with health among middle-aged and older adults." There are a number of associated health benefits with practicing positive sexual health. Positive sexual health often acts as a de-stressor promoting increased relaxation. Researchers also report health benefits detailing decreased pain sensitivity, improved cardiovascular health, lower levels of depression, increased self-esteem, and better relationship satisfaction. The former could also imply the consequences of negative sexual health and lack of sexual activity, such as depression, low self-esteem, increased frustration, and loneliness. Health risks and education There are already numerous health concerns linked primarily with aging, but when sex is added into consideration, this opens up discussion for many other related concerns. Sex and aging come with many challenges for the older population as well as their primary care providers. The task for these care providers is to accommodate to the changing needs of this older sexually active generation. Common health conditions hindering older adults are illnesses such as cardiovascular disease, diabetes, degenerative and rheumatoid arthritis, stroke, cancer, kidney disease, and spinal cord injury. These conditions heavily impact individual sex lives. Separate from these are physical concerns related specifically to sexual health and bodily functions. Researchers gathered that, "the most common concerns for older adult men include erectile dysfunction and premature climax, and older adult women most commonly report lack of desire, problems with vaginal lubrication, sexual pain, and inability to reach orgasm." Consideration of these aging-related health problems and sexual-related health problems together require primary care providers and professionals to be updated on the latest health findings and to know patients' needs and possible solutions. A major problem with improving education and seeking solutions for aging sexual health risks is the lack of verbal discussion on these matters from older individuals. "Older adults often avoid seeking help for sexual concerns because of a lack of knowledge about their sexual problems, embarrassment or discomfort talking about sex, and stigma-related beliefs about older adults and sexuality in older age being inappropriate." Another major problem with improving education and seeking solutions for aging sexual health risks was found after researchers looked at the readiness and training of 777 physicians and 452 nurse practitioners from the American Medical Association Masterfile. Researchers noted that amongst their representative sample there were reports of limited training in sexual health as a general topic. From this information, they assumed that "training that is specific to older patient’s sexual health is limited,