Sex and the Aging Male

I’m receiving a startling number of correspondences lately from older men and their partners, highlighting the sexual difficulties of the aging process. It’s not surprising that these people are noticing the changes in their sexual response cycle as they age, but it is astonishing that they haven’t attributed the changes to andropause.

A Little Frustrated

Dr Dick,
I’m a 54-year-old man, who three years ago managed to finally come out and live the life I so desperately longed for all my life. My question: Is there a biological clock in men like women have to deal with in menopause? During the last years of my marriage, there was no sex life—other than with myself. Now I’m living a fantastic life, with a great man whom I love very much. I know there is more to life than sex, but now that I’m finally able to express myself physically with a ma, I am unable to perform—and not for lack of trying!

I tried Viagra a few years ago. It used to work maintaining an erection, but it was just by myself, and I always had fun. But the side effects—headaches and discomfort—made me wonder, “Do I really want to take this stuff?” But now, even the meds don’t help, and as for my libido, it suffers due to my lack of ability.

I’ve been tested for testosterone levels, and they say I’m right where I should be at for my age. I’ve seen two doctors about the issue, and when they find out my partner’s sex, they don’t want to deal with it, and seem to just pass it off as an age thing. (BTW: I’m in fairly decent shape; I exercise three to four days a week at the gym.) Can you send me any advice on a path to take?
—A Little Frustrated

A little frustrated? Holy cow, darlin’, you sound a lot frustrated—and rightfully so! You finally find what’s been missing your whole life, only to discover that your plumbing is now giving out on you. Ain’t that a bitch!

And before I continue, I want to tell you and all the other alternative lifestyle people in my audience: Don’t settle for a sex-negative physician—no matter what. Find yourself a sex-positive doctor who will look beyond your choice of partner; someone who will give you the respect you deserve!

Andropause

You raise an interesting question about the aging process when you ask if men experience something similar to menopause in women. The short answer is—you betcha! In fact, it even has a name: andropause. It’s only been recently that the medical industry has started to pay attention to the impact that changing hormonal levels have on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!

All men experience a decrease in testosterone, the “male” hormone, as they age. This decline is gradual, often spanning 10 to 15 years. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

And listen: When a physician says that your testosterone level falls within “an acceptable range,” he/she isn’t telling you much. Let’s just say you had an elevated level of testosterone all your life, ’til now. Let’s say that you now register on the lower end of “acceptable.” That would mean that you’ve had a significant loss in testosterone. But your doctor wouldn’t know that, because he/she has no baseline for your normal testosterone level.

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more elongated, too.

Andropausal men might want to consider Testosterone Replacement Therapy (TRT). Just know that most medical professionals resist testosterone therapy. Some mistakenly link Testosterone Replacement Therapy with prostate cancer, even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. I encourage you to be fully informed about TRT before you approach your new sex-positive doctor, because the best medicine is practiced collaboratively—by you and your doctor.

Finally, getting the lead back in your pencil, so to speak, may simply be an issue of taking more time with arousal play. Don’t expect to go from zero to 60 in a matter of seconds like you once did. Also, I suggest that you use a cock ring. But most of all, fuckin’ relax, why don’tcha already? Your anxiety is short-circuiting your wood, my friend. And only you can stop that.

Here’s Gwen, who reports on her husband’s condition:

Dr Dick, My husband and I have been married for 33 years. Our relationship is hell when it comes to sex. My husband is overweight, and he’s stressed out about his elderly parents. Sex is non-existent. He never was the instigator in our relationship. And he is the kind of guy who thinks having sex on the couch as opposed to the bedroom is adventuresome. He has become so boring. I don’t believe the man feels sex should be that important at our ages. (I’m 57 and he’s 62) I, on the other hand, am more sexually aroused and creative than ever now that I am more mature and the kids are out of the house. Menopause and all the sex on the Internet helps too. 😉 Is there anything I can do to make my man return to being a healthy sexual being once again? Thank you.

No—thank you, Gwen. Your complaint is a familiar one. So familiar, in fact, that I regularly offer therapy groups for couples in long-term relationships, like you and your old man, who have, for one reason or another, hit a wall when it comes to their sex lives.

I’m sad to say there’s not much you can do to beef up your sex life if there’s no interest on the part of your husband to do so. I mean, you can lead the horse to water, but you can’t make him drink. You confide that you husband is overweight and stressed; not a happy combination when it comes to his sexual response cycle, even if we don’t factor in his age. In fact, your husband sounds like a heart attack waiting to happen. Perhaps if your challenged him about his general health—encourage weight loss and stress reduction—you might find that it might also reignite his sex drive. It’s worth a try.

And thank you for mentioning menopause. So many women find the changes that take place in midlife confusing and disorientating. It’s so good to hear from someone eager to explore and enjoy her sexuality post-menopause.

It’s clear that as we age, both women and men need more time and stimulation to get aroused. The slower, more sensuous foreplay that often results is a welcome change for most women and even some men. Increased focus on sensuality, intimacy, and communication can help a sexual relationship remain rewarding even well into our most senior years. If your husband is avoiding intercourse, there still many ways of expressing your love and staying connected:

Hugging, cuddling, kissing
Touching, stroking, massage, sensual baths
Mutual masturbation and oral sex

However, if your husband is more wedded to food and to stress than he is to you, and if he continues to refuse to join you in finding an appropriate outlet for your sexual frustration, then it’s up to you to make this happen on your own. Age 57 is way too soon to say goodbye to your sex life.

May I suggest joining a women’s group? Not a therapy group, but more of a support group or activities group. Getting out of the house, involving yourself with other self-actualized mature women, may uncover the secret solutions other women have put in place to find sexual satisfaction when they are without a partner or have a partner who’s no longer interested in them. I think you will be surprised by how creative your sisters can be. Make it happen, Gwen. Don’t sink to the lowest common denominator of living a sexless life.

Good luck!

The male menopause

— Genuine condition or moneymaking myth?

Late onset hypogonadism, sometimes likened to a ‘male menopause’, occurs in 2.1% of men who are almost exclusively over the age of 65.

Experts say there is no equivalent of the menopause for men and symptoms such as depression and low sex drive have other explanations

By

This week brought reports that “male menopause” policies are in place at several NHS trusts, with some HR managers suggesting staff could receive up to a year of sick pay if they experience symptoms. This is despite the NHS itself saying male menopause is not a clinical condition and that it is not national NHS policy to offer leave for it.

We take a look at the science behind the term.

What is meant by the “male menopause”?

The male menopause, also known as the andropause, is a term often used to refer to a cluster of features seen in some men in their late 40s to early 50s, such as depression, loss of sex drive, mood swings, erectile dysfunction, problems sleeping and loss of muscle mass.

However the NHS notes this is not a clinical condition. Rather, it says, it is an “unhelpful term sometimes used in the media”.

So this isn’t a male version of what women go through?

In a word, no.

Dr Ravinder Anand-Ivell, associate professor of endocrinology and reproductive physiology at the University of Nottingham and an expert of the European Academy of Andrology, says that the two are quite different.

“The menopause represents acute symptoms caused by the relatively abrupt cessation of ovarian hormonal function due to the exhaustion of a woman’s egg reserve at around 50 plus [or] minus five years of age,” she said. “Men have no equivalent physiology.”

Prof Richard Sharpe, an expert in male reproductive disorders from the University of Edinburgh, agreed.

“There is no question that, in normal men at the population level, blood testosterone levels decline with age from late 30s to early 40s onwards,” he said. “However, there is no precipitous fall in [blood testosterone] levels akin to that which occurs for estrogen levels in women at the menopause.”

Sharpe also stressed that some men may experience little blood testosterone decline when ageing. “It can be quite variable between individuals – unlike the 100% occurrence of menopause in women,” he said.

Does that mean the “male menopause” is made up?

Not exactly.

“There is a condition in some elderly men, known as ‘late onset hypogonadism’ or more recently called ‘functional hypogonadism’, which is characterised by low concentrations of testosterone in the blood together with symptoms of testosterone deficiency such as loss of libido, bone and muscle weakness, etc,” said Anand-Ivell.

But, she added, this occurs in approximately 2.1% of men, almost exclusively over the age of 65.

While some men with late-onset hypogonadism (LOH) may benefit from testosterone replacement therapy, its wider use has caused controversy. Some experts have raised concerns that it is being given to patients who have some similar symptoms to LOH but may have blood testosterone levels within the normal range for that age group.

“This is what I refer to as a ‘charlatan’s charter’; as such, general symptoms will occur in most men during – and before – ageing, but are almost always driven by other factors,” said Sharpe.

So what is behind this cluster of symptoms?

Anand-Ivell said men who reported sudden symptoms, and at a younger age, might well be experiencing another underlying health problem.

Indeed, as the NHS notes, features that have been ascribed to a “male menopause” could be down to lifestyle factors or psychological problems.

“For example, erectile dysfunction, low sex drive and mood swings may be the result of stress, depression [or] anxiety,” the NHS says, adding other causes of erectile dysfunction include smoking or heart problems.

Financial and life worries may also play a role in the symptoms some men experience during ageing, as could poor diet, lack of sleep and low self-esteem, the NHS notes.

Sharpe added that conditions such as obesity, and its downstream disorders, were also generally associated with lower blood testosterone levels in men, with some arguing it might predispose them to further weight gain.

As for treatment, Prof Frederick Wu of Manchester Royal Infirmary said the approach was threefold: “Lifestyle change, weight loss and improve general health,” he said.

Why is the male menopause getting attention?

Experts say a key reason the “male menopause” is a hot topic is money.

Anand-Ivell said: “A lot of the ‘andropause’ literature stems from commercial interests, particularly in the USA, wishing to draw spurious comparisons with the female menopause in order to sell testosterone-related products for which there is no clinical evidence of benefit.”

The latest headlines, meanwhile, have been fuelled by the revelation that male menopause policies are in place at several NHS trusts. Sharpe said: “For myself, I am amazed that any health board would even talk about there being an andropause, let alone suggesting time off.”

Complete Article HERE!

Don’t feel pressured, learn to ‘simmer’ and keep experimenting

— How to have great sex at every stage of life

Expert tips on a fun, fulfilling sex life – for teenagers, octogenarians and anyone in between

By

Age 16-25

Don’t worry if your first time isn’t perfect
“It’s not helpful to think of sex as having one big ‘first time’. You’ll probably have lots of first times,” says Milly Evans, author of Honest: Everything They Don’t Tell You About Sex, Relationships and Bodies Instead, she advises breaking it down into all the individual firsts you might have – “your first time having oral sex, penetrative sex, using hands or using toys”. Even if you experience all of these with one person, there will be a whole new set of firsts to explore with a different partner.

Communication is the thing that matters most
This holds true whatever age you are, according to Clover Stroud, author of My Wild and Sleepless Nights “Communicating clearly about desire, or how you like to be touched or treated, isn’t easy. I wish I’d known how much sex improves as you get older and become more confident about what you like and how to communicate those needs.”

Being ready to have sex is more than just a feeling
“It’s about lots of practical and emotional things too,” says Evans. “Does the idea of having sex make you excited or anxious? Do you know enough about contraception, STIs and consent? Do you know where to access support if something doesn’t go to plan? Would you have to drink alcohol in order to feel confident enough to have sex? Is there a safe place for you to have sex? Safety, comfort and wellbeing are essential.” If you can’t answer all of these questions positively, you probably aren’t ready.

