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The Thrill Is Gone


Name: Billy
Gender: Male
Age: 46
I have heard it’s normal for sex drive to diminish as you age. I’ll run this by you. I’m a 46 year old male and the last time I was at a strip club with bare boobs bouncing around me, you may as well have rolled a grapefruit across the floor. Actually, I can see more use from the grapefruit. I don’t recall the last time I did it, and jerking off was almost disgusting. My tool has shrank to nothing. I barely touch it and it just dribbles, it doesn’t fire off anymore. I don’t even like to touch it to go piss anymore. I’ve had to shave around it, so I actually find it, to keep from pissing my pants. Is this normal?

No, Billy, this isn’t normal. I think you already know that too, right?

andropauseDo you know anything about andropause? If not, you ought to. Here’s what I suggest. Use this site’s search function in the sidebar. Type in the key word: “andropause” and you will come up with a wealth of information about this issue.

You can also use the CATEGORY pull down menu. Look for the subcategory: Sex and Aging, under the main category: Aging. Everything is alphabetized.

But for the time being, here’s a typical question and response —

Name: Wilson
Gender: male
Age: 58
Location: Lancing MI
I’m a successful entrepreneur, in decent health (I could stand to lose a few pounds.) I have just about everything a man could want in life, but I’m miserable. I have no energy and I feel like I’m sleepwalking through my life. I have no sex drive at all; my wife thinks I’m having an affair…I wish. Even Viagra doesn’t do the trick anymore. Is this just old age, or what?

Old age, at 58? Middle age, perhaps! Regardless what we call it, you sound like you’re in the throws of andropause — male menopause — ya know, the change of life!

Never heard of such a thing? You’re not alone. It’s only been recently has the medical industry has begun to pay attention to the impact changing hormonal levels has on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!andropause-1

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

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 pronounced too.

While most all of us have heard of a mid-life crisis, and it’s tragic consequences — red convertible sports cars, comb-overs, and the trophy wife or lover — fewer have heard of andropause. A mid-life crisis is essentially a psycho-social adjustment to aging — bored at work, bored at home, bored with the wife or partner — that sort of thing. Andropause, although it may coincide with a mid-life crisis, is not the same thing. Andropause is a distinct physiological phenomenon that is in many ways akin to female menopause.

Unlike women, men can continue to father children after andropause, but like I said, the production of testosterone diminishes gradually after age 40. I suppose you know that testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for our sexual drive. But did you know that by the age of 55, the amount of testosterone secreted into our bloodstream is significantly lower than at 45. And by age 80, most male hormone levels have decreased to pre-puberty levels.

Men, are you over 50? Are you feeling weak, lethargic, depressed, and irritable? Do you have mood swings, hot flashes, insomnia, and decreased libido, like our buddy Wilson, here? Then you too may be andropausal. You need to get some lead back in your pencil!

mutateAll kidding aside, andropausal men might want to consider Testosterone Replacement Therapy (TRT). Ask your physician about this. Just know that some medical professionals resist testosterone therapy, mistakenly linking Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. However, before starting a testosterone regiment, insist on a complete physical, including blood work and a rectal examine. Mmmm, rectal exams!

Testosterone is available in many forms — oral, injectable, trans-dermal and by way of implants. The oral form is not recommended because of the high risk of liver damage. But injections, patches, pellets, creams and gels might be just the answer. I encourage you to be informed about TRT before you approach your doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Good luck

Sexual Frustration Reigns

Hello Dr. Dick

First time question to you. I’m sure you’ve probably heard this one a million times, but I could use some advice :-)

I married my best friend. Sex has never been frequent or great. Most of the time he finishes in less than five minutes of penetration and I rarely if ever get to orgasm. The first and last time I think I did have an orgasm I think was the day we conceived our little girl.

He’s a great guy in all other aspects, but when it comes to the bedroom, it doesn’t happen. I’ve tried seducing him (which he responds to eagerly, finishes and then rolls over and goes to sleep), tried asking if we could try different things (different has ended up being one of two positions – missionary and woman on top – he does not like and will not do anything else). He also does not want to and won’t do stimulation with his hands or anything else for that matter. He also does not like or want toys in the bedroom, for him or me.

