Sex and aging: a guide for men

As the years roll by, you might find you don’t have the sex drive you once did. But many men are still having satisfying sex as they get older.

Among adults aged 65 to 80, 40 percent were sexually active and 51 percent of men were still having sex, according to the National Poll on Healthy Aging, published by the University of Michigan in 2018.

There may be health benefits to staying spry, too. A 2018 study published in the journal Sexual Medicine found that sexual intercourse is associated with improved well-being in older men.

No doubt there are challenges that come with the years: Falling testosterone levels and loss of libido are some of the changes men may have to contend with. Erectile dysfunction, delayed ejaculation, and changes in an older partner can also contribute to a shifting sex life.

But that doesn’t mean you have to give up on sex. Here are some common issues that crop up over the years and what you can do about them.

Erectile dysfunction

Erectile dysfunction (ED) involves having trouble getting or maintaining an erection, and it’s a common problem for older men, says Michael J. Belsante, MD, a urologist in Nashville, Tennessee. “As men get older, rates of erectile dysfunction increase,” he says.

Causes of ED can be physical or psychological. Physical issues like diabetes and high blood pressure, which are more common as people age, can contribute to ED. Feeling stressed, depressed, or anxious about your body can affect you, as well.

Other physical causes of ED can include the use of antidepressants and medication to lower blood pressure, as well as tobacco and recreational drugs like alcohol and cocaine. These physical and psychological causes often become a feedback loop.

“You get anxiety due to the physical causes of your ED, and that makes it even harder to perform,” says Dr. Belsante.

Delayed ejaculation

One of the more common sexual problems for younger men is premature ejaculation. The American Urological Association reports that up to 30 percent of men in the United States say they experience it.

Older men tend to have the opposite problem.

“Premature ejaculation can happen at any point, but it tends to be less of a problem in men as they get older,” says Belsante. Instead, delayed ejaculation is more of a complaint, which can be due to low testosterone, blockages in the anatomy of the penis, nervous system problems, or side effects from certain medications.

Peyronie’s disease

Another sexual condition that can emerge later in life is Peyronie’s disease. With Peyronie’s disease, scar tissue forms in the penis, causing it to curve or bend. It can lead to painful erections and can make intercourse difficult or impossible. Peyronie’s is an inflammatory process that takes time to develop, which is why it’s most often found in men over 40, according to the Urology Care Foundation.

Consider your partner

You may not be the only one for whom sex is changing. If your partner is around the same age as you, their body is also going through changes that may affect sex. For example, a woman who has experienced menopause can have less vaginal lubrication and may have pain with intercourse. That can affect both partners, says Belsante.

As men age, it may take longer for them to achieve an erection. Combined with what your partner may be experiencing, it might be a good idea to take it slow and spend plenty of time on foreplay.

Sex may be, by necessity, different as you get older, but it can still be positive and enjoyable. If you have any concerns or issues, make an appointment to speak with your healthcare provider about any issues you may be confronting and remedies that can help.