Think about what you want ahead of time
“Reflecting can help you feel more prepared and in control,” says Evans. “Take a look at boundaries around things like touch, communication and time. Ask yourself if the relationships or sex depicted on TV, in books or on social media are what you’d like from your own. And remember that sex is something that happens with you, not to you – speak up about what you want, and encourage partners to do the same.”

Switch off negativity
“As you’re looking at movies or television or porn, or magazines or music videos or social media, ask yourself, ‘After I see this, am I going to feel better about my body as it is today, or worse?’” says sex educator Emily Nagoski, in her book Come As You Are. “If the answer is ‘worse’, stop buying or watching those things.” This is especially important where porn is concerned.

As the recent report from the children’s commissioner for England, Rachel de Souza, has highlighted, the increasingly abusive, aggressive behaviour depicted on many mainstream porn sites is normalising sexual violence and exploitation among teenagers, affecting their mental health and undermining their ability to develop healthy sexual relationships.

You have the right to change your mind
“Don’t feel pressure to do something sexually that you’re not comfortable with,” advises psychotherapist Silva Neves, author of Sexology: The Basics. “You can always say ‘no’ or ‘pause’, or say ‘no’ after you’ve said ‘yes’.”

Age 25-35

It’s good to simmer
“The happiest erotic couples make a point of enjoying feeling aroused together for its own sake – even on days when sex isn’t on the menu,” says US sex therapist Stephen Snyder, author of Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship. “In sex therapy we call this simmering. It’s what teenage couples do whenever they get a moment’s privacy. Quick, intimate bodily contact, fully clothed – just enough to get you slightly buzzed.”

Penetrative sex isn’t the gold standard (nor, for that matter, is simultaneous orgasm)
Many of what we have come to perceive as cultural markers of sexual excellence are spurious ideas that are now being refuted by science – and more honest, open debate around the subject. Such ingrained cultural beliefs are worth challenging. Do what works for you rather than what society tells you ought to work for you. For example, says Neves: “Many gay men don’t have anal sex at all, but prefer oral sex and intimate touching. Similarly, many women have very good sex without penis-in-vagina sex.”

You need to set the right conditions for sex
Context is everything, explains Nagoski. If you’re feeling relaxed, loved and fully present (as opposed to, say, worrying about an email you need to send, an argument you’ve just had, or whether the children might walk in on you) you’re likely to have better sex. If you’re not, it doesn’t matter how sexy your partner is, how much you love them, how fancy your underwear is or how many candles you light – almost nothing will activate that desire. Nor is it about what you do with your partner, which body parts go where, or how often, or for how long. It’s about sharing sensation in the context of profound trust and connection, and recognising the difference between what great sex is really like and what most of us expect great sex to be like.

You don’t have to have sex at all
“Gen Z are having less sex than millennials, who have less sex than older generations. This is often treated as a bad thing, but it might reflect more self-awareness in a hypersexual society,” says Aimée Lutkin, author of The Lonely Hunter: How Our Search for Love Is Broken. “Think about what you want out of sex and be honest about whether it is the thing you are really seeking. Is it intimacy? Community? Distraction? If it is sex, that’s great. The more in touch you are with your needs, the more likely it is you’ll make the connections you want to.”

Commitment and monogamy can be exciting
“In my teens and 20s, I thought good sex was about physical desire,” says Stroud, “but in my 30s I realised that feeling psychologically ‘seen’ by another, and trusting them implicitly, is where good sex starts. Then you learn to take huge risks with them too. At that point, commitment and monogamy get really exciting.”

Age 35-45

It’s normal for sex to drop off the list of priorities
“When you have a new baby or you’re caring for an elderly parent, overwhelmed with work or coping with some other form of stress, sex won’t be top of the agenda (though for some it will be a useful stress reliever),” writes Nagoski. “Don’t panic about it. It’s a phase you’ll pass through when you’ve managed the stress, and you’ll find your way back to the other side.”

Have a six-second kiss
“Greet one another at the end of the day with a kiss that lasts at least six seconds, or a hug that lasts at least 20 seconds. That guarantees you will both produce the hormone of emotional bonding, oxytocin,” says relationships expert John Gottman, co-author of The Seven-Day Love Prescription.

Make sex a priority
“Don’t make lovemaking the very last item on a long to-do list,” says Gottman. “Make it a real priority. Go on an overnight romantic date at a local B&B, or farther afield, at least four times a year.”

Don’t try to second-guess what your partner will enjoy
Whether you’re trying to sustain sexual satisfaction in a long-term relationship or wondering why a new partner isn’t responding to your usual moves the way a previous one did, the key is to be really honest about what works (or doesn’t) for you, instead of expecting your partner to guess. “About a quarter of women orgasm reliably with intercourse,” writes Nagoski. “The other 75% sometimes, rarely or never do, but might orgasm through manual sex, oral sex, vibrators, breast stimulation, toe sucking or pretty much any way you can imagine. They’re all healthy and normal. Similarly, a woman can be perfectly normal and experience arousal nonconcordance, where the behaviour of her genitals (being wet or dry) may not match her mental experience (feeling turned on or not).”

Have sex with yourself
Whatever age you are, “masturbation can be a great way to explore your body and fantasies”, says Evans. “Spend time creating your own storylines and find out what turns you on. You can also explore a whole world of visual, written and audio erotic content – but make sure it’s ethical (ie it is consensual, treats performers with respect, and pays performers and makers fairly). Audio erotica, in particular, has become more mainstream, especially among those who aren’t into visual porn, enjoy bringing their imagination into solo sex or want to try something new.” Two of the best-known platforms are Quinn and Dipsea, but it’s a fast-growing market.

Mothers are allowed to enjoy sex, too
“It is a complicated balance, being both a mother and a sexual being,” says Lucy Roeber, editor of the Erotic Review, which relaunches later this year. “In our society, we sometimes expect women who give birth to pass through a door into an idealised state of maternal preoccupation without a backward glance. Yet they have the same messy lusts and cravings. My advice is: don’t strive to be too perfect a mother and don’t deny yourself pleasure. It is surprisingly easy for women to accidentally put their sexual being to one side while they work on motherhood. Yet the two can and should work together. After all, in most cases, it was sex that started the process of parenthood in the first place.”

Age 45-55

To cuddle or not to cuddle?
Snyder says that “cuddling tends to deplete a couple’s erotic energy. If you like to cuddle together while watching TV, then be sure to ‘simmer’ [see above] during the ad breaks.” Gottman, however, advises “a daily cuddling ritual for watching films and TV shows at home where you actually stay physically in touch with one another. On one of these nights offer to give your partner a 15-minute massage.”

Don’t wait for desire to strike – practise creating it
“Too many couples only have sex when they feel desire,” says Snyder. “That’s fine when you’re 20. But by 50 most people are more interested in a good night’s sleep. What to do? Have sex anyway.” Nagoski agrees that pleasure matters more than desire. She says: “Create a context that allows your brain to interpret the world as a safe, fun, sexy, pleasurable place. It’s called responsive desire and it asks that your partner help you in creating good reasons for you to be turned on. While some people have a spontaneous desire style (they want sex out of the blue); others have a responsive desire style (they want sex only when something pleasurable is already happening). The rest, about half of women, experience some combination of the two.”

Embrace body confidence
“I’ve found that being in my 40s is entirely liberating. We get better as we shed the self-consciousness of youth, the desire to please, the emotional pliability. I love my body. It is the map of the years I’ve lived,” says Roeber. Nagoski questions wider sex-negative culture. “If you’ve learned to associate sexual arousal with stress, shame, disgust and guilt, you won’t have as good a sex life as someone who associates it with pleasure, confidence, joy and satisfaction,” she says. “Begin to recognise when your learned disgust response is interfering with your sexual pleasure. Your genitals and your partners’, your genital fluids and your partners’, your skin and sweat, and the fragrances of your body – these are all healthy elements of human sexual experience.”

Manage the menopause
Hormonal changes during the menopause and perimenopause can trigger a host of symptoms (low libido, fatigue, low mood, vaginal inflammation or dryness) that do not make a recipe for romance, according to Dr Louise Newson, GP, menopause specialist and founder of the Balance app. “If you notice any of these changes, see a healthcare professional for a proper diagnosis and to discuss treatment options.” Don’t assume these issues will only start in your late 40s, either. “Though the average age of menopause is 51, one in 100 women will go through menopause before the age of 40. Even if you have an ‘average’ menopause, the perimenopause often starts in your early 40s.”

Have a sex date
“Set a date to meet naked in bed to do absolutely nothing at all,” advises Snyder. “Talk, if you like, but this isn’t the time for deep conversation. Instead, focus on experiencing what’s going on in your body at that moment. Time is an endless string of such moments. Pay attention to a few of them. That’s often the best preparation for good lovemaking afterwards.”

Learn how to reconnect
“It can be hard to connect to someone intimately if you don’t feel connected to them emotionally. Launching into ‘You don’t make me come any more’ or ‘You never want sex and I feel rejected’ will put your partner on the defence,” says Ammanda Major, head of service quality and clinical practice at Relate. “Saying, ‘I’ve noticed we seem to have drifted a bit on this and I’m really hoping we might talk about it’ is gentler. You’re not making assumptions about what your partner might be feeling, but you are showing that you’re interested in what they have to say about it. Once you’ve got those things in place, you can have a conversation about how to deal with it.”

You’re never too old to experiment
“We have one body, but it can experience so many different forms of pleasure, especially when we open our minds. The more we accept the lie that our lives are over at 40, the more we are just cutting ourselves off from possibility,” says Lutkin. Newson agrees: “Your 50s and 60s can be a time of sexual liberation when your children may have flown the nest or you may be back on the dating scene after the end of a relationship. Many of my patients tell me that HRT and testosterone have given them a new lease of life. Make sure you are using lubricants [see below] and toys that are safe. These can ease discomfort and make sex more enjoyable, but many brands of lubricant contain irritants like glycerine and parabens, and should be avoided.”

Age 55-65

Focusing on sex drive is a wrong turn
So often we use the catch-all phrase “sex drive” to describe our enthusiasm for, or lack of interest in, sexual activity. In reality the process is more complicated than whether you’re feeling in the mood or not. “Your brain has a sexual ‘accelerator’ that responds to ‘sex-related’ stimulation: anything your brain has learned to associate with sexual arousal,” says Nagoski. “It also has sexual ‘brakes’ that respond to anything your brain interprets as a reason not to be turned on. Constantly monitoring for footsteps in the hallway? Have sex when no one else is home. Tired? Have a nap. Icked out by grit on the sheets? Change them. Cold feet? Put on socks. Sometimes it really is this simple.”

Follow the recipe for romance
While everyone’s particular sexual preferences may differ, studies suggest there are some commonalities among couples who claim to have great sex lives. “From the largest study ever done on what makes for great sex, the Normal Bar study, as well as our own studies, there are a baker’s dozen suggestions that set apart people who say they have a great sex life from people who complain that their sex life is awful,” says Gottman. “Things that work include kissing passionately, giving each other surprise romantic gifts, talking comfortably about their sex life and having weekly romantic dates.”

