Men, Sex and Aging in Relationships

I have previously written about women and the menopause, I am now turning my attention to men, sex and aging in a heterosexual context.

Research indicates sexual activity declines with age however as we see older people being portrayed as healthy, attractive and vigorous, we are more likely to acknowledge this age group as sexually attractive and therefore potentially sexually active.

In psychosexual terms feeling healthy, feeling good about your body and being reasonably fit are factors in feeling sexually attractive and of course these are likely to make a partner more responsive. Whilst the recognition of desire, lust and libido in the later stages of life must be a positive shift it may hide some of the struggles that older men are facing in the bedroom.

There are inevitable physiological effects of age on erectile function. Age UK says that 40% of men over 60 experience erectile problems. Erectile tissue becomes less elastic over time, testosterone levels are reduced, blood flow to the penis decreases. Apart from achieving an erection, difficulties in maintaining it, ejaculating too quickly or not being able to climax at all are common problems.

Sexual problems are frequent amongst older adults. In one study about 25% of older adults with a sexual problem said they avoided sex as a consequence. There are links between poor health and lack of sexual activity. In the same study the most common reason cited for a lack of sexual activity was the man’s ill health. Examples included drinking alcohol to excess, smoking, stress and a lack of exercise and conditions like high blood pressure, type 2 diabetes and heart disease.

Sexual problems are infrequently discussed with doctors and communication about sexual problems can be poor. Apart from the fact that sexual problems may be symptoms of an underlying physical condition, undiagnosed and undiscussed sexual problems may lead to depression and social withdrawal.

The kinds of problems that do not get discussed include concerns about medication for other conditions that impair men’s sexual performance, as well as drugs to improve sexual performance that have unpleasant side effects such as headaches and indigestion. Men might choose to stop taking medication if they feel they will have better sex without it and they may give up taking medication to improve their sex lives if they cannot tolerate the side effects.

In 2015 prostate cancer accounted for 13% of all cancers in the UK. The survival rate has been improving over the last 40 years but survivors can be left with lasting changes to their sense of themselves as sexual beings. One of the treatments is hormone therapy, which effects the production of testosterone and reduces the desire to have sex. Men put on weight more easily and can develop man boobs and they may find themselves crying more often. It is no wonder that a man might ask himself, “Am I still a man?”

In a relationship the impact of an older man’s difficulties on achieving and sustaining an erection will depend on their partner’s own experience of sex and aging. A man with a younger partner may feel he is letting his partner down. A couple may feel safer distancing themselves from each other and avoiding even affectionate physical contact in case it leads to unsuccessful sex. Men with partners no longer interested in sex may feel shameful about masturbating using pornography or fantasising about other women.

We do not readily talk about sex, it makes us feel very vulnerable. Seeking support and sharing feelings in counselling and psychotherapy can be a step to rebuilding a sense of self and sexual confidence and the start to thinking about new ways of relating.

Angela Rogers is an Integrative Psychotherapeutic counsellor working with  individuals and couples in Hove.