This ppt explains the physical and psychosocial changes that occur during menopause.

1. Physical Changes - Sensory and
Psychomotor Functioning
1. Age-related visual problems
i) Presbyopia – lessened ability to focus on
near objects – Farsightedness resulting when the
lens of the eye becomes less elastic (‘presby’ –
‘with age’)
ii) Nearsightedness (Myopia) also increases
iii) Dynamic vision (reading moving signs)
iv) Sensitivity to light
v) Speed of processing visual information

2. Physical Changes - Sensory and
Psychomotor Functioning
• Gradual hearing loss – Presbycusis, normally is
limited to higher pitched sounds than those
used in speech
• Sensitivity to taste and smell generally begins
to decline in midlife – Individual differences
• Adults begin to lose sensitivity to touch after
age 45 and to pain after age 50. However,
pain’s protective function remains; they feel
pain less and become less able to tolerate it

3. Physical Changes - Sensory and
Psychomotor Functioning
• Strength and coordination decline gradually from their peak during 20s
• There is gradual decrease in basal metabolism (use of energy to maintain
vital functions)
• Manual dexterity becomes less efficient after 30s
• Simple reaction time - single response to single stimuli (ex., pressing a
button when light flashes) slows;
When vocal rather than manual response is called for, age
differences in simple reaction time are substantially less;
Tasks that involve a choice of responses (ex., hitting a button when a
light flashes and another button when a tone is heard and complex motor
skills involving many stimuli, responses and decisions (as in driving a car)
decline more – but the decline does not result in poor performance.
Knowledge based on experience and “Overpracticed skills” are resistant to
the effects of age.

4. Structural and Systemic Changes
• Skin
• Hair
• Sweat glands – decreases
• Accumulation of body fat
• Shrinkage of intervertebral disks
• Bone density
• Vital capacity – Amount of air that can be drawn in with a
deep breath and expelled – may begin to diminish
• Temperature regulation and immune response may begin
to weaken
• Less deep sleep

5. SEXUALITY IN
MIDDLE ADULTHOOD

6. • www.mentimeter.com
• 313377

7. SEXUALITY
• Climacteric – a term that is used to describe the midlife
transition in which fertility declines.
• Menopause – the time in middle age, usually in the
late 40s or early 50s, when a woman’s menstrual
periods completely cease.
• Individual variation – average age – 51 – later
menopause – increased risk for breast cancer;
• There is little or no correlation between onset of
menarche and onset of menopause
• Perimenopause – Transitional period from normal
menstrual periods to no menstrual periods at all –
often takes upto 10 years.

8. Climacteric (Change of life)
• Perimenopause – The period of several years
during which a woman experiences
physiological changes that bring on
menopause – menstruation becomes
irregular, with less flow than before and
longer time between menstrual periods,
before it ceases altogether.

9. Menopause and its symptoms
• Influenced by heredity and experience
• In women who smoke on a regular basis, menopause
occurs one or two years earlier because tobacco smoke
and tar can damage ovaries (Gosden, 2007)
• Menopausal symptoms increased in women who
smoked cigarettes, drank alcohol, currently using oral
contraceptives, were depressed, and ate high sugar-
content foods (Sabia & Others, 2008).
• An 8 yr longitudinal study of women in their 40s and
50s found that walking regularly 1⅟2 hours a day five
days a week – fewer symptoms of anxiety and
depression- transition period (Nelson & Others, 2008).

10. Symptoms
• Production of estrogen by the ovaries decline
dramatically, this produces uncomfortable
symptoms in some women – “hot flashes”,
nausea, fatigue, rapid heartbeat, etc
• Cross-cultural studies reveal wide variations in
the menopause experience; Ex., hot flashes are
uncommon in Mayan women; Asian women
report fewer hot flashes than women in Western
societies
• Reason - Genetic, dietary, reproductive or cultural
factors?? – difficult to determine

11. The experience of Menopause
• Menopause overall is not the negative experience
for most women
• Loss of fertility is an important marker – they
have to make final decisions about having
children
• HRT (Hormone Replacement Therapy) was
prescribed often until recently – to augment the
declining levels of reproductive hormone
production by the ovaries – included various
forms of estrogen, usually a progestin.

12. Is HRT a solution?
• HRT increases the risk of stroke
• Combined estrogen and progestin hormone therapy increases the
risk of CVD
• Preliminary data – indicates increased risk of dementia
(deterioration of mental functioning)
• On the positive side – estrogen lowered risk of hip fractures;
• did not increase the risk of heart attacks or breast cancer (other
studies contrary findings) / cognitive aging (studies for and against)
• Long-term hormone therapy should be seriously reevaluated
• When benefits outweigh risks…
• Better alternative – Regular exercise, dietary supplements, herbal
remedies, relaxation therapy, acupuncture, non-steroidal
medications.

13. Hormonal changes in
middle-aged men
• Most men, during middle adulthood, do not lose
their capacity to father children, however, there is
a modest decline in their sexual hormone level
and activity.
• Changes are not dramatic – Testosterone
production begins to decline about 1% a year
during middle adulthood and sperm count
usually shows a decline, although they do not
lose their fertility – testosterone deficiency linked
with obese and diabetic men.

14. Hormonal changes in
middle-aged men
• Erectile dysfunction – inability to adequately achieve and maintain
an erection that results in satisfactory sexual performance
• Researches - ⅔ of men report that erectile dysfunction has
impaired their self-esteem and ⅓ claim that it has harmed
their relationship with their partner (Mirone & Others, 2009)
• Middle aged men’s erections are less full and less frequent
and require more stimulation to achieve them; Once these
were attributed to psychological factors – but 75% stem from
physiological problems – smoking, diabetes, hypertension,
elevated cholesterol levels;
• Low testosterone – Obesity, metabolic syndrome, high level of
triglycerides
• Drugs – Viagra, Levitra, Cialis; Viagra – increases blood flow
into the penis and produces erection – improved self-esteem,
confidence and relationships; side effects

15. Sexual Attitudes and Behavior
• The ability of men and women to function
sexually shows little biological decline in
middle adulthood; sexual activity occurs on a
less frequent basis
• Sexual thoughts, Other forms of sexual
behavior, how sexually active they are
depends on many socio-cultural factors.

16. Changes in human reproductive
systems during middle age
Female Male
Hormonal Change Drop in estrogen and
progesterone
Drop in testosterone
Symptoms Hot flashes, vaginal
dryness, urinary
dysfunction
Undetermined
Sexual Changes Less intense arousal, less
frequent and quicker
orgasms
Loss of psychological
arousal, less frequent
erections, slower orgasms,
longer recovery between
ejaculations, increased risk
of erectile dysfunction
Reproductive Capacity Ends Continues; some decrease
in fertility may occur