Manage dryness
“One symptom affecting a healthy sex life that should be on every woman’s radar is vaginal dryness,” says Newson. “You might also experience soreness, itching, irritation, painful sex, vulval changes and UTIs. It can be hugely distressing – I’ve treated women who have been in so much discomfort they can’t put on a pair of trousers or even sit down, let alone have intercourse. But it can be managed by using vaginal oestrogen or HRT and avoiding tight-fitting clothing. You should also avoid perfumed soaps and shower gels or intimate-hygiene washes.”

Find out what you like as a couple and make it happen
Monogamy is sometimes framed as the death knell of erotic connection, but, says Nagoski, this is a red herring. “Passion doesn’t happen automatically in a long-term, monogamous relationship. But it does happen if the couple takes deliberate control of the context,” she says. So find out what is pleasurable for you as a couple and spend time creating the context that leads to it. Often, but not always, we fall into one of two categories – those who need space from a partner in order to create spontaneous desire and those for whom great sex tends to happen when it’s preceded by affection and intimacy.

Don’t take things for granted
People often get stuck in familiar routines in the bedroom but, whether you’re with a long-term partner or starting a new relationship, it’s important to check in now and then and ask whether your usual approach is working. “If something doesn’t feel quite right, it’s important to be able to talk about it honestly and caringly,” says Major.

Age 65-plus

Don’t rush things
“If you’ve been in a partnership for many years that has now ended, you may want to get out there and meet people,” says Major. “But if something doesn’t feel right, it isn’t. Whether you’re 18 or 58, having sex is something to do when you feel confident that there is a degree of trust. New partners may have different expectations from you and different experiences. That’s potentially two very different sets of boundaries.”

Make the wellness connection
Older generations sometimes see sex as a taboo subject. If that’s the case for you, try reframing sexual wellbeing as one component of your wider physical and mental wellbeing. Whether you’re eager to discover positions that are easier on arthritic joints or prefer the closeness of a cuddle, maintaining intimacy can significantly boost overall wellness. Conversely, good health habits can improve our sexual wellbeing, particularly as the effects of ageing start to kick in. “Not drinking too much, eating sensibly and exercising regularly can all have a beneficial impact on our sex lives,” says Major.

Seek medical help when needed
Many older couples say erectile dysfunction medications make sex less anxiety-provoking, says Snyder, just as a lubricant can help some women. “Sex and worrying don’t go well together. As a sex therapist, I’m always happy when a couple has one less thing to worry about.” Major agrees: “Issues like erectile capacity and vaginal dryness need not rule out a satisfying sexual connection. But seeking medical help where needed is important – lumps, bumps, weird bleeding and poor erectile capacity can be symptomatic of health issues. And with the number of STIs in the over-65s having significantly increased as people move out of long-term relationships and start new ones, it’s important to get checked out.”

Strive for connection
“Being able to share intimacy with a partner, as opposed to just wanting intimacy for yourself, is vital,” says Major. “Your level of energy or physical connection might be quite constrained, but it’s very possible through gentle touch, words or kindness to maintain that core intimacy. For some couples, the physicality of sex becomes unimportant in later life, but what they have is a deep emotional connection – an ability to talk honestly and openly and caringly with one another.”

Welcome your sexuality
“The most important thing you can do to have a great sex life is to welcome your sexuality as it is, right now,” says Nagoski, “even if it’s not what you wanted or expected it to be.”

Complete Article HERE!

Unraveling the Mystery of “Male Menopause”

Is andropause a real thing? Or just a buzzy invention of masculine media?

Women lose estrogen. Men lose testosterone. It’s a simple comparison…right?

By Josh Sims

The thing about getting older is that it’s hard to know whether the symptoms that come with it are normal or require medical attention. Tiredness, brain fog, mood swings, loss of libido, erectile dysfunction, weight gain, and muscle loss all have arrive with degrees of subjectivity. Maybe they’re par for the course of middle-age. Maybe you feel like you’ve entirely lost your mojo. Or maybe they’re symptomatic of the andropause.

That’s not a term that Dr. Robert Stevens of London’s Men’s Health Clinic much likes. Sure, it’s a catchy media concoction, suggesting the male counterpart to female menopause. That said, he stresses, the menopause is a defined biological event — the slowing and then cessation of periods, with accompanying hormonal flat-lining — whereas the andropause, sometimes dubbed the “manopause,” is much less clear, and, in a way, much more complex. 

Indeed, many in the medical world argue that there’s no such thing at all. “Endocrinologists don’t like the vagueness of it. They want to find a definitive pathology and can’t,” says Stevens. The whole idea has only been on the medical radar for a decade or so — on the medicinal timeline, that’s not very long at all.

Still, this is a collection of symptoms that many men, typically in their 40s and 50s, regularly experience. And often, though not always, testosterone replacement therapy (TRT) does provide relief. Hit that age group and testosterone levels in men start to drop away, albeit very gently.

Unlike the rapid shutdown of estrogen production that ushers in female menopause, men typically see only a 2% testosterone decline per year over their thirties and beyond. Whatever physical or biochemical symptoms this process heralds will likely be spread out over many years and affect men over a much broader age range (relative to menopausal women). In some cases, it may fail to arrive at all.

“The main thing is coming to some conclusion in yourself as to whether the way you feel is a product of ageing, which arguably you just have to accept, or whether it’s in some way properly and negatively affecting your quality of life and you should do something about it,” suggests Dr. Chris Airey, medical director of the Optimale men’s health clinic. “The whole subject [of ‘the male menopause’] is complicated and even the terminology is woolly. I’ve never had a patient come to me and say ‘I think I’m going through the andropause’.

“But what is clear is that as men age some will complain of a common set of symptoms,” Airey adds. “We might investigate those to determine if that’s because there is an underlying cause or, well, because that’s just what getting older is like. But we have to be mindful of the fact that, as awareness of testosterone deficiency grows, we also sometimes see men with very normal testosterone levels who are nonetheless convinced the problem is their testosterone levels.”

Clinical resistance to TRT is often influenced by common misconceptions of testosterone. Rather than being seen as the primary sex hormone — found in men and women alike, and stable levels of which are necessary for normal physiological function — its injection is, Stevens says, too often conflated with anabolic steroid abuse “and the idea that there are men who just want to look good with their tops off.”

Plus, while the role of testosterone is incredibly important, “it’s not well-taught in medical school, because it’s not well-understood,” he says. All told, you have a perfect storm of a lot of men feeling bad but unable to work out why, some of them jumping to the wrong conclusions, too many clinicians biased towards an overenthusiastic prescribing of testosterone, and some not keen on it at all.

Testosterone isn’t even mostly about sex, interest in sex, or your ability to get it up (all things that, inevitably, cause most men acute embarrassment and further stop them seeking medical advice). Indeed, testosterone’s decline is also linked to muscle atrophy, reduced bone density and a susceptibility to depression; and there’s an inverse correlation with obesity and mortality from heart failure — the less testosterone you have, the more prone you are to both issues. Not for nothing, then, some experts dub the ‘male menopause’ as something more akin to Testosterone Deficiency Syndrome.

But that only account for part of the hormonal story. Current understanding suggests that subtle shifts in testosterone levels are more part of a broader package of metabolic changes in various key hormone levels — prolactin, gonadotropin, DHEA and others you’ve likely never heard of — with consequences similar to those experienced by menopausal women. So where does that leave you?

Let’s be clear: lifestyle is a major part of this. The major part. “You can’t get around lifestyle. Testosterone is no substitute for those things you need to be doing, anyway,” as Airey puts it.

If you head to to a doctor, seeking TRT as some silver bullet to solve this higgledy-piggledy set of symptoms — some of which are debilitating, others are just irritating — the first thing they’ll do is assess how you live, and ask you to make necessary corrections. Are you sleeping enough? Are you eating well? Do you smoke or drink too much? Do you get enough exercise? Do you do anything to mitigate stress?

You should, at a minimum, be taking good, regular, long walks. You might train gently but regularly with weights. Eat a low-carb, high protein diet. Get a good eight hours sleep every night. Address the stress in your life rather than normalizing it. But if you do all this, and your way of life is largely health positive, yet you still feel like crap, then the next step is blood screening; you’ll definitely want to assess testosterone levels. But they’ll check for adrenal and thyroid dysfunction too. Both are also more common in middle-age. TRT is the end of the road, after all, not the start of it.

And for good reason: it’s expensive. Prices vary, but we’re typically talking at least a few hundreds dollars per month; and unsurprisingly, those who recommend this treatment profit from it. Working out a patient’s ideal level of testosterone for their physiology is hard: their normal operating level may be atypically high or low…who knows? And once you’re on TRT, your body’s own testosterone production shuts down — sometimes that’s for good, making TRT a crutch, not a cure, while sometimes (if you’re on TRT for a limited period), it might allow the the patient to return to their pre-TRT levels.

That’s why Stevens’ clinic adopts an approach based more on testosterone micro-dosing and frequent monitoring, an idea worth pursuing with your own physician if it comes to it. Prescription levels of testosterone vary wildly country to country, which is testament to the idea that there’s a lot of guesswork going on here.

Is more research required? Definitely. We still have miles to go in fully understanding menopause…so unpicking the andropause has barely begun. That’s a problem for those men in middle-age who feel deeply out of sorts in ways they can’t quite understand or mitigate or name.

Complete Article HERE!

10 Top Sex Ed Tips for Those 50 and Older

Making love is about more than intimacy. It’s good for your health, too

By Robin Westen

How sexy are your 50s?

If you think sex is the province of the young, you’re wrong. People in their 20s are having less sex now than ever before, studies show, so it’s possible that you’re as active, or more so, as the average millennial. About a third of us are getting busy several times a week, one survey found.

And most of us are still in the game: 91 percent of men and 86 percent of women in their 50s report being sexually active, although activity levels vary widely. So, there’s no “normal” amount of sex for people our age. What matters more is that you and your partner are happy with your sex life. Men and women age differently, and some studies indicate that sexual interest wanes differently as well. Combine that with emotional and physical issues, and it’s possible that you and your partner aren’t on the same wavelength when it comes to making waves.

The upsides, however, go way beyond our cravings for intimacy, pleasure and connection. Sex boosts our immune systems, improves self-esteem, decreases depression and anxiety, relieves pain, encourages sleep, reduces stress and increases heart health. (In one study, men who had sex at least twice a week were 50 percent less likely to die of heart disease than their less active peers were.) Another bonus: You burn more calories making love than by watching The Great British Baking Show.

Not only is there a lot of science around the subject of later-life lovemaking; there’s also a range of products and medicines that can help. Take these steps to revitalize your sex life.

1. Connect emotionally

Women are twice as likely as men to lose their enthusiasm for sex in long-term relationships, research shows. The problem isn’t always reduced estrogen; it could be an absence of emotional closeness. In these cases, try listening more, praising more and showing more kindness. Individual, couples and/or sex therapy can help as well. Look for a sex therapist certified by the American Association of Sexuality Educators, Counselors and Therapists.

2. Address vaginal dryness

It’s one of the top impediments to sex among older women: 34 percent of women ages 57 to 59 experience dryness and discomfort during intercourse, one study found. For help, try over-the-counter remedies before and during sex, such as water-based lubricants (K-Y Jelly and Astroglide), oil-based lubes (olive, coconut and baby oils) and OTC moisturizers (Replens and Revaree). Use these a few times a week, even if you’re not having sex.