Any ideas on how I can convert him into a wife pleaser? I’m at my wits end. Last time I seduced him to get some “cock” in me was two months ago and needless to say I didn’t get any satisfaction. For the first time though I took care of things myself and at least I slept without really resenting him :)

I’ve been trying to not care, but I’ve found out I’m a very passionate woman who only gets more passionate with time… and with those needs not being met, I’m wondering if it’s the end? Can people be happy without sex? I haven’t found a way to yet but if you know of something, please let me know.

Anyway, if you have a chance to respond to my ramblings it would be appreciated… even if you have some insight into his actions/non-actions it would be greatly appreciated.


You’re right; I have heard this a million times.

sexual frustrationI’m gonna spare you the niceties and get right t the point, Coral. Your husband is clearly not up to the task of being your lover. His behaviors and his disinterest in finding a solution to the problem you have together tells me that he is a selfish lout. And how in the world can he be your best friend. Best friends don’t behave like this.

Let me put it to you another way. If you were writing to me to tell me that your husband hordes all the food in the house to himself. That he has you feed him till he is satisfied, but offers you only crumbs to sustain you. And that he won’t even negotiate you getting the food you need to survive and sustain yourself. What do you think I would say about that?

I suppose you see where I’m going with that, right? Listen, you oughtn’t be beggin’ for shit that is rightfully yours.

I have one real simple premise that I live by. And that is, each of us has a right to a happy, healthy, integrated sex life. If there is something that is getting in the way of achieving that, whatever it might be, it is a problem that needs to be addressed immediately.

As far as relationships go, I am of the mind that we ought, first and foremost, work to honor our commitments of fidelity and mutual support. Are there ways that these two moral principles — a right to a healthy sex life and one’s relationship commitments — can coexist when one’s relationship excludes the possibility of happy sexual expression? Yes, I believe there are. And many couples achieve this balance, because they have an overriding love and concern for one another.

Now the facts — not all loving relationship have a sexual component. Many, for one reason or another, simply don’t. But if a partner is unwilling to provide sexual satisfaction to his/her partner and he won’t even begin negotiate an amicable solution or other accommodations then, I believe, this a form of sexual abuse.factors-of-sexual-dissatisfaction

If what you report about your husband’s distaste for anything sexually adventurous is accurate, then you have a very hard row to hoe. (BTW,are mutually enjoyed sex toys in the bedroom all that adventurous these days?) Trying to negotiate a satisfactory solution to a problem is all the more difficult when your partner is opposed to even discussing the issue. Here’s what I suggest. Have a frank talk with the bonehead. Tell him, in no uncertain terms, that he has first right of refusal to you and your long-suffering naughty bits. If he isn’t interested in keeping you sexually satisfied, that means the door is open for you to get your groove on elsewhere. If he balks at that, stand your ground. Insist that he has just the two options of taking it or leaving it.

If this means the end of this relationship, as I suspect it might. Then have the spine to make a clean break of it. Because, if you don’t, then you are complicit in the abuse you are suffering.

Good luck

The extraordinary case of the Guevedoces

Catherine and his cousin Carla, Guevedoces in the Dominican Republic

Catherine and his cousin Carla, Guevedoces in the Dominican Republic

The discovery of a small community in the Dominican Republic, where some males are born looking like girls and only grow penises at puberty, has led to the development of a blockbuster drug that has helped millions of people, writes Michael Mosley.

Johnny lives in a small town in the Dominican Republic where he, and others like him, are known as “Guevedoces”, which effectively translates as “penis at twelve”.

We came across Johnny when we were filming for a new BBC Two series Countdown to Life, which looks at how we develop in the womb and how those changes, normal and abnormal, impact us later in life.

Like the other Guevedoces, Johnny was brought up as a girl because he had no visible testes or penis and what appeared to be a vagina. It is only when he approached puberty that his penis grew and testicles descended.

Johnny, once known as Felicita, remembers going to school in a little red dress, though he says he was never happy doing girl things.

“I never liked to dress as a girl and when they bought me toys for girls I never bothered playing with them – when I saw a group of boys I would stop to play ball with them.”

When he became obviously male he was taunted at school, and responded with his fists.

“They used to say I was a devil, nasty things, bad words and I had no choice but to fight them because they were crossing the line.”

