Senior Sex: How to Maintain or Improve Intimacy

Sex in the Senior Years

By Mark Stibich, PhD | Updated on August 13, 2023
Medically reviewed by Isaac O. Opole, MD, PhD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key takeaways:

‧ People in their 70s and 80s and beyond can continue to enjoy sex.

‧ Striving for optimal physical and mental health can allow one to continue to enjoy sex in older age.

‧ Issues you cannot resolve on your own should be brought to the attention of a qualified medical professional.

Many people in their 70s and 80s are not only sexually active, but satisfied with their senior sex lives.1 Though the frequency or ability to perform sexually may decline with age due to physiological changes, these don’t necessarily affect how a person experiences or enjoys sex.

Aging-related problems like erectile dysfunction (ED), vaginal dryness, or urinary incontinence can affect sex. But their impact can also be minimized by using medication, managing chronic conditions, seeking individual or couples counseling, and changing sexual practices.2

This article explores the sex lives of adults 65 and over and the problems that can interfere with sex as the body ages. It also discusses the various treatment options and ways to maintain—or even jumpstart—your senior sex life.

Sexual Activity in Older Adults

Studies suggest that men are almost twice as likely as women to still have sex or masturbate in their later years. A British study found close to 60% of men ages 70 to 80 and 31% of men ages 80 to 90 are still sexually active. In women, those figures drop to 34% and 14%, respectively.3

This lower rate of sexual activity in older women may be due to a lack of opportunity rather than a lack of desire. Research shows that older women are less likely to have partners (due in large part to the fact that they often outlive their partners). This is sometimes referred to as “the partner gap.”1

Sexual Health Problems in Older Men

It is common for men to experience sexual problems after age 40. Reasons include a natural decline in testosterone levels, heart disease, and prostate problems. The inability to achieve or sustain an erection or reach orgasm or ejaculation are common concerns.4

Erectile Dysfunction

Erectile dysfunction (ED), formerly known as impotence, is the inability to achieve or maintain an erection firm enough for sexual penetration and long enough to achieve orgasm.

While ED is more common in older men, aging itself does not cause the problem. ED is related to conditions, sometimes several at once, that directly or indirectly interfere with erections.

Risk factors include high blood pressure, diabetic nerve damage, smoking, obesity, Peyronie’s disease, depression, and even certain medications. An accurate diagnosis is needed to ensure the right treatment.5

ED drugs like Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are often the first-line treatments for ED. Lifestyle changes and counseling can also help. For some men, hormonal therapy, penis pumps, and penile implants may be recommended.
Is There a Female Viagra?

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a non-cancerous enlarged prostate and one of the most common health problems in older males.6 BPH can cause symptoms like difficulty urinating, frequent urination, or waking up in the middle of the night to urinate (nocturia).

On top of this, BPH can cause sexual problems like low libido (low sex drive) and delayed ejaculation (difficulty reaching orgasm).

Among the treatment options, testosterone therapy may help restore libido. There are also certain drugs used off-label that may help with delayed ejaculation, including cabergoline (originally marketed as Dostinex) and Wellbutrin (bupropion).7

Because some BPH medications can also cause sexual dysfunction, a change in the dose may help resolve these concerns.8

Sexual Health Problems in Older Women

More than a third of older women experience sexual problems. These are typically due to menopause, when estrogen levels steeply decline. Hormonal changes can lessen sexual desire and make it harder to become aroused.9

Sexual organs also change as a person gets older. A woman’s vagina will shorten and narrow. The vaginal walls become thinner and less flexible, tearing more easily. Vaginal lubrication decreases, making vaginal intercourse more painful.10

Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is diagnosed when an absence of sexual fantasies, thoughts, and desires causes personal distress. It is a problem that is common among many older women.

A medication known as Addyi (flibanserin) is used to treat HSDD in women. It is currently only approved for premenopausal women, but research shows that it can also improve libido in older women as well.11

Vaginal Dryness

Vaginal dryness is uncomfortable and can make sex painful. Over-the-counter (OTC) remedies that can help relieve irritation and itching from vaginal dryness include lubricants such as K-Y Jelly or vaginal suppositories like Replens.

