I was once asked, “Why would you come out at 40? You were too old for sex anyway.” It’s true that sex is not the same at 40 as it was at 20, and it certainly is not the same at nearly 75 as it was when I was 40. But older people can have satisfying sex.
In measuring men’s sexual function, four dimensions are considered: sexual desire, erections, ejaculation, and sexual satisfaction. As men age, these dimensions of sexuality evolve. Sexual desire, erectile strength, and ejaculatory volume, and strength all diminish over time. That’s the bad news – especially if we think that sex is a performance.
But there is very good news for older men: sexual satisfaction can remain nearly constant over time. In other words, when we accept that sex is about pleasure, not performance, we can experience a satisfactory sex life throughout our lifetime.
Let me be even more specific: good sex does not require a world-class erection. We live in a world where many believe that it takes a little blue pill to put the magic in lovemaking. Even young men now use medications like Viagra as sexual performance enhancers. When we believe that sexual pleasure demands the kind of erections we were capable of as teenagers, we’re in for some disappointment.
The truth is that all men from time to time will struggle with erectile dysfunction (ED) – obtaining and maintaining an erection. It’s a given. Accept it. Unfortunately, at the first sign of difficulty, men often begin to wonder, “Am I losing it? Is my sex life coming to an end?” They expect that the struggle will only become worse, and once that concern becomes established, it almost guarantees that things will become worse. In fact, it can become a bit of an obsession. Instead of anticipating sex as something pleasurable, it becomes a question of, “Am I going to be able to perform?”
Unfortunately, it can become even more complicated if a man’s sexual partner becomes too insistent: “You don’t find me sexy anymore.” Shame and guilt can replace sexual desire. A fear of failure may drive the partners apart so that they don’t even try to have sex.
The work of Masters and Johnson on sexuality in the 1960s was largely forgotten until the recent television series “Masters of Sex.” Through their research, they discovered that many of the causes of ED were psychological, and they developed what they called Sensate Focus Exercises to treat these psychological causes. Their treatment techniques were the basis of some of the most humorous moments in a film called Hope Springs, which includes scenes of a middle-aged wife (Meryl Streep) fondling her husband (Tommy Lee Jones). But what was most remarkable about the film was that it portrayed the struggles of sexually active older folks.
For older men, it is important to realize that the excitement phase of sexual function is slower. It takes longer to reach a full erection, and it is easier to lose the erection even when feeling sexual excitement. But losing an erection doesn’t mean it’s all over; an erection can be lost and recovered several times during an episode of lovemaking. Unless they understand that, men often make the mistake of pushing harder and faster at that point – precisely the wrong thing to do. The solution is actually counterintuitive: stop, back off, and start engaging in some sexual playfulness again.
Especially for older men, we can’t ignore that there may be physical explanations for ED: diabetes, high blood pressure, heart disease, alcohol and smoking, obesity, low testosterone, prostate problems, and prescription medications. But even in these circumstances, men can have satisfying sexual experiences when sex is about giving and receiving pleasure, emotional as well as physical intimacy.
One of the advantages of being older is the freedom of discretionary time. Sex doesn’t need to be squeezed in while rushing from appointment to appointment. Older people can learn to enjoy sex at a slower pace and share physical and emotional intimacy without expecting a bouquet of roses at the end of their “performance.”
Loren A. Olson, MD, is a board-certified psychiatrist with over forty years of experience. He is a Distinguished Life Fellow of the American Psychiatric Association and has been named an Exemplary Psychiatrist by the National Alliance for Mental Illness. He is the author of Finally Out: Letting Go of Living Straight.
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