What is the physician’s role in helping patients with sexual problem in later years?

The physician should explain to both partners, the physiological changes that occur with age and measure them that a healthy conjugal relationship is a normal and acceptable form of behavior, at any age, because sexuality is as important for the old as it is for the young. Sex education material may be provided to educate the couple, clear any misconceptions and desensitize previous taboos. Sensate focus exercises (sensuous interplay short of intercourse), or other alternatives such as oral .sex, more foreplay, different positions may be advised depending upon the individual needs.

How does one overcome depression?

Supportive psychotherapy could be of great help and if the depression is severe then a psychiatrist’s intervention may be helpful.

When an individual has sexual desire he departs from the normal state and enters into the ‘sexual state’ and is deemed to have undergone ‘sexual grounding’. ‘Sexual grounding’ or the ‘Sexual state’ is a state in which the subject becomes receptive to the perception of stimuli inputs as sexual. Once this occurs, psychobiological stimuli arouse the sex center in the brain which starts sending out impulses, which are usually pleasurable. When such impulses reach the genitalia they lead to congestion of blood which is usually manifested as erection in the male and lubrication in the female. Further stimuli further arouse the individual and eventually lead to orgasm.

How can one know that once has reached an orgasm?

An orgasm is like a sneeze - it is difficult to describe but once you have had one you know what it feels like. Orgasms may differ. Usually one experiences a heightened sexual ecstasy accompanied by rhythmic vaginal contractions in females and ejaculation in males, followed by a fooling of relaxation.