Impact of ageing in male sexuality
In this piece I am specifically writing about men and the sexual changes that occur with age. This includes organic and non-organic factors alongside treatment options. There is a normal change in men when they age and often this is not something that is readily discussed. Information and messages about sex and ageing are that it is not a priority as we get older. If this is the perceived; it makes it difficult for men (and women) to know what to expect and what is acceptable for them sexually as they age. It would also make it difficult to express concerns about their sexual functioning. However, a happy sex life increases satisfaction in life and the desire for intimacy is timeless. As you age, sex may not be the same as it was in your 20s, but it can still be very fulfilling.
The reduction in testosterone is believed to play a part in the decrease in sexual desire in both men and women, however in healthy individuals it should not cease altogether. Studies have shown that there is a clear decline in sexual functioning as they age, affecting sexual desire, erectile response and ability to ejaculate, these are specifically not dependent on the presence of illness or medication use. Over time, as men age, what they may seem to notice is that it takes longer to get an erection or that the erection is not as hard as in earlier years. This can be specifically difficult in relationships if there are different levels of desire within the couple.
Any condition that affects your general health and well-being may also affect your sexual health. Organic factors are physical causes that can affect sexual functioning; these include diabetes, heart and vascular disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, prostate and bladder problems. When a man has an additional medical condition it can affect his sexual desire, getting or keeping an erection and ability to ejaculate. This is not limited to age and may occur in younger years, however as one ages organic issues are more likely to take effect.
Non-organic factors relate to psychological causes such as work-related stress, retirement, concern about sexual performance, relationship problems, depression and grief to name but a few. When a man is living with a sexual dysfunction as well this may compound the negative effects the emotional and mental health issue is causing. This can affect the man’s self-esteem and confidence which may in turn make the things worse. As men go through different changes in life it can affect them emotionally and they might develop mental health issues like anxiety and depression which may need treated with medication and/or talking therapy.
There are many treatments options available for men facing dysfunctions at an older age, options such as PDE-5 inhibitors (phosphodiesterase inhibitors), vacuum pump, penile injections, penile implants. In the first instance seeing a GP is the best starting point. Don’t be afraid to talk with your doctor if you have a problem that affects your sex life as there is much they can do to help.
When there is not a physical reason to discuss a sexual dysfunction, some men may find it difficult to start up the conversation and something that may be a normal change in ageing can become overwhelming and life limiting. However, it doesn’t have to be. Reaching out to a psychosexual therapist either privately or through your GP may help to ease these worries. It may mean adapting sexual activity to accommodate physical health and other changes. Starting a dialogue is the first step. A therapist should be able to support and guide individuals and couples to not only understand how the body changes over time, but also how it can be used to regain control and have a happy sex life.