If OTC remedies don’t help, your doctor may prescribe estrogen cream as well as estrogen-containing vaginal rings and vaginal suppositories.

There are also plant-based products, like black cohosh, that have estrogen-like effects. These should be used with caution in women who have had or are at risk of breast cancer.12

Pain With Sex

Painful intercourse is more likely in older women as vaginal tissue tends to thin and tear easily after menopause. Standard treatments for vaginal dryness can often help ease pain during sex.

If that is not effective, prescription drugs like Osphena (ospemifene) and Intrarosa (prasterone) can treat thinning vaginal tissues and help relieve moderate to severe vaginal dryness.12

Pelvic Organ Prolapse

The pelvic floor muscles and tissues hold the bladder, uterus, cervix, vagina, and rectum in place. Pelvic organ prolapse (POP) occurs when the pelvic floor weakens, causing the pelvic organs to drop and bulge (prolapse) in the vagina. This can cause pelvic pain and pressure, pain with sex, and urinary incontinence.13

POP is often treated with pelvic floor physical therapy to strengthen the supporting muscles. In some cases, surgery may be needed.14

Other Health Concerns

Chronic medical conditions become more common as a person ages. Many of these can interfere with an older person’s sex life.
Arthritis and Chronic Pain

Arthritis and other chronic pain conditions are common among older adults and can make sex very difficult. Depending on the cause, doctors may recommend physical therapy to strengthen muscles and improve flexibility.

Nonsteroidal anti-inflammatory drugs (NSAIDs), both over-the-counter and prescription, can be taken before sex to help ease the pain. Opioid drugs, while effective as a pain reliever, can cause a drop in testosterone and contribute to ED.15

If the pain only occurs in certain sexual positions, let your partner know and try different positions. Bolstering your bodies with pillows and cushions can also help.

Diabetes

In the United States, almost one-third of adults over 65 have diabetes. Approximately half of these are undiagnosed.16

Diabetes can cause sexual dysfunction in both men and women. This can be due to circulation problems, medication side effects, or nerve damage. Problems include:17

‧  Low libido
‧ Difficulty with arousal
‧ Erectile dysfunction
‧ Painful intercourse
‧ Reduced genital sensation
‧ Urinary tract infections
‧ Yeast infections

The best way to reduce the impact of diabetes is to gain control of your blood sugar. Speak with your doctor if you have difficulty managing your blood sugar, and be sure to mention any sexual health problems you may be having. It’s important for your doctor to know.

Heart Disease

Older age is the greatest risk factor for heart disease.18 Heart disease causes problems as arteries start to narrow and harden (referred to as atherosclerosis). This reduces blood flow throughout the body, including the pelvis and genitals, resulting in sexual dysfunction in both men and women.

Heart disease is one of the leading causes of erectile dysfunction in men. It can also cause women to have difficulty achieving orgasm due to the decreased blood flow to the genitals.

There is no one way to resolve these issues, but there is evidence that statin drugs used to reduce the risk of heart disease can improve erectile dysfunction in some men.19 Some studies suggest that similar approaches may improve sexual function in women with heart disease.20

People with heart disease may also be nervous about sex due to fear of a heart attack. While sexual activity is generally safe, talk to your health provider if you are concerned.21

Obesity

Today, more than 40% of adults over 65 meet the definition of obesity.22 Research shows that women who are obese are more likely to experience sexual dysfunction than non-obese women.23 In addition, obesity increases the odds of erectile dysfunction in men.20

These issues may be directly related to higher rates of diabetes among people who are obese as well as reduced blood circulation due to atherosclerosis.24

Weight loss, achieved with a healthy diet and routine exercise, is considered the best strategy to overcome obesity. It may also improve a person’s self-image and sense of well-being while making sex easier to navigate.

Urinary Incontinence

Urinary incontinence is the loss of bladder control. This becomes more common with age, especially in women.