3. Emphasize foreplay

“Regardless of the level of dryness, every woman needs to be primed with foreplay before intercourse,” says Elizabeth Kavaler, M.D., a urologist-urogynecologist at Total Urology Care of New York. Another tip: Encourage a woman to orgasm first, which provides more moisture for intercourse and other penetration.

4. Don’t let ED keep you down

Half of men who are in their 50s experience erectile dysfunction (ED), and the gold standard for treatment is prescription meds. Safe, effective options include Viagra (which lasts for four to six hours), Levitra (four hours), Cialis (up to 18 hours) and Stendra (up to six hours).

For the minority of men who can’t rely on a pill, other choices include alprostadil (a drug that’s self-injected into the penis) and Muse (a suppository that slides into the penis). Vacuum pumps use suction to coax erections, and new treatments include platelet-rich plasma (PRP) therapy, which may regenerate nerves and improve blood circulation.

5. Don’t ignore other conditions

Any problem that affects overall health can interfere with sexual pleasure. “Cardiovascular issues such as high blood pressure, as well as diabetes, can negatively impact blood flow,” which isn’t good for sexual arousal, notes New York ob-gyn Alyssa Dweck, M.D., coauthor of The Complete A to Z for Your V. “And depression or anxiety can reduce the desire or ability to have sex.” The problem? Medicines that treat these conditions may also affect sexual desire and response. Speak with your health care provider about side effects and possibly switching meds or adjusting the dosage or timing.

6. Consider estrogen

Women, if over-the-counter lubricants aren’t doing the trick, consider estrogen replacement therapy (ERT), which treats hot flashes and vaginal dryness. The most common delivery methods are creams and pills (you can self-apply Estrace and Premarin with an applicator or take these in pill form), insertable tablets (with Vagifem, you use an applicator to slide a tiny tablet into the vagina) and a ring (Estring, which your doctor inserts, or you can do this yourself; it needs to be replaced every three months). ERT is not recommended for anyone who has or had breast cancer, or for those who have recurrent or active endometrial cancer, abnormal vaginal bleeding, recurrent or active blood clots, or a history of stroke.

7. Think about lasers

A treatment called fractional laser therapy can help reduce vaginal dryness without estrogen. It works like this: A laser creates tiny superficial burns in the vaginal canal. As the area heals, this leads to fresher collagen development and increased blood supply, which makes the area more elastic and responsive, Kavaler explains. (She cautions against vaginal rejuvenation surgery, which is a cosmetic procedure: “It can reduce sensitivity in the area and can make orgasms even more difficult to achieve or, in some cases, sexual intercourse permanently painful.”)

8. Confront incontinence issues

In a national poll of more than 1,000 women, nearly half of those over age 50 reported bladder leakage during sex. The primary reason: Sexual stimulation puts pressure on the bladder and urethra. If you’re hoping to get lucky in the hours ahead, avoid consuming beverages or foods with caffeine, such as coffee and chocolate; caffeine stimulates the bladder and acts as a diuretic (citrus fruits and juices are diuretics, too). Men whose prostates have been removed can also experience incontinence during sex. This condition, known as climacturia, can be treated in a number of surgical and nonsurgical ways. Plus, medications such as Ditropan and Vesicare can decrease urination frequency.

9. Turn down testosterone

In late 2020, the American College of Physicians stated that testosterone replacement should no longer be administered to treat a lagging libido (testosterone can have serious side effects, including an increased risk of prostate abnormalities). Denver urologist David Sobel, M.D., offers three easy alternatives: “sleep, reducing stress, and — the big one — exercise.” Even better: Work out with your lover. Seventy-one percent of runners say that running as a couple plays a healthy role in their sex life, according to a 2021 survey according to a 2021 survey.

10. Overcome arthritis aches

About 58 million Americans have arthritis, and over half are younger than 65, reports the Centers for Disease Control and Prevention. Arthritis can limit your ability to engage in sex. In addition, an empathetic partner may resist sex to avoid creating discomfort. An option: Ask your partner to experiment with more comfortable positions. Also, time sex for when you feel best (rheumatoid arthritis pain is usually more acute in the morning), the Arthritis Foundation advises. Taking a warm bath, alone or together, can help relax joints before making love. If the pain is severe, try an OTC medicine such as ibuprofen before having sex, or speak with your doctor about prescription medications.

Complete Article HERE!

Senior sex

— Tips for older men

What you can do to maintain a healthy and enjoyable sex life as you grow older.

By Mayo Clinic Staff

As you age, sex isn’t the same as it was in your 20s — but it can still be satisfying. Contrary to common myths, sex isn’t just for the young. Many seniors continue to enjoy their sexuality into their 80s and beyond.

A healthy sex life not only is fulfilling, but also is good for other aspects of your life, including your physical health and self-esteem.

Senior sex: What changes as men get older?

As men age, testosterone levels decline and changes in sexual function are common. These physiological changes can include:

  • A need for more stimulation to achieve and maintain erection and orgasm
  • Shorter orgasms
  • Less forceful ejaculation and less semen ejaculated
  • Longer time needed to achieve another erection after ejaculation

You may feel some anxiety about these changes, but remember they don’t have to end your enjoyment of sex. Adapting to your changing body can help you maintain a healthy and satisfying sex life. For example, you may need to adjust your sexual routine to include more stimulation to become aroused.

Senior sex and health problems

Your health can have a big impact on your sex life and sexual performance. Poor health or chronic health conditions, such as heart disease or arthritis, make sex and intimacy more challenging.

Certain surgeries and many medications, such as blood pressure medications, antihistamines, antidepressants and acid-blocking drugs, can affect sexual function.

But don’t give up. You and your partner can experiment with ways to adapt to your limitations.

For example, if you’re worried about having sex after a heart attack, talk with your doctor about your concerns. If arthritis pain is a problem, try different sexual positions or try using heat to alleviate joint pain before or after sexual activity.

Stay positive and focus on ways of being sexual and intimate that work for you and your partner.

Senior sex and emotional issues

At any age, emotional issues can affect your sexuality. Many older couples report greater satisfaction with their sex life because they have fewer distractions, more time and privacy, and no worries about pregnancy.

On the other hand, some older adults feel stressed by health problems, financial concerns and other lifestyle changes. Depression can decrease your desire for and interest in sex. If you feel you might be depressed, talk to your doctor or a counselor.

Senior sex tips

Sex may not be the same for you or your partner as it was when you were younger. But sex and intimacy can continue to be a rewarding part of your life. Here are some tips for maintaining a healthy and enjoyable sex life:

  • Talk with your partner. Even if it’s difficult to talk about sex, openly sharing your needs, desires and concerns can help you both enjoy sex and intimacy more.
  • Visit your doctor. Your doctor can help you manage chronic conditions and medications that affect your sex life. If you have trouble maintaining an erection, ask your doctor about treatments.
  • See a sex therapist. A therapist may be able to help you and your partner with specific concerns. Ask your doctor for a referral.
  • Expand your definition of sex. Intercourse is only one way to have a fulfilling sex life. Touching, kissing and other intimate contact can be rewarding for you and your partner.

    As you age, it’s normal for you and your partner to have different sexual abilities and needs. Be open to finding new ways to enjoy sexual contact and intimacy.

  • Adapt your routine. Simple changes can improve your sex life. Change the time of day you have sex to a time when you have the most energy. Try the morning — when you’re refreshed from a good night’s sleep — rather than at the end of a long day.

    Because it might take longer for you or your partner to become aroused, take more time to set the stage for romance. Try a new sexual position or explore other ways of connecting romantically and sexually.

  • Don’t give up on romance. If you’ve lost your partner, it can be difficult to imagine starting another relationship — but socializing is well worth the effort for many single seniors. No one outgrows the need for emotional closeness and intimacy.

    If you start an intimate relationship with a new partner, use a condom. Many older adults are unaware that they are still at risk of sexually transmitted infections, such as herpes and gonorrhea.

One final piece of advice for maintaining a healthy sex life: Take care of yourself and stay as healthy as you can:

  • Eat a healthy diet.
  • Exercise regularly.
  • Don’t drink too much alcohol.
  • Don’t smoke.

See your doctor regularly, especially if you have chronic health conditions or take prescription medications.

Complete Article HERE!

Sex in the Senior Years: Why It’s Key to Overall Health

Lovemaking isn’t just for the young — older people gain a lot of satisfaction from amorous relations as well.

But things get complicated as people age, and many folks let this important part of life drift away rather than talk about sexual problems with either their partner or their doctor, experts told HealthDay Now.

“Not many people talk about sex with their doctors, especially as we age,” said Alexis Bender, an assistant professor of geriatrics with the Emory University School of Medicine, in Atlanta. “So many people do report sexual dysfunction on surveys, but they don’t when they’re talking to their doctors. And so it’s important to have those conversations with primary care physicians.”

It’s worth discussing. A healthy sex life brings many benefits to seniors, experts say.

Sex has been linked to heart health, as well as overall mental and physical health. “It’s definitely an association, and it’s positive,” Bender said.

For example, lots of beneficial biochemicals are released by the body during sex, said HealthDay medical correspondent Dr. Robin Miller. These include DHEA, a hormone that helps with cognitive function, and oxytocin, another hormone that plays a role in social bonding, affection and intimacy.

“Having sex is a really important part of overall health and happiness, and people that have it, they live longer,” said Miller, a practicing physician with Triune Integrative Medicine in Medford, Ore.

Sex can actually get better as you get older, Miller added.

“For instance, for men, they can control their ejaculation better as they get older,” Miller said. “Women aren’t worried about pregnancy once they go through menopause, so they’re freer.”

Unfortunately, aging does complicate matters a bit when it comes to sex, Bender noted.

“For both men and women, we see changes in physical health such as diabetes or cardiac conditions that might limit desire or ability to have sex,” Bender said. “Activity decreases with age, but interest and desire does not, for both men and women.”

The changes wrought by menopause and andropause also can affect the sex lives of older men and women, Miller said.

Continued

“For women, vaginal dryness is a big issue. With men, it’s erectile dysfunction,” Miller told HealthDay Now.

Luckily, modern medicine has made advances that can help with these problems. Hormone replacement therapy can help women with the physical symptoms of menopause that interfere with sex, Miller said, and men have Viagra and other erectile dysfunction drugs.

“The story of Viagra is very interesting, actually,” Miller said. “In 1998, they were experimenting using it as an antihypertensive. What they noticed was when they were experimenting with these men, when the nurses arrived to check on them they were all on their stomachs, because they were embarrassed since they had erections.”

“That’s when they realized this was a much better medicine for erectile dysfunction than high blood pressure, and that’s made a big difference for men,” Miller continued.

Women can take Viagra as well, “but women don’t like the side effects. Men don’t really like them, either, but they’re willing to put up with them,” Miller said.

“What I found is for women that you can use Viagra as a cream on the clitoral area,” Miller said. “I call it ‘scream cream.’ You can get it made up at a compound pharmacy. It works like a charm. You still have to wait 40 minutes like men do, but there’s no side effects, and it works, especially for women who are on antidepressants, who have trouble reaching orgasm. It really is very helpful.”

