Describe the sexual dysfunctions among men and women in middle adulthood.

Answers will vary. Sexual dysfunctions are persistent or recurrent problems in becoming sexually aroused or reaching orgasm. Many of us have sexual problems on occasion, but sexual dysfunctions are chronic and cause significant distress. We do not have precise figures on the occurrence of sexual dysfunctions. The most accurate information may be based on the report by Ronald Lewis and his colleagues, which summarizes data from surveys around the world. Although there is wide variation in the figures gleaned from the surveys, we can make some generalizations:
~Women report a higher prevalence of sexual dysfunctions than men do.
~The prevalence of every sexual dysfunction except premature ejaculation increases with age.
~The most prevalent sexual problems in women are low sexual desire and difficulty reaching orgasm.
~Despite the stereotype that men are "always ready" to engage in sexual activity, many men report having low sexual desire.
~Repeated erectile problems, characterized by persistent difficulty in achieving or maintaining an erection during the course of sexual activity, may make men anxious when sexual opportunities arise because they expect failure rather than pleasure. As a result, they may avoid sex. Their partners may also avoid sexual contact because of their own frustration. The reduction in testosterone levels that occurs in middle and later adulthood may in part explain a gradual loss of sexual desire in men-along with some loss of muscle mass and strength. But women's sexual desire may also decline with age because of physical and psychological changes. Some medications, especially those used to control anxiety, depression, or hypertension, may also reduce desire. Fatigue may lead to erectile disorder in men, and to inadequate lubrication and, consequently, painful sex in women. But these will be isolated incidents unless the person attaches too much meaning to them and becomes concerned about future performances. Painful sex, however, can also reflect underlying infections or medical conditions. Biological causes of erectile disorder affect the flow of blood to and through the penis, a problem that becomes more common as men age or experience damage to nerves involved in erection. Erectile problems can arise when clogged or narrow arteries leading to the penis deprive the penis of blood and oxygen. Similarly, aging can affect the sexual response of women. Perimenopausal and postmenopausal women usually produce less vaginal lubrication than younger women and the vaginal walls thin, which can render sex painful and create anxiety about engaging in sexual activity. Artificial lubrication can supplement the woman's own production, and estrogen replacement may halt or reverse some of the sexual changes of aging. But partners also need to have realistic expectations and consider what kinds of sexual activities they can engage in without discomfort or high demands. Middle-aged and older men might try weight control and regular exercise, measures which may ward off erectile dysfunction. Exercise seems to lessen clogging of arteries, keeping them clear for the flow of blood into the penis. Oral medications-Viagra, Levitra, and Cialis-are commonly used to treat erectile disorder.