Incontinence can be embarrassing and make sex awkward. Women who experience stress incontinence may be afraid to orgasm. Extra pressure on the abdomen during intercourse can also cause urinary leakage.

If you have incontinence, empty your bladder before sex. Changing sexual positions can help prevent urinary leakage by avoiding the compression of the bladder. Pelvic floor exercises can also help strengthen the muscles that aid with urine control.

Medications

Some medications used in older adults can cause sexual dysfunction in both men and women. These include:25

‧  Antidepressants
‧  Antihistamines
‧  Chemotherapy
‧  Diuretics (“water pills”)
‧  High blood pressure medicines
‧  Opioid painkillers

If you are having sexual difficulties, let your doctor know and advise them of any drugs you are taking, including over-the-counter, prescription, or recreational.

Lifestyle and Mental Health

Lifestyle and mental health issues can also contribute to sexual problems in older adults. These issues can be just as difficult—and sometimes even more difficult—to overcome than physical ones. If you are faced with any of these issues, there are things you can do to turn them around.
Alcohol

For some people, drinking a glass of wine helps them relax and get in the mood. However, too much alcohol can end up impairing sexual function. According to the National Institute on Drug Abuse, alcohol is the most-used drug among older adults, with 65% of people 65 and older reporting high-risk drinking.26

Alcohol can impair a man’s ability to get an erection, cause premature ejaculation, or delay orgasm.27 In women, too much alcohol can make it difficult to climax.2

Reducing the amount you drink can help, but if you are unable to control your alcohol use, speak to your doctor about treatment options.

Depression

In the United States, between 5% and 10% of adults over 65 are estimated to be depressed.28 This can lead to many health concerns, including sexual dysfunction.29

In people with depression, neurotransmitters—chemical messengers that send signals between the brain and body—are out of balance. This can affect sexual desire, arousal, and orgasm. Ironically, medications used to treat depression can have the same effects.

While the benefits of antidepressants often outweigh the risks, therapy and counseling may offer a reasonable option for those with mild depression.

Stress

Stress can be a contributing factor to sexual dysfunction. Financial worries and health concerns are just some of the common stresses affecting older adults.

To relieve stress (and the effect it has on your sex life), consider stress management techniques like mindful breathing, tai chi, yoga, and meditation. Research shows practicing mindfulness and meditation can ease the effects of stress and improve overall feelings of well-being.30 This alone may help improve sex.

In addition, seek professional assistance from financial advisors, health advocates, and social workers to help better deal with the other stresses in your life.

Relationship Issues

Lack of sexual intimacy is often related to relationship problems. If you are and your partner are not connecting emotionally, it can lessen your desire to be intimate.

On the flip side, studies show that older couples who engage in sexual intercourse with their partner are likely to share a closer relationship. Moreover, closeness to one’s partner has been shown to increase overall well-being.31

While this issue is not unique to older couples, many people find talking to a marriage counselor can help them work through relationship issues and rekindle sexual feelings and attraction.

Self-Image

With age can come weight gain and other body changes that may affect one’s sense of physical attractiveness. Self-consciousness can spill over into the bedroom and affect a person’s confidence during sex.

A 2019 study among older women found that those who were self-conscious about their bodies reported less sexual satisfaction. By contrast, those who had greater self-acceptance of their bodies irrespective of weight or aging-related changes had a more satisfying sex life.32

Self-acceptance is ultimately the key. Working with a therapist, either alone or as a couple, can help you discuss your feelings openly and find a way to embrace a more positive self-image.

How to Maintain a Healthy Sex Life

The benefits of maintaining your sex life as you age are physical and emotional. Being sexually active is associated with a lower risk of medical conditions and a longer life. It’s also associated with a greater sense of happiness and overall well-being.3

If your sex life has become stagnant and you’d like to rev it back up, here are a few things you can do.

Communicate

Good sex begins with good communication. Couples who have been together a long time often think they know what the other is thinking. But no one is a mind reader.

Talk to your partner about any concerns you have. You may feel as though your mate is no longer attracted to you because sex has become infrequent, when in fact they are experiencing a decline in sexual interest.

