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Our Sexual Bodies Really Do Change, Part I

Our bodies change as we age, so sex should, too.

Gray hair and a bit of a belly are the least of it. With all due respect to the circus that can be menopause, men’s bodies also change as we get older—and the changes have many sexual implications. Let’s hold off on the obvious, and start by examining the many other issues that get overlooked in its shadow. With an eye toward sex, here’s what most men over 50 are, or will soon be, dealing with:


People snore more as they age. As a result, their sleep may not be as restful, leading to grouchiness (bad for sex) or fatigue (bad for sex). If the snoring gets bad enough, a couple may decide that separate beds or separate rooms are necessary. That doesn’t have to be bad for sex—but for couples whose sexual relationship is already waning, it can accelerate the decline.

Joint pain

Aches and pains are almost universal as people age. The back, neck, knees, elbows, and hips are central to sexual functioning with a partner, and when they hurt, sex becomes frustrating. Unfortunately, many men feel required to stay quiet about their pain and its sexual impacts, and either silently endure a degraded experience, or withdraw from one sexual activity after another without explanation.


Men in middle age and beyond have to pee practically all the time. Really. The bladder is constantly signaling the brain to empty it, but it empties with decreasing efficiency. Needing to pee and finding it hard to do so is not just aggravating, it’s scary. And when you need to do it again 15 minutes later, it’s hard to relax. Worry interferes with sex, of course. So does needing to pee.

Hearing problems

Most people know that hearing problems increase with age. Some people get hearing aids, many don’t. Those who do typically remove them for sex. As a result, words said in a whisper may not be heard, leading to romantic misunderstandings or disappointments.

Declining grip strength

Most men really hate to talk about this, but grip strength declines with age.
Carpal tunnel syndrome, arthritis, and workplace injuries can make opening a jar or using a screwdriver torturous. One result is that masturbation can become more trouble than it’s worth—a terrible loss. Another is that caressing a partner, especially squeezing her breasts and butt, can lead to far more pain than pleasure—another terrible loss.

Oral ecology

The older people are, the more medications they take. Men take some drugs way more than women do—for high blood pressure, cholesterol, and ulcers, among other things. Some drugs can reduce the amount of saliva in the mouth, leading to unpleasant smells or tastes. Although professionals rarely discuss this (why?), it can dramatically reduce the enjoyment of kissing. This effect is multiplied when people take several medications at once, including antibiotics, anti-inflammatories, and chemotherapy.

Erection, orgasm

These are the effects people know best—or at least they say they do. As men age, it’s harder to get erect, and the erections may not be as firm or reliable as they used to be. Erection drugs like Viagra may help, although they cannot be used by men taking certain other medications, like those for high blood pressure. On the other hand, if a man doesn’t desire or enjoy his partner, an erection drug won’t change that.

Most older men also experience a dramatic change in their ability to orgasm and ejaculate. The amount of fluid that comes out at orgasm decreases year by year. Perhaps more dramatic, the middle aged or older man may have sex and simply be unable to climax. As a result, some men stroke their penis to have an orgasm after partner sex. Of course, men who are too shy to do so (or women who think it’s gross) don’t have this option.

Unfortunately, a lot of women think a man’s lack of erection or orgasm reflects a lack of excitement, desire, or satisfaction. In fact, I’ve seen some women in my office get quite fierce about this, calling their husbands (and me, in the bargain) liars when they were actually describing their experience quite honestly. Ladies, it may not be all about you. It may not be about you at all. Why resist this good news?

What to do about all these changes? Take a deep breath and keep redefining sex. Focus on the body parts that work, the activities that feel good, and do whatever you need to do to create an emotional connection with your partner. And when you find a workable combination of body parts, activities, and connection—call that “sex” and enjoy it.