Male Physiological Changes with Aging

Today I will be talking about men’s physiological changes with aging. And I’d like to start out showing you this one chart here, and it’s from a study where they asked people in different age groups – we have age 45 to 59 here, age 60 to 74, and over age 75. The blue boxes are women and the red are men. And the question was whether people said that a satisfying sexual relationship is important to the quality of their life. And so, as you can see, it’s really the case for all of these age groups – even though it’s declining a little bit for people over 75 – between 40% and 50% said that a sexual relationship was still important to them. So I think this is important data to keep in mind when we’re talking about aging.

One thing I want to start out mentioning, and I want to be sure that I’m not forgetting to say this, is that for men in general it’s considered not a problem if they lose erections once in a while, or if they’re unable to keep their erections once in a while. And that’s actually usually something that’s not discussed in the locker room, and men are not familiar with the fact that it’s not a problem if once in a while they lose their erections. Maybe they had too much to drink, maybe they were too tired, maybe they were not really aroused. In fact, if a woman doesn’t get aroused, it’s not quite as obvious as for a man. But if he doesn’t really feel aroused maybe he can’t get an erection one night, and there’s no problem with that. Maybe he’s nervous – if a man is nervous, he has a hard time keeping or getting an erection, and that can then turn into performance anxiety, it can turn into a problem. But I do want to be sure to mention that in any man, any age, it is considered normal to once in a while not be able to get an erection.

Now I want to talk about the changes with aging and I’m going to talk about erections here as well. One of the things that I always point out – I like to talk to both men and women in my office about these normal changes because some women actually have wrong expectations about their partner, and a lot of men have wrong expectations about themselves. But as he gets older, and it can really start as early as the 30’s and 40’s, he will need more and more direct stimulation of his penis. So not just the mental stimulation, the thoughts, but on top of that, he will need more physical direct stimulation of his penis. And that’s very important, because a lot of men don’t quite realize that this is a fact, and they think that they should be able to just get erections from thinking about sex and having sexy thoughts. The other thing that age is going to change is that the erections become less strong. However, erectile dysfunction, the inability to either get an erection or keep an erection is not normal, and it always needs to be followed up by a health exam, a physical exam.

The next thing that is normal as someone ages – and again I’m saying this can start as early as in the 30’s and 40’s, but definitely in the 50’s and 60’s – is that erections don’t last as long. The other thing that is very typical also is the time frame between – let’s say a man has an erection and ejaculates, when he’s very young it doesn’t take a very long time and he can get another erection and ejaculate, so that time frame is very narrow. However as a man gets older, this time frame gets longer and longer – in fact, a man in his 70’s it’s considered completely normal that if he ejaculates and has an erection one day it will take him up to two days to be able to get another one. That time frame is now two days, it used to be maybe twenty minutes, now it’s two days – and that is a normal aging response. The other thing that also usually changes is that the amount of ejaculate changes. The volume becomes less, and the force of how the ejaculate is expelled also usually becomes less. And some men, not all, experience less sensation with orgasm. And then another thing that’s related simply to the drop in hormone levels is that the testicles, the size of them gets smaller. And those are all normal changes with aging.

I think a lot of people have this idea that they need to perform – everything is about performance. They need to have erections, they want to ejaculate, and as one gets older I think it’s important to try to get away from this, what I call the “performance model.” But think about pleasure more – try to move from performance to pleasure. Those two words both start with a P but they are very different, so instead of thinking about performance all the time, embrace pleasure instead. And as one of my clients in his 70’s said – he was still enjoying sex with his spouse at the time, and they had been married for many years, but he said “I wish when I was 30 that I had been able to enjoy the ride as I am now, and not just be wanting to get there.” So I think it’s a nice way to think about it – trying to enjoy the ride, and not just wanting to rush to wherever you want to get.

I want to make one little quote – it’s actually a book for women, called “Women’s Sexualities,” but I really like this author’s quote about what she calls being “sexually successful.” She says “I think of a couple as sexually successful when they create mutual erotic pleasure to whatever level and in whatever form they desire on any particular occasion, so that each ends up feeling good about herself or himself and the other, experiencing a good time, and enhancing their relationship.” So again it’s like being able to enjoy the ride and not wanting to get there necessarily.

There are a couple of books that I want to recommend to you. One is written by Dr. Robert Birch, who is also one of the Love and Health experts here on the website. He wrote this book called “Sex and the Aging Male” – a very nice book that incorporates all of the changes with aging. And then another book that is also very good is “The Sexual Male: Problems and Solutions” by Julian Slowinski. He is covering not just aging, but he and Dr. Milstein have a very nice chapter on aging in the male.

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