We also filmed with Carla, who at the seven is on the brink of changing into Carlos. His mother has seen the change coming for quite a while.

“When she turned five I noticed that whenever she saw one of her male friends she wanted to fight with him. Her muscles and chest began growing. You could see she was going to be a boy. I love her however she is. Girl or boy, it makes no difference.”

Child on swing



So why does it happen? Well, one of the first people to study this unusual condition was Dr Julianne Imperato-McGinley, from Cornell Medical College in New York. In the 1970s she made her way to this remote part of the Dominican Republic, drawn by extraordinary reports of girls turning into boys.

When she got there she found the rumours were true. She did lots of studies on the Guevedoces (including what must have been rather painful biopsies of their testicles) before finally unravelling the mystery of what was going on.

When you are conceived you normally have a pair of X chromosomes if you are to become a girl and a set of XY chromosomes if you are destined to be male.

For the first weeks of life in womb you are neither, though in both sexes nipples start to grow.

Then, around eight weeks after conception, the sex hormones kick in. If you’re genetically male the Y chromosome instructs your gonads to become testicles and sends testosterone to a structure called the tubercle, where it is converted into a more potent hormone called dihydro-testosterone This in turn transforms the tubercle into a penis. If you’re female and you don’t make dihydro-testosterone then your tubercle becomes a clitoris.

Foetus at 12 weeks

When Imperato-McGinley investigated the Guevedoces she discovered the reason they don’t have male genitalia when they are born is because they are deficient in an enzyme called 5-alpha-reductase, which normally converts testosterone into dihydro-testosterone.

This deficiency seems to be a genetic condition, quite common in this part of the Dominican Republic, but vanishingly rare elsewhere. So the boys, despite having an XY chromosome, appear female when they are born. At puberty, like other boys, they get a second surge of testosterone. This time the body does respond and they sprout muscles, testes and a penis.

Imperato-McGinley’s thorough medical investigations showed that in most cases their new, male equipment seems to work fine and that most Guevedoces live out their lives as men, though some go through an operation and remain female.

Another thing that Imperato-McGinley discovered, which would have profound implications for many men around the world, was that the Guevedoces tend to have small prostates.

This observation, made in 1974, was picked up by Roy Vagelos, head of research at the multinational pharmaceutical giant, Merck. He thought this was extremely interesting and set in progress research which led to the development of what has become a best-selling drug, finasteride, which blocks the action of 5-alpha-reductase, mimicking the lack of dihydro-testosterone seen in the Guevedoces.

My wife, who is a GP, routinely prescribes finasteride as it is an effective way to treat benign enlargement of the prostate, a real curse for many men as they get older. Finasteride is also used to treat male pattern baldness.

A final interesting observation that Imperato-McGinley made was that these boys, despite being brought up as girls, almost all showed strong heterosexual preferences. She concluded in her seminal paper that hormones in the womb matter more than rearing when it comes to your sexual orientation.

This is still a controversial topic and one I explore later in the film when I meet Mati, who decided from the earliest age that though “he” looked like a boy, Mati was really a girl.

As for Johnny, since he developed male genitalia he has had a number of short term girlfriends, but he is still looking for love. “I’d like to get married and have children, a partner who will stand by me through good and bad,” he sighs wistfully.

Complete Article HERE!

A Farewell to a great man

Dear sex fans,

I realize this is a bit off topic for this blog, but I want to acknowledge the death of famed British neurologist and author, Oliver Sacks.

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City. (Photo by Nancy R. Schiff/Hulton Archive/Getty Images)

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City.

In February, he wrote an op-ed in The New York Times revealing that he was in the late stages of terminal cancer, after earlier melanoma in his eye spread to his liver.

“It is up to me now to choose how to live out the months that remain to me,” he wrote. “I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.”

Earlier this summer I read Dr Sacks’s memoir, On the Move.  I love it.  It’s an interesting memoir by a fascinating personality.  And while reading I discovered that we had a dear friend in common, Thom Gunn.  What a small world!  So I decided to send him a note.

