How men can stay sexually healthy with age
Aging brings about all sorts of physical changes, some of which can affect the ability to have or enjoy sex. For men, while age might affect sexuality, there are ways to support sexual health and function as the years go by.
“The majority of men certainly don’t like talking about sex, especially sexual dysfunction, and I always remind men of how common it is,” says Dr. Ryan Flannigan, director of the University of British Columbia’s (UBC) Male Infertility and Sexual Medicine Research Program. “I reassure them that they made a good decision in sharing this with their physician. There are so many treatment options available.”
Testosterone is the major sex hormone in men. Produced by the testes via a signal the brain sends to the pituitary gland, it regulates sexual desire (libido), sperm production, muscle size and strength, and bone mass. As men age, testosterone levels drop. This shift is associated with a condition called andropause, but what differentiates it from menopause in women is that the decrease in hormone levels is more gradual. Although what’s considered optimal levels of testosterone isn’t clear, symptoms of deficiency include diminished sexual desire and infertility. Low levels could also lead to erectile dysfunction (ED), which includes weaker erections or trouble getting an erection.
Testosterone levels decrease by 0.4 to 2 percent annually after age 30, according to a 2016 study published in Therapeutic Advances in Urology, a medical journal. Rapid ejaculation can occur, according to Flannigan. Although this can be distressing, there are several ways to address it. Behavioural strategies include “stopping and starting” or pinching the head of the penis once close to orgasm, Flannigan explains. Using condoms may also help. Finally, you may also want to chat with your health care practitioner about certain creams.
Erectile dysfunction becomes more and more common as decades increase, Flannigan says, although the exact rates aren’t known. “The true prevalence of ED is in the magnitude of three to eight times higher than what is presented to doctors,” Flannigan says. “The vast majority of men aren’t seeking help or investigation.” ED is also associated with other health conditions, including diabetes, obesity, and high blood pressure.
Some men experience ED in the form of delayed orgasm or ejaculation. Prevalence increases over time, jumping from 3 percent of 50-year-olds to 35 percent of 75-year-olds. “Of all the sexual dysfunctions, delayed or inability to have an orgasm are some of the most bothersome to men,” Flannigan says.
Peyronie’s disease may affect between 1 and 23 percent of men between ages 40 and 70. Men with this condition develop plaque or scar tissue in the lining of the penis that results in a curve, bend, or deformity. The cause is unclear. “It can be quite devastating,” Flannigan says. “Curves can range from very subtle to over 100 degrees. There can also be indentations or hourglass deformities that look like a concentric band around the penis. Some men will also develop problems with erectile function, which can be limiting for individuals as well as their partners in finding positions that will work.” Speak with your health care practitioner if you suspect Peyronie’s disease, as there are multiple treatment options.
About 35 percent of men in their seventh decade have lower testosterone levels than younger men, according to the aforementioned Therapeutic Advances in Urology study. Keep in mind that ED is associated with cardiovascular disease, the incidence of which rises with age. Helpful strategies to prevent both include weight loss, regular exercise, and clean eating. “What’s good for your heart is good for your penis,” Flannigan says.
Natural, or bio-identical, hormones are chemically identical to the ones our bodies produce naturally and are derived from plant estrogens. Both conventional (synthetic) hormone-replacement therapy and natural hormones have risks and benefits; talk to your health care practitioner to see which is best for you.
Although more research needs to be done, some supplements including maca, tribulus, and ginseng have been used as sexual enhancers. L-arginine, an amino acid, may help improve erections, while niacin, a B vitamin, may help address ED in men who have high cholesterol.
This form of meditation, which involves paying attention to the present moment in a nonjudgmental way, has been studied extensively in women with sexual difficulties, but it can help men, too. Research by Lori Brotto, director of the UBC Sexual Health Lab, has found that mindfulness helps with rapid and delayed ejaculation as well as sex-related pain. “We have found that reshaping arousal using mindful observation rather than getting focused on goal-centred excitement has produced useful results,” Brotto wrote in a 2015 commentary in the Journal of Sexual Medicine.
“Anything that improves mental well-being most certainly will enrich your sexual well-being,” Dr. Ryan Flannigan says. “Hormones that are produced with stress essentially counteract the physiological mechanisms of erectile functioning. Mental health is critical to having a good sexual life.”
Certain medications, such as antidepressants, could be causes of ED. If you’re concerned, take some time to review your medications with your health care practitioner.
Gail Johnson is a Vancouver-based writer and broadcaster who teaches fitness classes as a hobby and has two kids.