So help is out there, but seniors will have to get over their hang-ups and talk to their doctor to take advantage of these options, the experts said.

“Sex and sexuality are taboo in our society,” Bender said. “Especially for women, sex is highly regulated and talked about at an early age, and we’re really socialized to not be sexual beings.”

Miller said, “I think it’s generational. Some Baby Boomers have a hard time talking about sex. My kids don’t have any trouble talking about it. I bet yours don’t either.”

Women also face practical problems when it comes to finding a sex partner, particularly if they’re looking for a man, Bender said. Women outlive men, so the dating pool shrinks as time goes on, and men tend to choose younger partners.

Continued

Through her research, Miller was surprised to learn that many women just give up on the search.

“Even though I think it’s important to have a healthy sex life and healthy partnership, a lot of women don’t want to reengage in partnership as they get older,” Miller said. “They’ve been married. They’ve taken care of people for a very long time. They’ve taken care of their husbands and their children. And they just say, I don’t want that anymore. I’m happy to sit and hold hands with someone, but I don’t want to get into a relationship again. And so that kind of challenged some of my generational thinking about what relationships mean over time.”

More information

The Mayo Clinic has more about good sex and aging.

Complete Article HERE!

Is “Men’s Menopause” a Real Thing?

And is it something you need to worry about?

By Kayla Kibbe

We’ve all heard of menopause, most likely in the form of insensitive jokes about hot flashes, mood swings and/or the state of being an aging woman in general. As a sympathetic adult man (especially one with a female partner) who has hopefully grown out of these dated stereotypes, however, you’re ideally already aware that educating yourself about the realities of menopause will behoove you, your partner and your relationship. But is menopause something you, a man, have to worry about personally?

As interest in testosterone replacement therapy has peaked in recent years, so has conversation (and concern) surrounding what is sometimes referred to as “men’s menopause,” “andropause” or, less formally, “manopause.” But is “men’s menopause” really a thing? The answer is both “No, not at all” and also “Well, sort of, maybe.” We (with the help of a few experts in the medical field) can explain.

Do men go through menopause?

Technically speaking, no, men do not go through menopause, largely because “menopause” — which literally means the pause or cessation of the menstrual cycle and thus fertility — refers specifically to a sudden and rapid decline in hormone levels experienced only by women and/or people with ovaries and related reproductive organs.

(It’s important to note that people born with this specific set of organs may not necessarily identify as women and may still experience menopause. For the purposes of this article, however, I will primarily be referring to cis man- and womanhood, and the biological experiences that generally accompany each, which people of any gender identity may experience.)

While the related term “andropause” attempts to create a more male-centric alternative by referring to androgens — a group of hormones (namely testosterone) that play a role in male traits and reproductive activity — experts like Dr. Alexander Tatem, a board-certified urologist specializing in male reproductive medicine, still say the term represents something of a misnomer.

“It tries to be a direct corollary to what women go through during menopause,” Tatem tells InsideHook. “Men experience something very different.”

While a man will experience a gradual decline in testosterone levels with age, usually beginning sometime in his forties or fifties, that decline is much less sudden and dramatic (and is often accompanied by significantly less intense symptoms) than what women endure during menopause.

“Male menopause, also known as ‘andropause,’ is really a misconception,” says Dr. Mohit Khera, MD, MBA, MPH, a board-certified urologist and Professor of Urology at Baylor College of Medicine. “It assumes that testosterone levels significantly decline due to aging.”

The reality, says Khera, is that “testosterone levels in males do not significantly decline due to aging alone,” as do women’s respective hormone levels around the time they hit middle age.

What hormonal changes can men expect with age?

As usual, men have won the genetic lottery in that most can expect to enjoy a gradual hormonal decline with age relatively free of dramatic symptoms.

“Men will lose about one percent of their testosterone production per year after about age 30,” says Tatem, adding that it is usually “a very slow, steady decline in a normal, healthy man.”

Still, just because most men can expect to experience a gradual, relatively innocuous hormonal decline with age doesn’t mean they have nothing to worry about. While men in general are typically spared the steep and symptom-ridden hormonal dropoff women endure as a natural part of their aging process, some men may still experience more worrisome declines in testosterone, or develop other conditions with age that could contribute to lower hormone levels.

“You can absolutely get to a point where you have a testosterone level that is low enough to be pathologic. That is a problem that is called hypogonadism or testosterone deficiency, which is a medical condition that deserves treatment,” says Tatem.

Moreover, adds Khera, “Many men acquire medical conditions such as obesity, diabetes and metabolic syndrome as they age. These acquired conditions can significantly drop serum testosterone levels. Thus, it is true that as men become older, they are more likely to have lower testosterone levels” — even if those lowered testosterone levels aren’t due specifically to aging alone.

Men experiencing testosterone deficiency may experience symptoms including fatigue, erectile dysfunction, low libido, increased fat deposition, decreased muscle mass and depression, says Khera.

According to Dr. Zaher Merhi, an MD, OBGYN and founder of the Rejuvenating Fertility Center in Westchester, New York, such symptoms sometimes associated with “men’s menopause” do not affect all men (the way menopausal symptoms do the majority of women) and are often mild. Still, significant symptoms may be cause for medical evaluation.

“It’s true that men will have a natural decline in their testosterone levels as they age, but there is a difference between a natural decline and something that is a problem that isn’t normal or healthy,” says Tatem. “It is not normal or healthy as a man to lose your erection, not normal or healthy to lose your energy, to lose your sex drive, to lose muscle mass, to gain fat [without trying to or for no obvious reason]. Those things aren’t normal; they’re pathologic.”

When to seek treatment for low testosterone (and when not to)

While a hormonal decline with age isn’t something most men will experience in the same way women do, real cases of low testosterone are something that should be addressed and managed by a health professional, especially because, as Khera notes, “Low testosterone can be a marker of overall poor health in men,” one that is associated with increased cardiovascular risk.

If men are experiencing the symptoms outlined above, says Tatem, “They should absolutely have their testosterone checked by a qualified professional who has their best interest at heart. And if they have low testosterone, then they absolutely should receive treatment.”

According to Merhi, “Conservative measures such as healthy diet, exercise and stress relief can help” in mild cases, while men experiencing more severe symptoms should consider having their testosterone levels tested by a medical provider who might recommend testosterone therapy.

Figuring out who counts as a qualified professional and what kind of treatment is needed, however, is the tricky part. According to Tatum, a growing number of cash-grabbing clinics are attempting to cash in on the testosterone trend by promoting testosterone supplements as something all men need after a certain age.

“I love testosterone. I think it is an amazing drug when used appropriately and judiciously,” says Tatem, who notes that he has worked with a prescribed testosterone to a wide variety of male patients. “But I think that we are experiencing a change in society where there’s increasing pressure on men from commercially backed clinics to push [testosterone therapy] onto people who maybe don’t need it and maybe create some problems.”

Those problems, according to Tatem, largely stem from the fact that testosterone is (and is often used as), in effect, a performance-enhancing drug. As with any other drug, taking testosterone in excess or when it isn’t needed can result in dependency. If you continue taking increasingly higher doses of testosterone in attempt to satiate that dependency, you run the risk of developing serious conditions related to high cholesterol and high blood pressure that can lead to kidney failure or heart disease.

Further complicating matters is the fact that there’s some disagreement among medical professionals about what actually constitutes low testosterone levels. “Because there’s debate,” says Tatem, “it’s very easy to make a case to give some guys testosterone who don’t necessarily need it.” This is great for cash clinics looking to profit off of men’s fears about their declining masculinity, but not so much for men seeking legitimate medical care to address their concerns.

Still, none of this is to say that testosterone therapy is inherently bad and no men should pursue it under any circumstances. If men are experiencing symptoms or have concerns about low testosterone, “they should absolutely go see a doctor and get tested,” says Tatem. The key is to seek care from the right sources.

“You should never go to visit a ‘clinic’ where you don’t know who the doctor is,” says Tatem. “Think twice and try to seek care from someone who specializes in men’s health, who is trained in this area, and who you know is a professional that cares about doing the right thing, and not so much about getting you to sign up for a monthly subscription service.”

Complete Article HERE!

What Is Andropause Or Male Menopause?

4 Health Tips Men Should Follow To Manage This

Male Menopause: Andropause is characterized by low production of male sex hormone, testosterone which happens gradually over years.

By Nmami Agarwal

Andropause or commonly known as male menopause refers to the symptoms that men experience due to low production of male sex hormone, testosterone gradually over years. The condition is more prevalent after the age of 50 years. ‘Andras’ means human male in Greek, whereas ‘pause’ is cessation, therefore, andropause may also lead to reduced sexual drive and can also cause depression in some cases. Clinically, this condition is known as testosterone deficiency syndrome or androgen deficiency or hypogonadism.

Signs and symptoms one may experience while undergoing andropause:

  • Irritability and frequent mood swings
  • Loss of muscle mass leading to difficulties in exercising
  • Fat redistribution that can lead to belly fat or gynecomastia (male breasts)
  • Lack of pleasure, enthusiasm and energy
  • Increased chances of insomnia, fatigue
  • Poor short-term memory and inability to focus
  • Decreased bone density
  • Hot flashes or sweat
  • Baldness, loss of hair
  • Decreased testicular size

Many people confuse this condition with lifestyle or psychological factors. But, that’s not always the case. In fact, some of the unhealthy lifestyle choices can lead to andropause. These may include- smoking, obesity, alcohol use, sedentary lifestyle pattern, or some medications.

Dietary Intervention:

1. Optimum calcium intake

Optimising the intake of calcium can help you relieve out the symptoms of andropause. Foods like milk, sesame seeds, ragi, eggs, fish (sardines, salmon), broccoli, and different types of legumes are rich in calcium.

2. Healthy fats

Adequate intake of essential fatty acids can boost the production of testosterone hormone. Make sure to include healthy fats in the form of nuts, seeds, dairy, lean meat, eggs, grass-fed ghee, or butter in your diet. Moderation is the key.

3. Get the right dose of zinc

Zinc is an essential mineral that serves the function of maintaining reproductive health and creating a balance of hormones including testosterone. The deficiency of zinc can also lead to an altered mood state. Zinc is readily found in seafood, legumes, nuts, seeds, and dark chocolate.

4. Maintain a healthy weight

Being overweight is a root cause of major health problems. So, make sure to maintain your weight to its normal in order to reduce the symptoms of andropause. Try to control your portion size and reduce the consumption of processed junkies, foods rich in artificial sweeteners, and bad fats from your diet.

Treatment

Testosterone supplements or hormone replacement therapy may be advised for some males but it may come with its own set of side effects and should not be done without doctor’s consultation. Your doctor is the best one to decide on the right course of treatment. Some therapies like CBT can be referred to such patients, it is a form of talk therapy that helps patients in dealing with signs of stress or anxiety.

The bottom-line

A balanced diet and a healthy lifestyle cannot be stressed enough for their importance. Small yet affirmative lifestyle changes can help regulate testosterone function, and may also improve sperm quality and fertility.

Complete Article HERE!