Dear Dr Sacks,

I just finished reading your memoir, On The Move.  What an amazing life you’ve lived.on-the-move-by-oliver-sacks

Of all the marvelous things you’ve done and all the fascinating people you mentioned in your book nothing surprised me more than your close friendship with Thom Gunn.  I was a friend of Thom too and I lived directly across Cole Street from him.  I moved to the flat at 1207 Cole Street in 1979.  At the time I was working on my doctorate in clinical sexology at the Institute For The Advanced Study of Human Sexuality in San Francisco.

I didn’t know Thom well at first.  However, I would regularly see him walking both in our neighborhood and elsewhere in town.  He was always in his leathers, rain or shine, and used to think to myself, “What a mensch!”

It finally dawned on me that he lived across the street from me.

Once he saw me in my roman collar.  (I was ordained a catholic priest in 1975 at the age of 25 in Oakland, CA.  I had come out to my local superiors; I was a member of the Oblates of Mary Immaculate, before I was ordained.  Like I said, I was working on my doctorate to become a sex therapist and prepare for an upfront gay ministry.)  Thom smiled at me when he saw me; I blushed and told him what I just told you.  He was fascinated, but I also believe he thought I was a twit.  He probably was right.

I knew nothing about Thom other than he was my neighbor.  Then one day I was in a bookstore on Haight Street and there was a photo of Thom in the window advertising a reading.  That’s when I started asking around about him.  Despite his cult status within the gay community, he was the most unassuming person.  I was honored to have a personal connection with him.small_front

I finished my doctorate in 1981.  My dissertation, Gay Catholic Priests; A Study of Cognitive and Affective Dissonance was directed by Wardell Pomeroy.  A firestorm of media attention followed.  The media branded me as THE gay priest, as if.  I think Thom read about me in the New York Times because next time he saw me he clapped me on the back and said, “Well done.”

No sooner did I complete my doctorate, and because of the media attention my public coming out caused, the leadership of my religious community in Rome began a process of dismissal against me.  I was devastated and lost.  I was even getting death threats.  Thom was always so supportive and encouraging.

I fought the church for the next thirteen years in an effort to save my priesthood and ministry.  Alas, the writing was on the wall back in 1981 and it was only a matter of time till they had their way with me.  I wrote about the travail in a book that was published in 2011, Secrecy, Sophistry and Gay Sex In The Catholic Church: The Systematic Destruction of an Oblate Priest.

Thom was always so solicitous about my wellbeing.  He knew how difficult life had become for me.  And both of us found ourselves on the forefront of caring for friends who were dying of AIDS.  One of my landlords died in 1986.

Thom introduced my housemate and I to Augie Kleinzahler and his girlfriend, Caroline Lander, who lived only a few blocks from us in Cole Valley.  We all became great friends and copious amounts of strong drink were consumed.  I wonder, do you know Augie?

When Thom turned sixty I surprised him with a homemade German chocolate cake.  I told him he was the oldest person I knew.  This made him laugh and he called me a whippersnapper.

In 1992 the surviving landlord sold the Cole Street duplex and I and my housemate moved to Oak and Ashbury.  Sadly, I didn’t get to see Thom as much as before.  I move up here to Seattle in 1999 because I could no longer afford to live in SF.  I was deeply saddened to learn of Thom’s death in 2004.  He was such a great guy, what a marvelous soul.

Again, thank you for your memoir; it was grand getting to know you on a personal level.  I read The Man Who Mistook His Wife for a Hat when it came out in the mid-eighties and loved it.  But I never guessed you and Thom knew each other or that you actually visited him when I lived across the street from him.  What a small world.  I wish I had known you back then.

Anyhow, thank you for the bringing me this unexpected flood of memories of Thom.  I wonder what he would have made of yesterday’s Supreme Court decision (Obergefell v. Hodges).  I contend that we got marriage equality only because we walked through AIDS first.  I think Thom would have agreed with me.

All the best,

Richard Wagner, M.Div., Ph.D., ACS

To my astonishment, Oliver wrote back; I mean that literally, a handwritten note.  Apparently, he never used a computer.

Dear Dr. Wagner (can I say Richard?),                                                          6/60/15

I am greatly interested and greatly moved, by your letter — your courage in being honest and forthright, at a time and on a subject bound, sooner or later, to cause your ejection from the priesthood. In another few years perhaps, with Pope Francis at the helm, these last bastions of Catholic bigotry may have fallen.

