Improving your self-esteem can improve your sex life Gravity is not kind to your body as you age. Nor are childbirth, an unhealthy diet, lack of exercise, and the hormone declines that lead to muscle loss, loose skin, and thinning hair. Worry about having your partner see your sagging skin or generous waistline can discourage you from having sex, or you may demand that sex take place only under the covers, with the lights out. Needless to say, these conditions don't leave much room for a sense of closeness or inspired lovemaking. Often, a preoccupation with your appearance while making love will prevent you from initiating or responding to sexual advances.   Get your copy of Sexuality in Midlife and Beyond   The physical transformations the body undergoes with age have a major influence on  sexuality. This Special Health Report, Sexuality in Midlife and Beyond, will take you through the stages of sexual response and explain how aging affects each. You’ll also learn how chronic illnesses, common medications, and emotional issues can influence your sexual capabilities. Finally, you’ll find a detailed discussion of various medical treatments, counseling, and self-help techniques to address the most common types of sexual problems. A negative self-image isn't always rooted in your appearance. Career setbacks or other disappointments can lead to feelings of failure and depression, both of which sap desire. For men, episodes of impotence can undercut confidence in their masculinity. No matter what its cause, a poor self-image can take a toll on a couple's sex life. When performance anxiety develops as a result, it can spark a downward spiral of repeated sexual failure and diminishing self-esteem. Correcting this problem demands serious attention to its origin. By shifting your focus away from your perceived flaws to your attributes and to the strengths in your relationship, you can boost your self-esteem and establish your own standards for attractiveness. Think back on what it was that made you attractive in your younger years. Was it your soulful brown eyes, your crooked smile, or maybe your infectious laugh? Chances are, those qualities are still as appealing as ever. Also, try directing your attention to the experience of giving and receiving pleasure during sex. This can help you find the confidence to give yourself over to the experience. Great sex is often the outgrowth of a deep emotional connection—something that's not guaranteed by having a perfect body. For people who are overweight, exercise can help foster weight loss, as well as provide a mental and physical boost. Even if you lose only a small amount of weight, being active can tone your body, which can improve your body image and, in turn, your sexual interest and response. To learn more about how sex can change for older adults and how to realize the full potential of later-life sex, read Harvard's Special Health Report, Sexuality in Midlife and Beyond. Share this story:

Testosterone therapy for women: Can it improve your sex life? When it comes to hormone therapy, estrogen gets all the attention. But testosterone is also a player in a woman's sexual response, and testosterone therapy is occasionally considered as a way to treat low sexual desire in postmenopausal women if there is no other treatable explanation for the problem, such as conflict in the relationship, fatigue, depression, or vaginal dryness. It's important to note, however, that although testosterone may influence certain aspects of sexual response, large studies in women of all ages have not identified a clear link between testosterone levels and sexual desire and satisfaction. Given the limited effectiveness of testosterone in women and the difficulty of proving long-term safety in a research study, it is unlikely that a testosterone product ever will be approved for use in women. Specially formulated testosterone lotions and gels for women are available nonetheless, but the quality and dose of these compounded products, which are made to order at special pharmacies, are inconsistent. Be aware of possible side effects Side effects of testosterone products can include mild acne, liver problems, and a slight drop in HDL ("good") cholesterol, as well as a deeper voice and facial and body hair. Women who do choose to use compounded testosterone therapy should have a blood testosterone level checked periodically to ensure it doesn't get too high, since the actual amounts of testosterone in these products are unreliable. Other potential problems could develop in the long run. Testosterone use has been associated with an increased risk of breast cancer, heart disease, and stroke. In fact, one study found that the risk of breast cancer was nearly 2.5 times greater in postmenopausal women who took hormone pills combining estrogen and testosterone than in those who didn't take the medications. Over-the-counter DHEA (dehydroepiandrosterone) supplements are promoted as another way to boost testosterone levels, since DHEA converts to testosterone in the body. However, there's little reliable evidence that the supplements reduce menopausal symptoms or improve sexual function in healthy women.  To learn more about how sex can change for older adults and how to realize the full potential of later-life sex, read Harvard's Special Health Report, Sexuality in Midlife and Beyond.  Image: © laflor | Getty images Share this story:

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Sexuality in Midlife and Beyond Featured content: • Understanding sexuality • Trends in sexual behavior among older adults • Emotional and social issues • Health problems and sexuality • Treating common sexual problems • SPECIAL BONUS SECTION: Everything you always wanted to know about sex therapy • Resources Click here to read more »