A Valentine’s Celebration of Sex, Hormones and Health
Florence Comite MDFebruary 14, 2022
Valentine’s Day is a celebration that lovers love – and single people love to hate! Flowers, chocolate and fancy dinners are great, yet sexual health is often ignored. However you feel about the day itself, February 14th is the perfect opportunity to talk about the myriad ways a fulfilling sex life and the hormones that drive libido and function impact our health. Optimizing hormonal activity has multiple benefits, and is a vital topic to explore. So what do we know? Well, one thing we know for sure is that our hormones decline from our 30’s, kicking off aging as we know it – but while some people might see that as the beginning of the end, it doesn’t have to be that way!
There are a bunch of oh-so-important reasons why a healthy sex life – with or without a partner – is typically said to ‘put a smile on your face’, yet what’s less known is that sex can add years to your life! Yes, you read that correctly – sex hormones not only influence mind, body, and spirit, but are known to in impact disorders of aging such as heart disease, osteoporosis, cancer, stress, depression, and anxiety, starting before menopause or andropause in women and men. A precipitating event is the loss of muscle that is accompanied by the visceral fat gain which triggers diabetes and other diseases. Most relevant is the impact on the immune system. So come with me on a guided tour of how your sex hormones are essential to mind, body, and spirit, and all will be revealed in brief for now.
There’s no better place to start our tour than the universal symbol of love. Not only is sex a great workout, but it also lowers your blood pressure – particularly systolic blood pressure. Weaker erections, particularly in the 30s and 40s, is frequently an early indicator of future heart problems, as plaque build up in smaller arteries – such as the pudendal arteries which supply the penis – is a common precursor of cardiac disease. The pudendal arteries are just a quarter size of the coronary arteries, so will manifest the effects of blockage and inflammation, with male erectile dysfunction seen earlier in life than a heart attack. Pay attention if your biological relatives were known to experience heart attacks at an early age (35 to 55), as that’s an added risk. Recall the heart is a muscle, and testosterone is a key factor, as is estrogen. The latter hormone is even more cardiac-protective, as women experience heart attacks that emerge beginning in the mid to late 40’s – about 10 years after men – yet quickly catch up.
Sexuality should be in your life, and a loss of sexual interest and function is not to be ignored as if aging is an excuse. Your personal physicians can help you initially explore the hurdles to sexual intimacy commonly experienced in andropause and menopause, and the earlier stages of periandropause and perimenopause. This is of vital importance, as sexual satisfaction is not only a good predictor of global life satisfaction in mature adults, but a vital component of it.
Sexual activity may boost estrogen and testosterone, which are key weapons to sustain bone. Doctors have known since the 40s that the sex hormone steroids regulate skeletal maturation, and bone turnover with preservation in both men and women. In the 80s we found that that sex steroid receptors were present in bone cells. While women show decline in bone density starting in their 40s, men start about 10 years later, ultimately catching up. Colles fractures of the wrist, hip and spine fractures occur with increasing frequency as the decades roll out beginning in the 40s to 50s. Cervical kyphosis, referred to as the ‘buffalo hump’ is a common manifestation in both sexes. As the years go by, men catch up with women, with 25% affected by osteoporosis. Men and women use a walker when they can no longer stand upright and look forward as their spine curves to a particular degree. Family history is a significant risk factor, as is ethnicity (Cacausian and Asian), the earlier you know, the more proactive you can be and the less likely your genes will be your destiny.
Mental & cognitive health
Loss of sexual desire is associated with lower life satisfaction in both men and women, which can lead to depression. Testosterone therapy has proved to be a game changer for depression and low libido in both sexes and erectile dysfunction in men, and intensity of sexual desire and response in women. Estrogen has an impact on cognition, and testosterone on memory, both critically important to protect as you age. Optimizing hormonal and metabolic function has a positive effect on the way you feel and think.
Women’s vaginal health
Vaginas are layered with muscle, and regular use keeps them in tip-top shape! Hormones are key for lubrication, comfortable sexual activity, foreplay, and orgasm. Kegel exercises are typically prescribed to tighten the vaginal musculature after childbirth, or with the age-related decline in hormones. Regardless of age, women who are sexually active are more likely to have a strong pelvic floor, with research suggesting that sex itself may act to strengthen these muscles during arousal and orgasm. In post-menopausal women, both sexual activity and hormonal optimization are crucial in preventing vaginal atrophy and avoiding urinary tract infections. When the vaginal mucosa is insufficiently moist, dyspareunia (pain with coitus) is a common complaint, easily addressed with a prescription for vaginal estrogen suppositories or cream. Of note, the estrogen will stay local, which is important if there is a personal or close family (mother, grandmother, sister) with a history of breast cancer.
Men’s genital & prostate health
Studies have shown that regular intercourse helps prevent erectile dysfunction in mature men, which contributes to general health and quality of life, with one suggesting that “doctors should support patients' sexual activity.” Prostate health is also a factor related to sexual activity. There’s more related to genital and prostate health in men that we plan to address in an upcoming blog.
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