Mindful Sex

Tips and techniques from the front lines of couples therapy.

Aging and Male Sexual Desire II: Physical Factors

Sexual functioning changes in mid-life and is strongly affected by biology.

 In Part II of this four part series on aging and sexual desire in men, I want to discuss some of the physical or biological issues that impact on male sexual desire. What is clear is that there are very different trajectories in men who are healthy in body, mind, and relationship from those who either have physical illness or not in good relationships.

Age and Desire: While we have doubled our life expectancy over the past century, our sexual equipment begins to lose functioning around the 5th decade in healthy men. However, this is highly variable; many factors will determine the quality of sexual function and desire. A recent large sample survey found that in both men and women, sexual desire decreased with age but not nearly as fast as popular belief. These authors found that it is not until age 75 or older that the majority of men report a low level of sexual desire. Low desire jumps from 27% of the sample at age 65 to 69 to 50% at age 70 to 77. Another study found that 63% of men age 80 to 102 continued to be sexually active Good news: there are many older persons having a good time being sexual. The trick is to adopt a healthy life-style, adapt to the normative changes in the sexual equipment, keep on working on your intimate relationship, and cultivate a “Zen” attitude of acceptance (Mindfulness).

Find a Therapist

Search for a mental health professional near you.

 Factors Relevant to Sexual Desire in Mid-Life

Testosterone: The age-related decrease in libido noted among men is most frequently attributed to a decline in testosterone levels and to changes in receptor site sensitivity to androgen. Around the 5th decade of life, testosterone production gradually declines. By age 80, it may be only a sixth of a younger man. The caveat is that while lowered testosterone parallels the decline in sexual libido noted with age, there is little evidence to suggest that loading up on testosterone replacement will augment sexual drive with men with normal baseline testosterone. However, if you are suffering from what is called “hypoactive desire disorder (HSDD), and one in five men post age 50 do, you might benefit from testosterone replacement. If you have absolutely no libido, are depressed, have poor concentration and energy you would be wise to consult your urologist and have your hormonal blood levels checked. 

Erectile Function: Normal age-related change in erectile function will affect sexual desire. These symptoms include a decrease in blood flow to the scrotum and penis; reduced tensing of the scrotal sac and delayed erection. Where a younger man may achieve a full erection in seconds, an older man may require several minutes to attain a similar response. More time and more direct penile stimulation may be necessary to achieve the desired results. Having a cooperative partner who is happy to provide manual and/or oral pleasuring will help facilitate and augment arousal. Assuming a mental attitude of nonjudgment, focusing your attention on the pleasurable sensations will help create the comfortable and relaxed atmosphere that promotes sexual arousal and intimacy. Being self-critical and demanding of a “performance” or comparing yourself to the way you responded when younger will create anxiety and stress. The stress response reduces reduce blood flow and hence, erectile function.

 More bad news: penile sensitivity also decreases with age. Bottom line: to compensate you need to have more time for sexual play and a tranquil, comfortable sexual “climate” in order to maximize blood flow and sensitivity. Being able to receive direct manual or oral stimulation prior to intromission and possibly at periods throughout the sex act will help to sustain erection until orgasm. “Adapt or perish” as they say. If you try to hold onto the way it was and resists the inevitable; that is, physical change accompanying aging, you will no doubt experience more pressure and anxiety. The male phallus does not like pressure and will be likely to fold in its presence. While penile rigidity declines gradually beginning in most men at age 60, couples can compensate by experimenting with more creative and novel foreplay and stimulation as well as different coital positions.

 In Part III of Aging and Male Sexual Desire, I plan on tackling the how life-style issues, illness, and medication affect male sexual health and libido. I will also attend to the complicated issue of relationship; that is, the importance of maintaining emotional intimacy and relationship satisfaction to sexual desire.

 

Dan F. Pollets, Ph.D. is a licensed clinical psychologist and certified sex therapist. more...

Subscribe to Mindful Sex

Current Issue

Dreams of Glory

Daydreaming: How the best ideas emerge from the ether.