In addition, as sex organs change with age, what felt good before may no longer feel good or may even be painful. Be open with your partner about these changes.

Communicating about sex can be challenging at any age, however. If you and your partner struggle to talk about sex, consider seeing a sex therapist.

Redefine Sex

Sex, as you get older, may need to change. But different can still be good, if not better. With an empty nest and possibly retirement, there’s more time and privacy to explore.

Research shows older adults have a broader definition of sexual activity than younger adults.33 In other words, they better understand that there is more to sex than just intercourse. Foreplay on its own can be quite satisfying.

Be creative and willing to try new things.

Rethink Intimacy

Sex isn’t just physical. It’s an emotional expression of intimacy. As you grow older, sexual intimacy changes. What this means to you and your partner may need to be redefined.

Emotional intimacy can be expressed through non-sexual physical touch. Examples of non-sexual physical touch include:

‧  Back rubs
‧  Cuddling
‧  Holding hands
‧  Hugging
‧  Placing your hand on your partner’s shoulder or arm
‧  Playful nudges
‧  Sitting next to each other
‧  Touching feet under the table

Another non-sexual way to build emotional intimacy is spending quality time together. Things you can do:

‧  Go out on dates with other couples.
‧  Look through old photos and reminisce.
‧  Play cards, board games, or word games.
‧  Read aloud to each other.
‧  Play music together.
‧  Travel, explore new places.
‧  Visit with friends or family.

Just Do It

Instead of waiting for the desire to strike, experts recommend that older adults just go for it. This is because sex has physical and emotional benefits. Orgasms release oxytocin, a hormone that induces a state of calm and improves sleep.

Even if you’re not in the mood, having sex can set the stage for more sex in the future. This is especially true for women. Having sex regularly helps increase natural lubrication and vaginal elasticity. It may also improve erections in men.

Summary

Older age can lead to sexual problems in different ways. Age alone increases the risk of erectile dysfunction, delayed ejaculation, low libido, vaginal dryness, and pelvic organ prolapse. Medical conditions like arthritis, diabetes, heart disease, obesity, and incontinence can also directly or indirectly interfere with sex.

Lifestyle and emotional issues that can impair sexual function in all ages can become even more profound in adults 65 years and older. These include stress, depression, negative self-image, relationship problems, and alcohol abuse.

By working with a doctor or therapist, you can overcome many of these concerns and improve not only your quality of life but your sex life as well. Keeping open lines of communication and embracing change as a natural part of life can also help keep your sex life fresh as you approach your later years.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. University of Michigan Institute for Healthcare Policy and Innovation. Let’s talk about sex.

2. National Institute on Aging. Sexuality in later life.

3. Lee DM, Nazroo J, O’Connor DB, Blake M, Pendleton N. Sexual health and well-being among older men and women in England: findings from the English longitudinal study of ageing. Arch Sex Behav. 2015;45(1):133-144. doi:10.1007/s10508-014-0465-1

4. Shigehara K, Kato Y, Iijima M, et al. Risk factors affecting decreased libido among middle-aged to elderly men; Nocturnal voiding is an independent risk factor of decreased libido. Sex Med. 2021 Oct;9(5):100426. doi:10.1016/j.esxm.2021.100426

5. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of erectile dysfunction.

6. National Institute on Aging. Prostate problems.

7. Abdel-Hamid IA, Elsaied MA, Mostafa T. The drug treatment of delayed ejaculation. Transl Androl Urol. 2016;5(4):576-591. doi:10.21037/tau.2016.05.05

8. National Cancer Institute. Understanding prostate changes: a health guide for men.

9. Harvard Health Publishing. Yes, you can have better sex in midlife and in the years beyond.

10. Szymański J, Słabuszewska-Jóźwiak A, Jakiel G. Vaginal aging—What we know and what we do not know. Int J Environ Res Public Health. 2021 May;18(9):4935. doi:10.3390/ijerph18094935

