Judy Scheel Ph.D., L.C.S.W., CEDS

Sex Is a Language

Sexual Performance Problems

Issues related to age, porn, or psychological problems are treatable.

Posted Aug 05, 2019

Sex is routinely a topic of intrigue, fraught with layers of fantasy, eroticism, and curiosity. It also remains a taboo subject matter, the forbidden fruit. Thinking, talking and engaging in sex often stirs anxiety.

Sexual dysfunction and issues of physical intimacy, including dissatisfaction, boredom, and lack of communication, are reasons why couples enter sex therapy. Resolution of the problems is achieved as couples, through the therapeutic process, become comfortable in talking about sex and in communicating their wants, desires, and fantasies to their partner. Sexual problems can be embedded in other relational issues and are the vehicle to express other conflicts or run parallel to the relational life in general.

Sexual intimacy issues are often driven by psychological and interpersonal issues like sexual shame and guilt, familial values and upbringing, religion, sexual trauma, gender norms, and expectations. The resolution of the problems generally deals with helping the couple confront the underlying intra-psychic and interpersonal issues toward the goals of emotional intimacy and enhanced sexual health and pleasure. The therapist discusses sound sexual exercises and behavioral techniques with the couple, who are instructed to conduct them at home and report back about successes, difficulties, and responses for further exploration.  

Sometimes, sexual issues have nothing to do with relationships or internal conflicts. Biological and external forces supersede and affect the couples' psychological well-being. Loss of control over waning libido and sexual functioning and desirability is inevitable with aging. Anxiety can set in.   Physical appeal, timing, age discrepancy, and the effects of aging all play a role in diminished sexual interest, arousal, and performance. More recently, the focus has been on performance issues for men and women. Difficulty in obtaining and maintaining an erection for men at all ages and desire, arousal, and lubrication issues for women of all ages saturate media sites. Advertising for "cures" are everywhere.   

People look for solutions to fix what is or feels out of their control. A quick fix for self-esteem boosting is sex; Tinder has made this possible. However, when reality strikes, as with diminished sex drive due to age, many are ill-prepared to accept it and adjust their behavior and perspective about sex. It is challenging to start communication about age-related biological matters like erectile dysfunction or vaginal dryness if a couple has not had a consistent conversation about sex throughout their relationship. Emotional intimacy is likely to be affected as sexual performance issues emerge.

Aging impacts sexual performance. Age-related sexual changes affect arousal synchronicity, particularly between heterosexual partners. 

Here are some things to consider:

  • Desire, love, style of sexual activity all contribute to the longevity of sexual performance and sexual life between a couple.  However, according to the Harvard Medical School, a 19-year-old male will have a “faster, harder erection and a more forceful ejaculation than his 55-year-old counterpart… [but] older man will have better control of his ejaculations.” And as a “woman moves through her 40s, her orgasms actually become more intense and she can still have multiple orgasms.” 
  • Older men often seek younger women, even though men over the age of 40 may find greater sexual satisfaction with a woman closer to their age; more mature women tend to be patient with age-related performance issues in men and are more comfortable with their bodies and sexual likes and needs.
  • As a man's sexual performance starts to wane with age, choosing a younger woman could better secure the need for lessened sexual demand for both. Relational and sexual Issues often emerge for a man as a younger woman ages and the woman’s sexual needs increase; incompatibility, increased frustration, relational and sexual boredom can easily emerge.
  • Women in their later 30s, 40s and 50s often are at a disadvantage in finding age-appropriate men. As sexual prohibitions diminish and gender equality increases, middle-aged women are increasingly seeking out younger men for sexual encounters. However, among women's chief concerns are fears related to competition with younger women and incompatibility with their younger male partner in experience and maturity. 

Caveat: Despite gains for women, American culture continues to judge women who seek younger men for sex, labeling them "cougars." The connotations are that women are aggressive, if not on the attack.

The porn industry, an exogenous force, seems to have further eroded sexual satisfaction and intimacy for couples. Frequent watching of pornography may have a deleterious effect on sexual performance and sexual response, though the evidence is typically correlational  (psychologytoday.com, 2014 & 2018). For example, a study conducted by urologists involving 312 men ages 20-40 found a statistical relationship between "porn addiction" and sexual dysfunction (healthday.com, 2017). Another study looked at the relationship between erectile dysfunction and preferences for pornography in men.  The researchers found that the rate of dysfunction was lowest among the respondents who reported preferring sex without pornography (22%). The incidence of dysfunction increased in men who preferred sex with pornography (31%) and was highest among men who preferred masturbation with pornography (79%)  (Medscape, 2017). 

Additionally, women may feel that they can never live up to the fantasy acts portrayed on screen or think that their porn-watching partner will never experience the same level of titillation toward them as their partners seem to derive from in the 'live' webcam actress. Real sex rarely matches the fantasy or contrived acts on the screen. 

In a sense, however, performance issues related to age, pornography, and inter-personal and psychological problems are all treatable. 

The advent of drugs to treat erectile dysfunction in men and safer hormones, bio-identical hormonal replacements and homeopathic remedies for women at all stages of life have lengthened and increased both men and women's sexual interest, arousal and climaxing experiences. These treatments are excellent news for couples who are facing age-related sexual performance issues. 

Treatment for a couple includes creating safety for open communication about sexual desires and needs and toward acceptance of age-related changes.  If pornography appears to be a problem, it may require individual therapy with the goal of elimination or reduction, though porn has a place as an adjunct to sexual fun. 

Sex at any age is enhanced through communication, modifications in practice when necessary, acceptance of nature's biological path, and medical assistance where needed. These changes and shifts in perspective can take a while as talking about sex for many people is not easy Ultimately, the cornerstone of joy and satisfaction in sexual intimacy is relational intimacy.

References

Brenner, G. 4 Ways Porn use causes problems. psychologytoday.com (March 5, 2018).

Harvard Medical School. (2019). Sexuality in Midlife and Beyond:  A special report.  Harvard Medical Publishing

McCarthy, B. (2015). Sex made simple: Clinical Strategies for sexual issues in therapy. PESI Publishing & Media.

www.medscape.com.  Porn Use Linked to Erectile Dysfunction - Medscape - May 14, 2017.

Streep, P. What porn does to intimacy. psychologytoday.com (July 16, 2014).

Thompson, D. Study links preference for pornography with real-world sexual dysfunction. HealthDay.com. May 12, 2017.