性行为的发展

正如我们反复指出的那样，人体的性反应会随着年岁的增长而开始减弱。尤其对大多数男性更是如此，他们的性能力、性动机和性行动在50岁后显著地降低或减少。这种衰退在女性不那么明显，她们的性行动水平通常从未达到男性本来所达到的程度。然而，两性如果摒弃不现实的期待，如果放弃人的性的早期、中期和末期的所谓“适当的”旧脚本，他们都能够一直得到令人满意的性行为。

对于女性，绝经期并不必定意味着性活动的终止。正相反，许多女性从此后变得更为活跃，因为她们不再需要担忧怀孕及其避免怀孕的方法。从生理上来说，老年妇女的阴道壁会变薄，阴道分泌液相应地会减少。这些症状可以通过局部使用激素药膏而改善。（在其它方面，健康的男女的全身激素替代疗法并不总是明智的。也许对一些案例是有用的，但是对其它的案例则证明是使用不当。）一些妇女，可能也存在环绕阴道的肌肉软弱无力，使阴道松弛。通过练习耻骨尾骨肌可以使这种“宽松的”阴道缩紧。当然，男性也可以利用这种练习来改善自己的性反应。不过，年长的男性可能会要较长时间才能达到阴茎勃起，而且也不能像先前一样的强硬。另一方面，达到性高潮和射精的需要通常变得不怎么紧迫，因而也许能够持续进行比年轻时更久的性交。无论如何，只要一对夫妻保持实实在在的亲昵接触和一直全神贯注的交流，相对较为微弱的性反应并不会以任何方式损害他们的性关系。反之，则正好相反。

耻骨尾骨肌 (PC肌) 这一块吊床样结构的肌肉从前方的耻骨延伸到后方的尾骨。 (左) 在女性，这块肌肉环绕阴道；(右) 男性的这块肌肉。

Stages of Development: Old Age

Sexual Response 1

As repeatedly pointed out, the human sexual response becomes weaker with advancing age. This is especially true for most males, whose sexual capacity, motivation, and performance noticeably diminish after the age of fifty. The decline is less obvious in females, whose performance levels, as a rule, never reach those of the males to begin with. Nevertheless, both sexes can continue to have satisfying sexual intercourse if they abandon unrealistic expectations and obsolete scripts about its “proper” beginning, middle, and end.
For a woman, the menopause does not have to mean the end of her sexual activity. On the contrary, many women become more active, because they no longer need to be concerned about pregnancies and the means to prevent them. Physiologically, older women experience a thinning of the vaginal walls and a corresponding reduction of vaginal fluid. These conditions can be treated by locally applied hormonal medications. (A more general hormone replacement in otherwise healthy females and males is not always advisable. It may be useful in some cases, but contraindicated in others.) In some women, there may also be a weakening of the muscles surrounding the vagina, making it less tight. Such a “loose” vagina can be tightened by exercising the PC muscle. Indeed, men can also use these exercises to improve their own sexual response. Nevertheless, older men may take longer to achieve an erection of the penis, and it may not be as firm as before. On the other hand, the need to reach orgasm and ejaculate usually becomes less pressing, and thus, the man may be able to continue coitus for a longer time than in his younger years. In any case, as long as a couple remains truly intimate and continues its full communication, a weaker sexual response need not impair their erotic relationship in any way, On the contrary.