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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 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 fifth 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 percent of the sample at age 65 to 69 to 50 percent at age 70 to 77.
Another study found that 63 percent 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 lifestyle, adapt to the normative changes in the sexual equipment, keep on working on your intimate relationship, and cultivate a “Zen” attitude of acceptance (mindfulness).
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, but 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 after 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.
Whereas 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 a 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.
Penile Sensitivity. 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 resist 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 how lifestyle 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.