11. Portman DJ, Brown L, Yuan J, Kissling R, Kingsberg SA. Flibanserin in postmenopausal women with hypoactive sexual desire disorder: Results of the PLUMERIA study. J Sex Med. 2017;14(6):834-842. doi:10.1016/j.jsxm.2017.03.258

12. Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018;10:387-395. doi:10.2147/IJWH.S158913

13. Department of Health and Human Services: Office on Women’s Health. Pelvic organ prolapse.

14. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev. 2017;5(4):470-485. doi:10.1016/j.sxmr.2017.07.001

15. Marudhai S, Patel M, Valaiyaduppu Subas S, et al. Long-term opioids linked to hypogonadism and the role of testosterone supplementation therapy. Cureus. 2020;12(10):e10813. doi:10.7759/cureus.10813

16. Kalvani RR, Golden SH, Cefalu WT. Diabetes and aging: unique considerations and goals of care. Diabetes Care. 2017 Apr;40(4):440–3. doi:10.2337/dci17-0005

17. American Diabetes Association. Sex and diabetes.

18. Steenman M, Lande G. Cardiac aging and heart disease in humans. Biophys Rev. 2017 Apr;9(2):131–7. doi:10.1007/s12551-017-0255-9

19. Kosti JB, Dobrzynski JM. Statins and erectile dysfunction. World J Mens Health. 2019 Jan;37(1):1–3. doi:10.5534/wjmh.180015

20. Nascimento ER, Maia ACO, Pereira V, Soares-Filho G, Nardi AE, Silva AC. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics (Sao Paulo). 2013 Nov;68(11):1462–8. doi:10.6061/clinics/2013(11)13

21. Penn Medicine. Sex and your heart: What to know about intimacy and heart disease.

22. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief. 2020;360.

23. Mozafari M, Khajavikhan J, Jaafarpour M, et al. Association of body weight and female sexual dysfunction: a case control study. Iran Red Crescent Med J. 2015;17(1):e24685. doi:10.5812/ircmj.24685

24. Ho JH, Adam S, Azmi S, et al. Male sexual dysfunction in obesity: the role of sex hormones and small fibre neuropathy. PLoS One. 2019;14(9):e0221992. doi:10.1371/journal.pone.0221992

25. Conaglen H, Conaglen J. Drug-induced sexual dysfunction in men and women. Aust Prescr. 2013;36(1):42-45. doi:10.18773/austprescr.2013.021

26. National Institute on Drug Abuse. Substance use in older adults DrugFacts.

27. Prabhakaran DK, Nisha A, Varghese PJ. Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: a cross-sectional study. Indian J Psychiatry. 2018;60(1):71-77. doi:10.4103/psychiatry.IndianJPsychiatry_42_17

28. Cheruvu VK, Chiyaka ET. Prevalence of depressive symptoms among older adults who reported medical cost as a barrier to seeking health care: findings from a nationally representative sample. BMC Geriatr. 2019;19(1):192. doi:10.1186/s12877-019-1203-2

29. National Institute of Aging. Depression and older adults.

30. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68. doi:10.1001/jamainternmed.2013.13018

31. Smith L, Yang L, Veronese N, Soysal P, Stubbs B, Jackson SE. Sexual activity is associated with greater enjoyment of life in older adults. Sex Med. 2019 Mar;7(1):11–8. doi:10.1016/j.esxm.2018.11.001

32. Gillen MM, Markey CH. A review of research linking body image and sexual well-being. Body Image. 2019;31:294-301. doi:10.1016/j.bodyim.2018.12.004

33. Hinchliff S, Tetley J, Lee D, Nazroo J. Older adults’ experiences of sexual difficulties: Qualitative findings from the English longitudinal study on ageing (ELSA). J Sex Res. 2018;55(2):152-163. doi:10.1080/00224499.2016.1269308

 

 

 

 

 

 

The Male Sex Drive — How it Changes With Age

Published on July 24, 2023 .
Kristopher Bunting, MD  Author

This article is a repost which originally appeared on healthnews

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

For many men, having a strong sex drive—or libido—can be an important part of feeling healthy and having a good quality of life.

Key takeaways:

‧ Male sex drive and testosterone levels decrease with age.

