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For many, the middle years of life mean renewed sexual freedom (sounds very Woodstock, doesn’t it?). Your children have either left the nest or are now driving themselves to their endless array of activities. Perhaps your career is established enough to give you a little breathing room or you’re even retired. As a result, you may find yourself more focused on your partner and the reality that the sex isn’t as “Far Out” as it used to be. This doesn’t mean packing a sixties-style Volkswagen Microbus adorned with peace signs and flower power stickers and heading for Colorado, but it may mean a frank discussion with your doctor about what may be interfering with a fulfilling sex life.

First off, it’s important to keep in mind that your symptoms may not be chronic. Sometimes it’s just a matter of making time for romance. Take turns planning a date night with your partner, even it’s as simple as renting a movie or retiring with a bottle of champagne. Gina Ogden, PhD, LMFT, author of The Return of Desire, says that it’s also important to recognize that what you wanted in your twenties may be very different from what you’d like in your fifties and beyond; especially if you’ve been together for years. Says Dr. Ogden: “When I talk with couples I ask ‘Are you still decorating your house with orange shag rugs and cinder-block bookcases or have your tastes changed?’ The same principle applies to sexual tastes and desires.”

Pepper Schwartz, PhD, professor of sociology at the University of Washington and author of The Normal Bar: The Surprising Secrets of Happy Couples says that mid-lifers should also recognize that although sexual problems are natural as we age, all hope is not lost. “There are many aids that can restore a great deal of sexual activity,” says Dr. Pepper. “It won’t be the same as when they were 21 but it could be very good indeed.” Here are some common age-related concerns, along with solutions for keeping the romantic fires well-stocked.

Decreasing hormone levels:

Yes, we’re all sick to death of the endless commercials about a particular form of medical malady known as erectile dysfunction, or ED, but the problem is real. Thanks to diminishing hormone levels and other health issues, men may have difficulty not only achieving an erection but maintaining one as well. After orgasm, loss of erection may also occur more quickly. According to the National Institute on Aging, most men suffer from ED once in a while. Worrying about it can actually trigger the condition by constricting the arteries that transport blood to the penis. Anxiety can also cause premature ejaculation. In addition to ED drugs and hormone treatments, other available options include vacuum devices, penile implants and penile injections. Cutting back on alcohol, quitting smoking and losing weight can also help.

In women, reduced estrogen levels can lead to vaginal dryness and discomfort. Taking antihistamines can also be a part of the problem by drying vaginal areas in the same way they combat runny noses. Douching can also cause dryness and irritation. This problem has a quick fix thanks to a number of over-the-counter, water-based lubricants which are easy to use and can make having sex more comfortable. Look for one that doesn’t contain glycerin which can dry out quickly but do your research. Some lubricants can break down the latex used to make condoms. You doctor can also suggest a form of vaginal estrogen to combat dryness.

Chronic Conditions and Sexual Surgeries:

Many chronic medical conditions, such as arthritis, diabetes and hypertension can make sex uncomfortable and even difficult. Regular exercise, pharmaceutical or over-the-counter drugs, warm baths and even changing the position or timing of sexual activity may help. Many older adults with heart disease fear that sex may trigger a heart attack. After checking with your doctor, set some fitness goals or join a cardiac rehabilitation program if you’ve already had heart-related surgery. If you are able to exercise to the point of working up a light sweat without experiencing symptoms, your doc may give you the green light to have sex.

Surgeries involving the breasts, uterus, ovaries or genital areas can cause not only physical issues but psychological problems as well. Prostatectomy, a surgery that removes all or part of a man’s prostate, for example, can result in urinary incontinence or ED. If you require surgery, talk to your doctor to address your concerns. Conversely, a woman who has had her breasts removed may not feel as attractive to her partner. A candid discussion about reconstruction surgery or seeking therapy may help. For surgeries that compromise hormone levels, replacement therapies can also be considered.

 Medication Side Effects:

The side effects of some medications also have the potential to create sexual problems such as reduced desire and difficulty with achieving arousal or orgasm. Check with your doctor before beginning any medication to determine its side effects. Sometimes another form of medication or a lower dosage may alleviate side effects.

Depression:

Feeling down and hopeless can wreak havoc on one’s sex life especially if you have issues with body image or performance anxiety. Depression is very treatable through therapy, medication or a combination of both. A sex therapist can also help; particularly if you feel you can’t discuss your issues with your partner. Go to AASECT.org to find a certified professional near you. Ramping up an exercise routine can also work wonders when you’re feeling blue.

Remember, even if your hippie (or at least bohemian) days are a distant memory it doesn’t mean you can’t rock on. In some ways the sex might be even better because you’re no longer feeling pressure to keep up with the Joneses. In Dr. Ogden’s national survey “Integrating Sexuality and Spirituality” many respondents over 50 said sex may be less frequent but they enjoyed it more because they no longer paid attention to messages that sex is supposed to be romantic and hot regardless of what else is going on in their lives. “What they valued most,” says Ogden “was the relational richness they developed with their long-term partner.”