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.

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.