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Are My Macho Days Over?

Many middle-aged men come to see me, troubled that their macho days  are over.  Few are cognizant of, or prepared for, the normal changes in the male sexuality that accompany ageing.  A large fraction of these men also  erroneously believes that age is just a 'state of mind', that chronology has nothing to do with  it, and that a man's sexuality  remains unchanged even in he seventies and eighties.  They thus attribute their present depleted sexual state to stress, or a stale  relationship,  or a passing phase, without even trying to  understand  the medical facts.  Braggadocio  claims made by some  impotent oldies  who boast  that they can have the sex addict   every day, only obscure the  picture further  for others.  Several men, even  the educated ones,  have fallen prey  to useless medication in the quack or aphrodisiac market for these  reasons.  After  many years, when nothing  has worked, they come to me.  Otherwise, the usual joke at parties is, 'Doc, you are  one specialist  I hope I never   have to come to.'  The irony is that, despite such  resolve, many  eventually do.  They land up at my office when they have finally come to terms with reality, have realized  that this phase  just doesn't  passage to manhood, and are  convinced that aphrodisiacs are not working  for them!  By this  time usually, a lot of water has already flown  under the bridge.  

So, what are the sexual problems of middle  and old age?  What can be considered  a normal, age-related change, and what  is abnormal

Let's talk about normal changes first.
The first of these  is that elderly men do not get aroused instantaneously, as they did in their  younger   years.  One Mr Sexually  sluggish, aged fifty-eight, told me, 'Doc, I am finished.  The kind of chicks that gave me instant hard-ones when I was younger, don't do anything  tome now.  I'm sure I am becoming impotent. Earlier, if a beautiful babe merely walked past, I'd  get horny as a beast.  Just the sight,  the thought, or the scent of a  woman  would unleash the lust  in me.  Touch, of course, was something else.  Why that, I'd  get  erections even on  bus rides and in autos just  like that,  like some vibrator was applied to my dick or something, without anything  sexual happening  in my  mind even.  I would  need periodic sexual release even in college  and in the office because I could not  concentrate on my studies  or work for too long  because  of uncontrollable satyriasis.  I would  have to sneak a stealthy  visit to the look every now and then to perform  the needful.  Oh, those  were the days! They are history now, of course.  Extinct.  Just like the bloody dinosaurs.   Nothing arouses me instantly any more.  My poor  partner has  to work hard on my limp penis transplants to awaken it.  often, it takes so much time that both of us lose interest, and don't  want to continue the traumatic charade any longer.  I feel  terrible for her,  doc, I am still very skilled with my fingers and tongue, but can they substitute for the  real thing?  We both know that it is a pathetic situation.  Give me something to pep  me up, doc.  It's going  room bad to worse.  And you know the one more thing, doc?  Mr wife's considerably younger  than I am, and still very attractive, and is out at work  all day.  Sometimes, I get so insecure that she'll  stray, I feel a wrenching pain in my gut.   I'm only human  doc, and she too.'  He sounded really miserable.

'Tell me,' I finally had a  chances to jump in, 'When you do get aroused  finally, how  are the erection, the  performance, and the satisfaction quotient of both partners?'

'Disastrous doc, I just told you.  Weak initial rigidity, no  sustenance, no ejaculation, no partner  orgasm.  Everything  is a disaster.'

I reassured him and proceeded to explain that sexuality changes  with age, and that  what he was going through was not  unusual, and that   millions of men the  world over go through  the same  things.  'After a particular age, men finally learn to  think with the right heads,' I tried to light-heartedly reassure him.   I was not telling him the whole truth, of course.   It is certainly  not normal for all elderly men to be totally impotent, but I didn't want to  break the bad news  to him yet.


