This story originally appeared on Out.Aging is not for the faint of heart. Your body and mind go through massive changes. Most people are aware that, as you move into your 50s and beyond, you need to start paying closer attention to your blood pressure and cholesterol. But few know you should also be keeping an eye on your sexual health.As you zoom past middle age, you might notice changes to your body like a drop in libido or sexual dysfunction setting in — even if you never had issues in the past. All of this can have a profound impact on your sex life. And the situation can be even more complicated for transgender women, transfeminine people, and gender diverse folks.Not only can your sexual health and medical needs different than cisgender people, but there is also so little information out there about what it’s like to age as a trans person (let alone how to improve your sex life in your golden years) that you may assume there’s not much you can do about the frustrating changes that come with aging. But that assumption couldn't be further from the truth. Not only are there inventive new ways you can have sex, but there are also plenty of changes you can make to your physical and mental health that will help you stop sexual function loss in its tracks.What sexual health changes should trans women and transfemmes over 50 expect?Trans women, transfeminine people, and gender diverse folks’ sexual health after 50 looks a little different than for their cis counterparts. While cis women struggle with the symptoms of menopause and cis men deal with hormone-driven sexual health changes because of significant drops in testosterone levels, those changes won’t be issues for anyone on stable hormone therapy. “This is because estrogen therapy keeps their testosterone suppressed and hormone levels steady rather than declining with age,” says OB/GYN Dr. David Ghozland, who is the founder of Intimate Health Center, with over 15 years of clinical experience specia