Ask Dr. Annie K: Sex and Aging

My husband, who is 78, can’t climax. He has the desire but loses the urge after a short time. He has had ed for several years but could still finish up to the last year or so. Is this age related? Any hope?
– Anonymous

Love+Medicine

 

Thank you for this great question. I assure you that many of my readers are interested.

This is a condition called Delayed Ejaculation (DE) or Anorgasmia. The erection is there but no climax. The answer to your first question, whether it is age related is yes. About 1/3 of men your husband’s age have problems reaching climax.

Let’s take a look at the science behind the male sexual response to understand what is going on. It is a cascade of events originating in the brain but involving the entire body. One system relaxes the body allowing for blood flow to the penis (erection), the other follows up with contractions necessary for ejaculation. These processes are sweetly choreographed to reach the big O.

What can cause DE?

Drugs – It is well known that antidepressants cause sexual dysfunction. Here are some others:
Alcohol
Diphenhydramine (Benedryl)
H2 blockers (Tagamet, Zantac, Pepcid)
Hydrochlorothiazide
Atenolol
Opiates
Furosemide (Lasix)
Triamterine (Maxzide)
Estrogen
NSAIDs (Ibuprofen)
Pseudoephedrine (Sudafed)
Finasteride (Propecia, Proscar)
Lipid-lowering agents
Digoxin
Levodopa (Sinemet)

Heart Disease – The arteries of the penis are often the first to show atherosclerosis.

Weak Pelvic Floor – These muscles weaken as we age.

Infection – Urinary tract infections, STDs and prostatitis.

Endocrine Conditions – Diabetes, hypothyroidism, low testosterone levels.

Psychological and Spiritual Factors – Anxiety, depression, relationship issues.

Consultation with a primary care physician AND a urologist are recommended to rule out these and other medical conditions. They may provide treatment options as well. Studies are limited but there are promising reports of acupuncture as a treatment for DE.

Sex is different as we age – biology we have to accept. I like to describe it as a quieter sex. Just as hot but more simmering than full boil. Pleasure comes equally from giving and receiving. Orgasm may not be the goal every time. Going through the natural changes and seeing them as normal may bring you closer as a couple.

 This is advice for all my sexually active seniors:

  1. Get in shape.
  2. Make love early in the day, when testosterone levels are highest.
  3. Eat healthy – What is good for your heart is good for your penis.
  4. Maximize oral stimulation.
  5. Fantasize about sex.
  6. Do Kegel exercises.
  7. Use your imagination.

Age is not a disease. Do everything you can to OPTIMIZE the functioning of your body and mind. In answer to your second question, there is definitely hope!