Talking to Your Partner When You Struggle with Hypogonadism

Communication is key for taking on this difficult condition

By Mark Gurarie

Generally unrecognized and often undiagnosed, hypogonadism can significantly impact relationships. Characterized by low levels of sex hormones, especially testosterone, it can arise due to physical injury, congenital defects, cancer or cancer treatmenst, benign tumors, or as a result of other conditions, such as older age, obesity, and metabolic syndrome (a group of conditions that can lead to heart disease, diabetes, and stroke), among others.1

What makes this condition particularly challenging for relationships is the way that hypogonadism impacts intimacy. Among its most prominent symptoms is low libido (sex drive), as well as mood and emotional changes. Men can also experience erectile dysfunction (ED).1 This can lead to severe relationship problems, making it essential that you and your partner are proactive and ready to support each other.

These may not be easy conversations to have, but they’re critical. If you or your partner suffers from hypogonadism, establishing a supportive dialogue is where the road to coping and living well with the condition starts.

The Impact of Hypogonadism

Given the nature of hypogonadism—and the wide range of causes and associated conditions—talking about it means understanding the impact it can have on you or your loved one. In many cases it’s a chronic condition, and ongoing therapy—often taking hormone replacement therapy—is necessary, making management a constant and evolving challenge.

How does hypogonadism affect relationships? Here’s a quick breakdown:2

  • Mental health: Studies have found a distinct association between hypogonadism and depression in both men and women of all ages. Rates of anxiety and bipolar disorder are also higher among this population, which can affect relationship quality, sexual satisfaction, and overall quality of life.
  • Sexual satisfaction: Given its effects on sexual function and libido, this condition significantly impacts assessments of sexual satisfaction. According to a 2021 study, up to 26% of males and 20%–50% of females with hypogonadism were sexually inactive. Problems with sex are often at the root of relationship issues and they can affect other aspects of mental health, as well.  
  • Erectile dysfunction (ED): Males with hypogonadism experience a much higher rate of ED, an inability to obtain or maintain an erection. A study of hypogonadotropic hypogonadism, a chronic congenital form of the condition, found that up to 53.2% of males reported this issue. This can further affect relationship health and is associated with higher levels of depression and anxiety and lower quality of life.

Managing and living with hypogonadism is a multifaceted affair. It means recognizing symptoms, it means getting medical help and keeping up with medications and appointments, and it means tending to mental health and relationships. Communication is crucial in all of these areas. Though it isn’t easy, you and your partner will have to have open discussions about this condition and what it’s like to live with it.

Loss of sexual desire is a hallmark of hypogonadism, as is erectile dysfunction, and it can be a chief source of relationship problems. Though it may not be easy to talk about your sex life, it is very important to do so. For both partners, imbalances in sexual desire are associated with less satisfaction in the relationship and higher levels of tension and frustration.3

What are some approaches to broaching this subject? What are strategies you can use to boost communication? Here are some tips:

  • Educate yourself: Whether you’re the one with hypogonadism or your partner is, it’s important to learn as much as you can about the condition. Your doctor or healthcare provider can direct you to educational resources, and there are many available online.4
  • Kitchen-table conversation: It’s a good idea to broach the topic of sex in a neutral setting. Bringing up sexual problems or dissatisfaction while in bed can cause negative associations with intimacy.5
  • Direct communication: In order to promote effective dialogue, use “I” statements, rather than “you” statements when having the discussion. Explaining how you feel—rather than what your partner is or is not doing—and what your aims are is a good starting point.4
  • Be open: For both partners, managing low libido means being open-minded, both to each other’s needs and to ways of restoring intimacy. It’s also worth discussing other health factors that may be affecting your relationship and whether to consider therapy or other ways to work on the relationship.5

While talking about how you’re being affected by hypogonadism and airing your feelings may seem intimidating, it’s necessary work. When it comes to issues of intimacy and sex, being open is the best policy. What you don’t want to do is hide your condition from your spouse or partner, as this can only make matters worse.

Ultimately, hypogonadism can be medically managed, and most who get treatment are able to live well with it. Good communication with your partner will prove essential as you take it on, and it can lay the groundwork for an even stronger relationship. The most important thing is to not stay silent.

Complete Article HERE!

New ways to think about sex

An enjoyable sexual relationship can happen without traditional intercourse.

By Matthew Solan

People’s bodies change over time. Probably nowhere is this most telling than with their sex lives.

For men, sexual drive can slow as hormone production naturally drops, and it’s common to experience erectile dysfunction or health issues that can interfere with sexual performance.

Women can have their own physical barriers to sex, such as vaginal dryness and lower libido after menopause. All of these issues can make conventional sex problematic and stressful for both parties.

“Even though older adults go through physical changes, they often expect their sex life to stay the way it was decades earlier, and that is just not always realistic,” says Dr. Sharon Bober, director of the Sexual Health Program at Harvard-affiliated Dana-Farber Cancer Institute. “Still, there are many ways to continue a strong, healthy sexual relationship without always relying on regular intercourse. Couples should see this new phase of their sex lives as an opportunity to explore different and exciting ways to satisfy each other.”

Redefining sex

The first step older couples should take is to re-examine their definition of “sex.” “Don’t give in to the idea of a so-called normal sex life being narrowly defined,” says Dr. Bober. “Sex refers to a broad spectrum, and there are many places you can land.”

Examine what sex now means to you and your partner. This could mean changing how you pleasure each other, routines you follow, and frequency — as well as making compromises about expectations. “Don’t assume there is only one way to have a sexual relationship,” says Dr. Bober. “It doesn’t have to be all or nothing.”

Your relationship status also can shape this new idea of sex. For instance, some couples may enjoy a connection based more on companionship, where the emphasis is on emotional bonding and spending quality time together and less on the physical side.

Language of love

As with most aspects of a strong relationship, communication is vital. “The more you avoid talking about your sex lives, the bigger the issues become,” says Dr. Bober.

Of course, talking about sex isn’t always easy, but most partners are open and willing to discuss and share if given a chance. “Often partners aren’t sure how to begin the conversation, so it never happens,” she says. There are many ways to initiate a sex dialogue. Here are some suggestions:

Seek permission. Begin the conversation positively. For instance, say something like “I want to find ways to reconnect that feel good for both of us” or “Our sex life has been on my mind and I have been wondering if I could share some of my thoughts. Is it okay to talk about it?”

By asking for permission, you can broach the topic without intimidating your partner. “This initial conversation is not about making demands, but about finding ways to explore mutual goals,” says Dr. Bober.

Invite a response. Make it clear you want to hear your partner’s feelings too. For example, say, “I’ve been wondering how you feel about our sex life. What has sex been like for you?” Inviting partners to participate can prevent them from feeling defensive and shows you care about their experience and input, says Dr. Bober.

Express what you both want. Talk about what you both hope to gain from this new sexual relationship, such as more excitement, greater closeness, or even reconnection. “Sharing your needs and expectations helps your partner express theirs, so you both can come to some kind of mutual understanding,” says Dr. Bober.

Different ways to satisfy

Once you’ve had these talks, then you both can look for different ways to approach your new sex life.

Dr. Bober says a good place to begin is with “outercourse.” Here, the attention and energy are directed toward foreplay and manual stimulation with your partner, like massages, hugging, petting, kissing, or just snuggling naked in bed.

“The emphasis is on intimacy and closeness without any big expectations of intercourse,” says Dr. Bober. “This can take the pressure off both partners and eliminate some of the stress and anxiety of having regular sex. It also shows that you can interact with your partner in various satisfying ways.”

Penetration is not always needed to achieve pleasure or orgasm for both people. Instead, try sexual aids like vibrators as well as manual stimulation, masturbation, and oral sex.

As you explore ways to stay intimate, be mindful that every couple is unique.

“A sexual relationship is defined by the two people in it and nobody else,” says Dr. Bober. “Focus on what matters to you and your partner. Your sex lives may have changed, but together you can discover what’s best for each other and your relationship.”

Complete Article HERE!

Male menopause

— Is it real? Should I care?

Hormone changes are a normal part of aging for both men and women. The terms “male menopause” and “manopause” have been used to describe decreasing testosterone levels associated with aging. The medical term for it is andropause. And it’s different than menopause.

A man’s hormone levels typically drop differently than a woman’s. For men, the decline is much more gradual. On average, a man’s testosterone levels decline about 1% a year, starting about age 40.

Dr. Alan Kelton, internal medicine specialist and faculty member with UCSF Fresno, says low testosterone is more common if you’re overweight.

“About one in three men that are overweight and in their 40s may have it,” says Dr. Kelton, “and certainly by the time men turn 70, about 30% will have measurably low testosterone levels.”

The typically gradual decline means many men never report any symptoms. But when they do, the most common symptoms are sexual:

  • Reduced sexual desire
  • Fewer morning erections
  • Erectile dysfunction

Other symptoms — including a general lack of energy, decreased joy for life and moodiness — are sometimes associated with low testosterone levels, but can have many other causes.

How can I tell if my levels are low?

Testosterone levels can be measured with a simple blood test. But unlike other lab work, your doctor isn’t likely to run this test unless you ask for it. If you’re having symptoms that might be related to low male hormones and if those symptoms trouble you, then speak up and ask your doctor for a test.

If the results indicate a deficiency, the test is often repeated to confirm the results. Confirmed low testosterone levels can lead directly to treatment, but often lead first to more tests to find the root cause.

What are the treatment options?

There’s basically one medical treatment for low testosterone levels — hormone replacement therapy — but there are several ways to deliver it. Injections, creams, tablets and patches can all be used to boost male hormone levels.

Dr. Kelton says it’s important to have realistic expectations about hormone replacement therapy and understand it won’t magically turn you into the muscular older men we see in the movies and on TV. “The truth is that most older men [who get hormone replacement therapy] will have an increase in sexual desire, with or without an increase in sexual functioning,” says Dr. Kelton. “You don’t get more strength, you don’t get more energy, but you do get an improvement in some of the sexual symptoms.”

There can be downsides to hormone replacement therapy too. Dr. Kelton warns, “Testosterone itself seems to contribute to plaque in the coronary arteries. You can get some increased cholesterol buildup or at least on a temporary basis. A man can also have an increase in their blood counts and sometimes at levels high enough to increase the risk of stroke. And if a man has sleep apnea, they’ll have more sleep apnea with testosterone replacement therapy.”

Lifestyle changes can also reverse many of the symptoms of low hormone levels. Dr. Kelton says, “If a man is not sleeping well, is not eating well, is overweight and not exercising, they’re going to have all of the symptoms of low male hormone. By reversing many of those things, testosterone levels can improve, and sometimes dramatically so.”

Focusing on better sleep, boosting nutrition and adding in more exercise can improve testosterone levels.

Is treatment really necessary?

Dr. Kelton says men should talk to their doctor and make an honest effort to make positive lifestyle changes before deciding on hormone replacement therapy. And in the end, he stresses that the numbers aren’t the most important thing. 

“Aging is a personal experience. For some men, it’s distressing to have a decrease in sexual functioning and sexual desire and they may report symptoms early on in life, even when their male hormone levels are completely normal. Other men see their decrease in sexual functioning and desire as just part of a normal part of aging and they’re not really bothered by it.”

Complete Article HERE!

Sexual activity linked to higher cognitive function in older age

A joint study by two England universities explores the link between sex and cognitive function with some surprising differences in male and female outcomes in old age.