I like to think of you as living across the street when I visited Thom, and glad to know that he appreciated you and your works. I still miss him deeply — there were not too many people with whim I could be entirely open — and I like to think that his ghost is pleased that my title came from his poem. (I find it a huge relief being open now to all and sundry {Oliver came out earlier this year} — I am so glad I completed my book before I became ill).

And what a liberation, an affirmation for us all that the Supreme Court voted as it did. I suspect that Ruth Bader Ginsberg, quite ill now, stayed on to ensure the 5/4 decision.

Thanks for your letter and my very best wishes,


Oliver Sacks01     Oliver Sacks02

Click on this link to see a copy of Oliver Sacks’s note.

Thank you Dr Sacks and farewell!

When did sex become shameful?

By Hanna G Ruby

Once upon a time sex was enjoyed without shame, as a gift of God, Goddess, the Great Spirit – an act of joy, of devotion, something perfectly natural and wholly divine – all at the same time.  Once upon a time the goddesses were venerated as the embodiment of love, passion, and sex, which were considered holy when performed in reverence for and in service of the female divinity.

But the mindset of patriarchy killed off the Goddess more than five thousand years ago. She was constrained to submission at worst, or virginal purity and celibacy at best; her divinity denied. With that, the idea of sexuality as spirituality, as something inherently divine, was eradicated for all women – young and old. Indeed, for all men as well!  Sexuality was severed from spirituality and became its extreme opposite; sex was dirty, primitive, and instinctual (and feminine in nature), while spirituality was pure and clean and transcendent (and masculine in nature).

In the West, however, it was only from our Bible onward that sexuality became a sin, the means by which the devil could tempt mankind into damnation, a shameful necessity of physical gratification that was obscene and dirty. Only from our Bible onward, were women considered inherently sinful and destined for eternal punishment.

Even before Eve bit that apple, there was poor, feisty Lilith (born initially as one with Adam – “male and female created He them” says the first Biblical reference), who, according to legend, preferred to have sex on top. Lilith represents lunar consciousness (waxing and waning, death and rebirth), sexuality, body, and intuitive wisdom – all of which patriarchy degraded and denied. She got a terribly bad press.

Previously, the Goddess had ruled the mysteries of sexuality, birth, life, and death. Now the patriarchal God took control of life and death, and split procreation and motherhood from sexuality and “magic and mystery”. Lilith refused to submit and flew off in a rage. Until recent decades, she has been universally demonized as seductive, witch, outcast – the enraged, avenging goddess, wife of Satan.

Solar was split from lunar; psyche from soma or physical, corresponding to a general disassociation from the body. Mind and body, spirit and body, soul and body were split entities, and unequal. The body was inferior, an unfortunate necessity – together with its most basic of functions, sex; and it was associated with the feminine. (I once read an old text that described women as “bags of filth”. The males’ organs of excretion were not referred to.)

Male and female were unequal; spirit and nature were unequal. Man headed the chain of command – after God. As women, and as a culture, we have paid dearly for this division. The misogyny of the patriarchy affected all cultures in the last 2000 years, one way or another.

The fierce, sexual, independent-spirited wise dark goddess aspect of Lilith was replaced by submissive Eve, who was yet blamed for the whole messy business anyway. She was the sinful one, secondary to Adam, and cursed forever to give birth in pain. (Medieval midwives were sinning when they alleviated the pain of childbirth.)

As long as Eve is sinful and physical matter corrupt in any way whatsoever, our sexuality is compromised – and our liberation incomplete. This split must be healed.

I am proposing that sexuality and spirituality are aspects of the same thing; that the split between psyche and soma (the physical) is resolved in the energetic unity of a higher order. “We have lost contact with what unites them,” says Alexander Lowen in The Spirituality of the Body.  Sexuality is psychosomatic – and by that I mean, not that it’s some kind of illness, in the more common meaning of the word, but that it overtly operates on both the physical and the psychic level.

Where science and religion are finding rapprochement in the infinite wave world of quantum physics, we find fresh metaphors for the lost unifying element. Waves of sexual sensations that emanate from the body can be visualized as cosmic, psychic energy, high-frequency vibrations that bridge us to higher consciousness.

These metaphors indicate possibilities that have profound implications generally, and more so for aging women today.

Complete Article HERE!

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