Q: I am a heterosexual, 45-year old woman. I have been single for over five years with no sexual contact (other than with myself!) during that time. I have recently started a new relationship which I hope becomes sexual soon. In preparation for this, I have visited my doctor, renewed my birth control, and plan to initiate the STD conversation soon. What else, emotionally, physically, or otherwise, should I be thinking about during this time in anticipation of being a middle-aged woman about to become sexually active again after a long hiatus?
Therapist Crystal Hamilton: A new relationship, after any hiatus, can be an opportunity to explore and/or redefine your sexual and sensual needs for your body, boundaries, and communication style. Although there is limited information that I can get from this question, I can tell that you have taken the time and effort to prepare yourself. I’m not sure what questions you haven’t considered, but I elaborated a little so feel free to take what is useful to you.
I. The STI/STD Talk:
First, let’s start with STI/STD considerations: How will you approach this conversation? Are you prepared for their response? What conversation do you have prepared if they have a STI/STD? Would you need boundaries for additional protection? (i.e., dental dams, condoms, communicating when outbreaks occur). Allow yourself to consider your boundaries, discuss them with your partner, and have in mind various types of protection for whatever the scenario might be. I added statistical information, if you would like, at the bottom as an example.
II. Emotional Needs:
That would depend on what conversations have already taken place (i.e., partnership dynamics about being monogamous or open, beliefs about sex toys and what foreplay looks like, what boundaries look like, etc); some of these also overlap with physical but I am labeling it with emotional as well. Consider these questions for yourself and your partner: Do you have any concerns that might cause distress for you? Is there trauma that needs to be addressed? Do you need safe words? How do you and your partner define sex and desires? What would sex aftercare look like?
Additional considerations might be: what would you like to change or keep from your experiences with past relationships? Why are these issues important to you? Are they equally or less/more important to your current partner? Are you comfortable with what you both can talk about and work out?
Overall, remember to explore what feels good to you and share things that have worked or that you are open to exploring.
III. Physical Needs:
I put these in two categories: medical and non-medical. Starting with medical, sometimes medications can change in the body with how it responds. Always consult with your doctor if you believe the birth control or any prescribed medications are impacting your sex life.
If you are close to the menopause, which can happen in your 40s or 50s, the average age is 51 in the United States. There may be some changes, including vaginal dryness. However, this can occur even before menopause. Options would be to discuss with your doctor and using lubricants; although lube can be a pleasurable additive no matter the age, sex, or gender.
Second, when considering non-medical aspects, think about how you explore and touch your body when you masturbate and if there is a limited routine as orgasms may feel different with fingers, vibrators, and/or penetration. Sometimes when masturbation has a set routine, the stimulus for perceptual pleasure become smaller when transitioning from solo adventuring to a plus-one event. Think about further exploring masturbation practices, if you haven’t done so already, to see how the body becomes responsive to different stimulation.
*Extra Notes and Examples for STD Information:
STD/STI’s are a charged and heavily stigmatized topic, so here is some information to help normalize and inform:
First, herpes simplex virus 1 &2 are very common and can easily be transmitted. According to Hopkins Medicine, “50 to 80 percent of American adults have oral herpes (HSV-1), which causes cold sores or fever blisters in or around the mouth. Genital herpes, caused by HSV-1 or HSV-2, affects one out of every six people in the U.S. age 14 to 49.”
In addition, NIH News in Health (from the National Institutes of Health, part of the U.S. Department of Health and Human Services), report that most people with HSV do not know it and can get “HSV-1 just from their relative kissing them” as “HSV-1 is often transmitted during childhood.” This is where communication would come in to help reduce the likelihood of getting HSV from a partner.
Second, the CDC reports that there is currently no approved test for HPV in men, although some HPV can be visually identified by a doctor, but only if there are any symptoms present. The CDC also reports that “HPV is the most common sexually transmitted infection (STI)” but there is the HPV vaccine, which helps protect you against certain types of HPV that can lead to cancer or genital warts (aka brand name Gardasil 9). It is recommended that unvaccinated men and women ages 27–45 should talk to their doctor about the benefits of the vaccine. In addition, some insurances will pay for it until age 45 or 46.
Resources:
Author: Therapist Crystal Hamilton
Crystal's typical teaching-style is reflective of gentle recovery-based yoga as well as Trauma Conscious Yoga (TCY). Gentle recovery-based classes encourage the connection of mind and body to promote holistic self-care. In addition, the primary focus is to increase mobility and recovery for those who cross train with high-impact activities.
Trauma Conscious Yoga (TCY) encourages the opportunity to be in the present moment through bringing awareness to the breath and the physical sensations of the here-and-now. The class provides a space to notice what we feel in our bodies and make choices about what to do with those movements.
To learn more about Crystal Hamilton, please visit: https://www.revolutiontherapyandyoga.com/crystal
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Note from Revolution Therapy and Yoga: Have an uneasy question would like to ask our therapists? Send us an email at nicole@revolutiontherapyandyoga.com.