By

  • A joint study by the universities of Coventry and Oxford in England has linked sexual activity with higher cognitive abilities in older age.
  • The results of this study suggest there are significant associations between sexual activity and number sequencing/word recall in men. In women, however, there was a significant association between sexual activity in word recall alone – number sequencing was not impacted.
  • The differences in testosterone (the male sex hormone) and oxytocin (a predominantly female hormone) may factor into why the male cognitive level changes much more during sexual activity in older age.

Countless studies have been done on the health benefits of sex – from an orgasm giving you clearer skin and a boosted immune system, to the physical activity keeping your blood pressure at a healthy level. A lowered risk of heart disease, the ability to block pain, a lowered risk of prostate cancer, less stress which leads to improved sleeping patterns…all of these are proven benefits of sexual activity.

The health benefits of sex have been studied again and again, and yet, there are still new things we’re learning about the benefits on the human body and brain.

Study links sexual activity to higher cognitive function in old age

The results of this study suggest there are significant associations between sexual activity and number sequencing/word recall in men and a significant association between sexual activity in word recall in women.

Cognitive function has been associated with various physical, psychological, and emotional patterns in older adults – from lifestyle to quality of life, loneliness, and mood changes as well as physical activity levels.

A 2016 joint study by the universities of Coventry and Oxford in England has linked sexual activity with higher/better cognitive abilities in older age.

This longitudinal study used a newly available wave of data from the English Longitudinal Study of Ageing to explore the connections between sexual activity in the older population (50+) with cognitive function.

The study consisted of 6,833 participants between the ages of 50-89 years old.

Two different cognitive function tests were analyzed:

  • Number sequencing, which broadly relates to the brain’s executive functions.
  • Word recall, which relates to the brain’s memory functions.

The results of these tests were then adjusted to account for each person’s gender, age, education level, wealth, physical activity, and mental health. The reason for this is that the researchers noticed there are often biases in other studies that examine the links between sexual activity and overall health.

For example, in this scenario, without taking those things into account, healthy older Italian men with a continued interest in sex would score higher on these tests. Women, who are more likely to become widowed and lose their sexual partner, would score lower.

The results…

While studying the impact of sexual activity on overall health, there are not many studies that focus on the link between sexual activity and cognitive function, and no other study that focuses on sexual activity and cognitive function in older adults.

The results of this one-of-a-kind study suggest there are significant associations between sexual activity and number sequencing/word recall in men. In women, however, there was a significant association between sexual activity in word recall alone – number sequencing was not impacted.

You can see the breakdown of this information here.

Why were the results for males and females so different?

One of the highlights of this study was exploring the differences sexual activity has in cognitive function in older males and older females.

Exploring the differences when it comes to the improved cognitive ability between the older males and the older females in this study was one of the highlights of the research.

Testosterone versus oxytocin

Testosterone, which is the male sex hormone, reacts very differently to the brain than oxytocin, which is released in females during sexual activity.

Testosterone plays a key role in many different areas such as muscle mass, facial and pubic hair development, and mood changes. It also impacts your sex drive and your verbal memory and thinking ability.

Testosterone belongs to a class of male hormones, and although the ovaries of a woman do produce minimal amounts of testosterone, it’s not enough to compare the impacts on the male and female bodies.

Oxytocin, on the other hand, is produced in the male and female bodies quite similarly, but ultimately the hormone reacts differently in the female body, triggering the portion of the brain responsible for emotion, motivation, and reward.

These differences in testosterone and oxytocin may factor into why the male cognitive level changes much more during sexual activity in older age.

Women’s ability for memory recall remains a mystery…

Another study, this time back in 1997, looked at the relationship between gender and episodic memory. The results of this study proved that women have a higher level of performance on episodic memory tasks (for example, recalling childhood memories) than men. The reason for this was not further explored in this study and has remained something of a mystery, even now.

The female brain deteriorates during menopause.

Women very commonly struggle with memory-related problems during and post-menopause. This could be the reason why the original study proved older men had a higher cognitive ability in number sequencing than older women.

Along with menopause-related cognitive decline, women are also at a higher risk for memory impairment and dementia compared to men.

Lead researcher of the original 2016 study, Dr. Hayley Wright, from Coventry University, explains:

“Every time we do another piece of research we are getting a little bit closer to understanding why this association exists at all, what the underlying mechanisms are and whether there is a ’cause and effect’ relationship between sexual activity and cognitive function in older people.”

Complete Article HERE!

We’re in Our 70s. This Is What Our Sex Life Is Like

“My sex life is better than at any other time, even during the ‘free love’ era of the 60s and 70s.”

by Mark Hay

Joel Kann, 70, knew he was aging when other grey-haired men started offering him their seats on the bus. Bonnie Nilsen, 71, knew it when she looked in the mirror one day and saw her mother. Still, neither of them ever felt old—like they’d gone through some major shift in their physical, mental, or sexual selves. But both say they’ve had people look at them, or hear their ages, and clearly instantly mentally write them off as desexualized beings.

That is not surprising given the fact that, for well over a century, American culture has embraced and perpetuated the idea that, as we age, our sexualities naturally wither away. As such, we rarely depict older people as sexual. When we do, it’s usually as a joke. The image of the sexless elder is so widespread that even medical professionals often omit older people in studies on sexuality and neglect to talk about sexual health during check ups. (Is it any wonder why STI rates among older adults are so high?) Perhaps the only time most people think about the intersection of sex and old age is viagra commercials—or when we hear reports about the (sadly common) phenomenon of elder caregiver and nursing home sexual abuse. And that is far from an affirming recognition of senior citizens’ sexual lives and selves.

As people age, their bodies usually do change in ways that affect sex. Those with penises tend to lose sensitivity. Their erections often get less firm and frequent and may take more stimulation to achieve or maintain, and their ejaculations are often weaker. Those with vaginas may take longer to get aroused and produce less natural lubrication, which can make sex less comfortable. Across the board, libidos tend to decrease and orgasms may feel less intense.

Non-sexual health conditions from arthritis to depression to heart disease can compound these issues, or lead to chronic pain, fatigue, or other symptoms that make sex difficult to have. Treatments for these conditions can likewise have side effects that take a toll on sex drive or capacity. On top of all of that, changes in skin appearance, muscle tone, and weight that often accompany aging can lead to body image issues that put a crimp in many people’s sexual confidence.

A few studies suggest that people aged 60 to 82 tend to engage in physical intimacy less often than their younger peers. Yet several studies also suggest that many older adults still have and value sex—some more than they did as middle-aged adults. Most sexually active seniors say the sex they’re having is as good as, if not better than, the sex they had earlier in life. (People often report they have more confidence and fewer distractions in life in general, freeing them up to truly focus on and enjoy sex.) Many older adults believe a vibrant sex life is important to their overall wellbeing. Quite a few also wish they could have more sex, and note that their sex lives are often limited not by health issues, but because they lack a partner.

In an effort to push back on the desexualization of older people, VICE recently spoke to Bonnie and Joel, who have been having sex with each other on and off since college and became a couple eight years ago, about how they navigate sex and sexuality in their 70s. Bonnie and Joel are the first to admit that they may not be typical seniors. The polyamorous and sexually adventurous couple recently had sex on camera for porn performer and producer jessica drake and sex educator Joan Price’s Guide to Wicked Sex: Senior Sex educational adult video. Yet for all that is unique about their story, it still touches on many experiences that will resonate with older adults of all stripes.

Bonnie: [When we first had sex in college,] we had this immediate connection—I don’t know what happened there. Part of it was sexual but there was something else going on there.

We actually only had sex twice [in college]: the one time at my apartment and the one time at your apartment when your wife was away. Our sex was the typical 20-year-olds looking at each other and ripping off each other’s clothes and falling off the bed [type of sex].

We stayed in touch on and off through the early 70s, but then lost track of each other.

Bonnie: In 2008 I put a couple of websites up about myself. I am a self-taught web developer. I guess he found me. [That fall I was 60 and] I went to the east coast for my father’s funeral and stayed at my brother’s house in New Jersey for a few weeks as we sorted through my parents’ house. And I invited Joel to come up. It was just immediate—I looked at him and said, “oh my god…”

Joel: I was living in North Carolina and she said, “do you want to come up and meet?” I thought really meet—go out for coffee. I showed up and she was standing outside with her overnight bag.

Bonnie: We’d already talked about getting a hotel room!

Joel: No, I don’t think so! And she jumped into my car with her bag and said, “Let’s go!”

Bonnie: We had one night together.

Joel: That was the first time that I had sex with you and you squirted. I’d never been with a women who squirted before. I was like, whoa, what’s this? I don’t know what it is, but it feels good.

Bonnie: Because Joel was still married, he backed off. He didn’t want to hurt his wife—totally understandable. He was, I think, kind of shocked that we had connected again. So for the next couple of years we stayed in touch on Facebook, writing emails to each other. Then in 2011, I was getting on with my life up in British Columbia and got a message from Joel saying, “Hey, would you be interested in going to a medical conference with me in Victoria, on Vancouver Island?”

Joel: I’d realized there was something there. I really liked her. My marriage was pretty much over. It was not an angry, terrible marriage. It had just died. I hadn’t had sex with my wife in almost 10 years. So I looked for a conference near her and Victoria was a close one. I said, let me see if she’ll come. We met up there and spent five days [together].

Bonnie: Which was amazing. We both fell in love again.

Joel: We met at the airport, went to the hotel lounge, said some nice things, then said, “okay, up to the room.” A soon as the door closed, clothes started coming off. We fucked over a chair by a window overlooking the parking lot and imagined that other people were looking at us.

We fucked twice that night, [then] once or twice a day [thereafter]. Bonnie started taking out lingerie and sex toys and rope and I said, “this is going to be interesting!” I ended up tying you to the rafters in the hotel room. [I was in my early 60s and] it was, I think, the first time I had anal sex in my life.

We both cried when we had to separate because we hadn’t really made any plans other than that. It was like: What are we going to do? This feels so good. We’re in love. Now I have to go back and decide if I’m going to leave my wife for you. And I eventually did. Then Bonnie eventually moved [to Raleigh, North Carolina] to be with me.

Bonnie: When we got back together [in 2008], our sex drive was good and the sex felt amazing. It still is. But it has changed.

I have had fibromyalgia for over 20 years and that hits you. You’re going through life in your 40s and suddenly [you feel like] you’re in your 80s. Everything hurts. If you turn or move too quickly, you’ll strain a joint. It can put me in bed for a day. But then get up the next day like, okay, here we go again.

Joel: As I’ve gotten older, I have joints that ache a bit more. I tend to ignore that. But certainly, I can’t perform on the same level as I did when I was younger. I’m not quite as acrobatic as I was.

And when you’re young, you can get several erections in a day, no problem. But as you get older, that gets to one a day, sometimes once every couple of days. If the stimulus is good, I can get them a couple times a day. But to ejaculate a couple times a day is rare. Sometimes [my erections] are a little soft, particularly if I’m using a condom or with new partners or having sex in public.

I’ve used Cialis and Viagra with new partners. But when Bonnie and I are together, I don’t have real problems [with erections]. Usually they are spontaneous, or [develop] with a little bit of stimulation.

will [sometimes] have an orgasm and no or little ejaculate will come out. [It’s called] retrograde ejaculation because of swelling in the prostate—the ejaculate goes into the bladder instead of out through the urethra. Then it slowly comes out the next couple of times you urinate. The first couple of times it happened, it was like, wow, what’s that?

