other forms of sexual stimulation can be used.

Many women find that their sexual desire and response is less in the first months after childbirth than it was before pregnancy. To a large extent this is because the demands of mothering make the woman tired and less able to respond quickly. A relating partner will realize this and will spend time in body contact and caressing, often without expecting that this is a necessary preliminary to sexual intercourse. Mutual pleasuring and communication will reduce or eliminate many of the sexual problems which can occur after childbirth and are a part of adjusting to parenthood.

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