I went on to tell Mr Sluggish about  the other changes  accompanying ageing.  One of these, I told  him,  is the ejaculatory experience.  With age, both the intensity and the volume  of ejaculation  can reduce.  This again, is a source of major  perturbation for many men.  Thus, a man who could proudly squirt his semen  a few  feet ahead  in his heydays, gets  a rude shock  when the squirt gets reduced to a mere ooze, a drop, or sometimes nothing  at all.  Besides, he whole ejaculatory  experience itself  becomes  much less intense, and is  no longer  'mind-blowing' or 'earth-shattering' like it used to be. In fact, quite often, the middle-aged man is content not ejaculating at all, and actually abandons coitus  without doing so even  though his erection is good.  The  overpowering  urge to release  pent up sexual tension and semen is simply no longer  there.  This actually perplexes  both him,  and his partner, but is again just a variation  of the normal.  Some years ago, such a sexual  response  would  have been unthinkable to the  same man.  The vascular  congestion  of the sexual  the better diet organs  consequent  upon sexual  arousal in both the sexes is  so severe  in younger  ages, that not attaining climax can actually cause congestive pains in the genital regions  and other symptoms elsewhere.  Many young men who  lack sexual opportunity and who  believe that masturbation is harmful and cause weakness, chronically suffer from such pains.  Sexual release is the only cure for this.

However, all this  changes  considerably  as the man ages.
Another sexual  area of concern to the middle-aged man is the refractory period, or the interval between  erections.  At eighteen  or twenty, a man  is ready for sex a second time within  minutes.  With age, this changes  a lo too,  and some men cannot  get another  erection for much longer periods.  Some men will not get another erection for several days after  one ejaculation.  A few  elderly men are able to make their first   and only erection last much longer.  Many also report delayed rather than premature ejaculation.   Thus, some sprinters of yore become  marathon men, nut  remain athletes nonetheless.  However, not all elderly men can do this.  In fact, more than half of all men over the age  of forty will have some  degree of erectile dysfunction (impotence).

With age, the angle of the erection also changes.  In young  boys and  young men,  erections are nearly vertical and almost  touch their lower abdominal walls.  With age, the 'angle of the dangle' reduces, and you can be  said to be doing well if the erection is at or just above the horizontal.  Of course, it goes without saying that you are in deep trouble  and need urgent help  if your  aroused  apparatus points  to the  ground.   If it's limp as  well, then that would constitute a really major dual fiasco. 

There are  other hormone-related  changes in the ageing male  too.    These affect  various organ  systems  in the body and are clubbed together  under the term 'andropause' or 'male menopause'.   This is discussed  in another chapter.

It is important that more men  understand these bodily changes  and come to  terms with a sexuality that is age appropriate.  Too many men are either  needlessly languishing  in misery or trying to compensate for their  waning manhood by posing as macho studs in their middle  age.  Remember, even top level athletes  and sportsmen in many fields retire when they are only in their  twenties  and thirties.  Physical fitness always  fades  after  a particular age.  It is inevitable.

You must be wondering what happened to Mr Sexually sluggish.  Well, I conducted  some tests on him.  these revealed that he did not  have any major  medical  condition like diabetes,  high  blood  pressure, high cholesterol  or very  low testosterone,  but he did have considerably reduced blood   flow to his penis.   I tried the new  wonder drugs on him but they worked  only partially.  I finally suggested a surgery, which  gives excellent results,  but, like  many Indian men, he is petrified of the scalped and is  taking his own time to make up  his mind.  Meantime, he is using  a vacuum device (an external device  used to induce  erection), with the help of which he seems to be doing  at least something. 

I hope that many of you are feeling much  better  now, after reading all this.  You may now put away  your protractors!

Take Home Message:

Male sexuality goes through different  phases as a man ages.  Unfortunately, on account  of various prevailing myths and misinformation, these   phases are very poorly  understood.  A correct understanding  of what  constitutes age-appropriate sexuality, and what constitutes an andrological  diseases state is important  so that one may take timely action if necessary.  Since  both venereal disease   states and physiological changes can co-exist  in middle age and beyond, it is  important to recognize the vas deferens between  men and women .  Physiological changes are to be lived  with, whereas pathological  states will require  treatment.