Bonnie: My sexual desire is definitely lower than it was [as well]. I could have sex one time a week. But we usually wind up having sex two to three times a week. That’s usually because Joel approaches me. And that’s fine. I’m not being forced into it. I’m more like, oh, okay, this is fun.

Joel: Eight years ago, we were having sex every day, sometimes a couple of times a day. Even now that her libido has dropped a bit, Bonnie is still more sexual than any woman I’ve ever [been with], at any age.

Bonnie: I’ve been thinking lately that I hardly ever masturbate. I used to masturbate almost every day. If I reminded myself to masturbate more, it would probably get my sex drive up again.

Joel: I also enjoy when she masturbates, whether I’m there or not. Just hearing about it is a turn on.

Things are different. Sometimes it takes more planning to have sex. It’s not always spontaneous.

Bonnie: The biggest thing between us is that we communicate well and have a sense of each other.

Joel: She told me about her fibromyalgia and how when [an attack] hits you, you wouldn’t be sure whether you’d want me to touch you for a day—whether you’d want me to hold you or stay away. We talked about that a lot—how that doesn’t mean you’re rejecting me. She warned me when we got back together: “You’re starting a relationship with someone with chronic pain. Are you sure you know what you’re getting into?” As a physician, I’d dealt with people with chronic pain and chronic fatigue, but not personally—not on this level. So it was learning what to do, what works, what doesn’t work, and communicating a lot: “What position are you comfortable in? How are you feeling now compared to the last time we had sex? What are you up for? What are you not up for?”

Bonnie: For me, it’s been learning to say. “no, I’m not into it right now.” If Joel wants to have sex, I’d love to. But my body sometimes [doesn’t].

Joel: Or [she’ll say], “I need to be on my side.” Or, “I don’t know if I can be on top for long.”

I had to learn how to feel comfortable being the one who more often than not initiates sex, but [also to] not be afraid when she can’t or doesn’t want to [have sex]—to not take that personally. It helps that she has such a great libido and is so adventurous. It wasn’t like I wasn’t getting any sex.

Bonnie: We’ve basically tried everything. And we still do. Just a lot less [often than we used to]. We just recently went to a Halloween party in Durham. It was a BDSM party.

Joel: I tied her to a cross and flogged her in front of a bunch of people. And we were into swinging for a while. Then we got into polyamory—this fits us better, getting to know someone and bringing them into our lives rather than just a quick hookup and then never seeing people together again.

Bonnie: [I don’t have many sexual relationships with other people these days.] With fibromyalgia, it’s like: Here’s somebody else who’s going to have to learn what to do with my body. I don’t really want to get into that. But I’m fine with Joel having other partners.

Joel: My sex life is better than at any other time, even during the “free love” era of the 60s and 70s.

Bonnie: When you were hitchhiking and fucking everybody you met on the road.

Joel: [One thing we want to say to other older people is:] Don’t let preconceived notions define you. You don’t have to act a certain way just because you’re getting older. There are things that change. Try to understand, physiologically, what’s going on and how you can adapt to that.

If you can’t get an erection, there are many ways to please your partner. With your hands. With your mouth. You don’t have to concentrate on penis-in-vagina sex to have a good sex life.

Bonnie: People like us are out here saying, “you can still have a great sex life in spite of changes.”

Joel: In spite of aches and pains.

Complete Article HERE!

The nitty-gritty of middle-age sex

‘It’s good to experiment’

By Alana Kirk

[I]f you are drinking your morning coffee while reading this, then perhaps this article should come with a warning. There are going to be phrases that we tend not to discuss much in public such as vaginal dryness, loss of libido and erectile dysfunction. However, they are a natural part of life, and if we want to continue to be active sexual people well into middle age and beyond, then we have to acknowledge and then address them, because turning the trials and tribulations of middle-age sex into the joy of sex is not difficult.

Sex is important to all of us, regardless of age. Not only is it excellent for getting the blood pumping and putting a youthful spring in your step, it has a number of other benefits too, such as reducing stress, strengthening your immune system, boosting self-esteem, and relieving depression.

The famous manual, The Joy of Sex, still has some salient advice for middle- aged and older people even though it was written nearly 50 years ago. It’s author Alex Comfort wrote: “The things that stop you enjoying sex in an old age are the same things that stop you from riding a bicycle – bad health, thinking it’s silly and no bicycle”.

Well, we can pump up a flat tyre, add some lubricating oil, and still be having sexual enjoyment with no partner. As recent research has shown, and despite an ageist societal view on the topic, our sexuality doesn’t die with middle and growing age. Our sexual needs and levels evolve and change over the years, and the particular issues that might arise from menopause, for example, do not mean we should give up on it. We just need to learn to adapt.

Emily Power Smith may be Ireland’s only clinical sexologist, and talks to large numbers of middle-aged women in her clinics and at talks around the country. “I’ve spoken and written more on this topic than any other related to sex, and the main driver for women coming to me with an issue is poor education. Generally women are very misinformed about what they should be expecting and are very quick to blame themselves.”

If we look at sexual activity as a life-long issue, there can be plenty of interruptions to the normal flow, including illness, childbirth and child rearing, loss of confidence, menopause, and hormonal fluctuations. Low libido, erectile dysfunction, and vaginal dryness are all just normal challenges that can affect our sexual lives, but importantly, ones that can be easily addressed.

“We do specific menopause consultations and counselling for women who start experiencing changes and want to know that they are a normal part of the ageing process,” says Dr Shirley McQuade, medical director of the Dublin Well Woman Centre. “Many women come in with a specific symptom thinking it’s all over, but in fact nearly all issues can be addressed. You just need to realise that your, and your partner’s body changes.”

So what are the main issues and what can be done about them?

Peri-menopausal symptoms

Menopause can effect every aspect of your being, and symptoms including hot flushes, not sleeping, and poor concentration levels, can affect how you feel about yourself.

“Hormonal changes can mean your libido and sex drive go, as well and the emotional havoc they can play,” explains Dr McQuaid. Mood swings, empty nest syndrome, trying teenagers, or work/life balance can weigh in to make us feel less than energetic about sex.

“It is really important to take the time for yourself when you are peri-menopausal, to take stock and adjust to the changes that are happening. I see lots of women who have reached senior career level or have lots of people depend on them and it can be difficult because they feel overwhelmed and aren’t giving enough time to themselves to deal with how they feel.”

The advice is to take pressure off yourself, and try and cull some of the responsibilities. Exercise, eat and sleep well and acknowledge that you can seek help if you need it. “I’ve seen women go to cardiologists because they think they have heart problems when they wake up sweating in the night, or go to rheumatologists with joint pain, when in fact they are just the symptoms of hormonal change.”

Hormone Replacement Therapy

HRT is a common treatment for women who are suffering from continued and difficult symptoms, and it only takes two or three weeks to find out if it will work for you. According to the National Institute for Health and Care Excellence (NicE) in their 2015 recommendations, the benefits of HRT, available in tablet form, gels, and patches far outweigh any risks.

According to Dr McQuaid, it is a positive option to take. “About 15 years ago there were scares about risks relating to heart disease and cancer, but the studies were seriously flawed. For women who take it through their 50s, the benefits are significant.”

HRT is available for as long as your symptoms last, with the average duration being eight years. Despite scaremongering to the contrary, there are no withdrawal symptoms or problems when you stop taking the drug, as long as you leave it long enough for your natural menopause to conclude. HRT masks the symptoms, so if you stop before they have fully receded, they will return.

Not all women experience menopausal symptoms, and for women who do, they do eventually pass.

Vaginal dryness

It is completely normal for most women in menopause to experience dryness. The drop in your body’s oestrogen levels means the vaginal membranes become thinner and drier which can makes for uncomfortable dryness. As a result, thrush and Urinary Tract Infections (UTI) are also more common. Lubrication is widely available and will transform your sexual experience if dryness is a problem. Dr McQuaid also recommends treating the underlying issue rather than just the symptom. A prescription product, licensed in Ireland as Vagifem, provides low levels of oestrogen to the local area, and if taken over the longer term can alleviate all symptoms of dryness. Regular sexual activity or stimulation from masturbation also promotes vaginal health and blood flow.

Erectile dysfunction

For men who may identify their every maleness with work and sexual ability, a lowering of libido or erectile dysfunction can be catastrophic. However, accepting that this will happen occasionally, and seeing it a normal part of the ageing process and hormonal changes may encourage them to seek help. The advice is to go to your GP to get checked out to make sure erectile dysfunction is not related to vascular changes and bold pressure / diabetes, and then again there is a simple medication solution.

Painful intercourse

Again this can be a common change in sexual experience, usually due to vaginal dryness. However, other reasons could be a prolapse of the uterus or front wall of vagina which can cause discomfort, so the first port of call for any pain is to get examined by your GP or at the Well Women clinics. All issues can be addressed with medication or procedures.

Heavy periods

A common complaint for women entering peri-menopause is very heavy periods, which are caused by the womb being uncomfortable and bulky. Some women from the age of 40 develop fibroids which make the womb heavier and along with hormonal fluctuations, combine to make structural and hormonal changes that affect the flow of periods. Some women have low iron levels, because heavy periods are the main reason for low iron which makes you tired, so it’s important to keep a medical check on your body while going through the menopause.

Traditionally this was often treated by a hysterectomy, whereas today women can access the pill or coil. All countries where the coil has been introduced have seen a significant reduction in hysterectomy operations.

Change of mind

Addressing specific symptoms is only one way of evolving our sexual lives. Changing the way we have sex is another. “I meet women who have only ever used one position, and now that that proves painful they are at a loss,” explains Dr McQuaid. “It’s useful to experiment and change. It’s more interesting too!”

What we need to remember is that sex is not just about intercourse. There is a variety of sensual, loving, exciting activities that can bring joy and satisfaction. For women experiencing menopause especially, they might need and want more touching and foreplay than before, but after years of marriage, it can be more difficult to change. Asking for what you need is important. Tantric sex – slightly ridiculed in the press after Sting and Trudie Styler admitted to it – is encouraged by many counsellors as it focuses on the sensual intimacy rather than an orgasmic goal.

Whatever the issue with sex may be, Dr McQuaid advises you start with a medical to check to make sure everything is okay. Once that is done, it’s just about dealing with specific issues. “I’ve had a 78-year-old woman come to me recently having a little bit of trouble because her partner has been given Viagra. So she went on Vagifem and has no more problems,” says McQuaid. “I have lots of women come to us for help and they’re happy and healthy and they certainly don’t stop having a sex life. Nor should they.”

Psychologically however, it is also important to rise above the social conditioning that we lose our sexiness as we get older. “There is just no scientific evidence to back this up,” explains Power Smith. “Irish women are very quick to blame themselves and feel guilty for not being better, not feeling enough or good enough. In part we are brought up to feel this way with magazines and media, and then when middle age hits, physical things happen to compound that.” She has three golden rules for women in their middle age with regards to keeping their sex lives healthy and functioning: masturbation, lubrication and communication.

So while the number of potential causes of sexual changes and challenges during menopause and middle ageing can seem overwhelming, there are just as many strategies and treatments for overcoming them.

You can go back to drinking your coffee now.

Complete Article HERE!