‧ Less sex does not mean less sexual satisfaction.

‧ Good health improves sexual function and sexual quality of life at any age.

‧ Aerobic exercise can improve sexual function and sexual satisfaction.

However, as men age and their bodies change, so does their sex drive. Sex drive tends to decrease with age after it peaks in men in their 20s, but that does not mean that aging has to have a negative effect on sex.

Age, sex drive, and sexual satisfaction

Most men (and women) are more sexually active in their 20s than in any other decade of life. Men’s sex drives seem to peak in their 20s and begin to decrease in their 30s and onward slowly. Men in their 40s and older are also more likely to have problems with sexual function, including erectile dysfunction.

Men have less sex as they get older, but that is only half the story. Sexual satisfaction does not necessarily decrease with age.

A study in Norway found that although sexual activity decreases with age and sexual dysfunction increases with age, sexual satisfaction is more complex. According to the study, men in their 20s had the highest level of sexual satisfaction, followed by men in their 50s. Surprisingly, despite increased sexual dysfunction and decreased sex drive, men in their 50s reported higher sexual satisfaction than those in their 30s and 40s.

Another study from the US found that overall, sexual quality of life tended to decrease with age but was higher in older people who had a better quality of sex. The authors attributed this to “sexual wisdom”—better sex through past experience. No matter the cause, this is certainly good news for anyone worried about their odds of having a fulfilling sex life as they age.

Testosterone and sex drive

Testosterone levels play a major role in the male sex drive. Testosterone is the primary sex hormone responsible for male sexual development and is also associated with sex drive. Research has shown that men’s testosterone levels decline with age beginning after age 30, and reach their lowest levels after age 70—when sex drive is at its lowest.

Low testosterone in men is called male hypogonadism. Hypogonadism in men can cause or contribute to lower sex drive, erectile dysfunction, infertility, loss of bone mass, loss of muscle mass, and depression.

Testosterone replacement therapy can treat male hypogonadism, and research shows that in older men, it can improve sexual activity, sexual desire, and erectile dysfunction. In a study of men with poorly controlled type 2 diabetes, testosterone replacement therapy was shown to improve not only sexual function but also the quality of life and memory.

While considered a normal part of aging, low testosterone can be caused by various medical conditions, including head injuries and some medications. Certain prescription medications can decrease testosterone levels, including opioids (painkillers), hormone therapy for prostate cancer, and a few other drugs.

Remember, do not stop taking any medication without first talking with your healthcare provider. If you are concerned about your testosterone levels, discuss it with your doctor or another healthcare provider.

Better health means better sex

As men age, health plays an increasingly important role in their sex life. According to research, people in better health are more interested in sex, have sex more often, and have a better sexual quality of life. On the other hand, high blood pressure, heart disease, and other conditions that affect blood flow can affect sex drive and contribute to male sexual dysfunction.

Medications can also affect sex drive and sexual performance in men, including some prescription medications for high blood pressure, depression, prostate disease, and hair loss. Common medications that contribute to low sex drive and sexual dysfunction are beta-blockers, diuretics, and finasteride (Propecia, Proscar). Always discuss possible medication side effects with your healthcare provider—the benefits may outweigh the drawbacks.

Erectile dysfunction

Along with a decreased sex drive, aging, poor health, and certain medications can also lead to erectile dysfunction—a known contributor to depression. Fortunately, modern medicine has dedicated a great deal of research to improving men’s erections.

Nowadays, there are several ways to successfully improve erectile dysfunction, including penile implants and medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxn). While these medications are safe for many men, they can cause dangerous side effects in people taking nitrates (such as nitroglycerin, isosorbide, and others).

However, it is possible to improve erectile function with natural means such as CBD oils. The latter is one of the best ways to reduce anxiety and stress interfering with libido. CBD oils and gummies improve blood flow in vessels, thus benefiting erectile function. Full-spectrum CBD oils are believed to be a better choice for erectile dysfunction containing both CBD and THC in moderate amounts.

Exercise can improve sex

It is no secret that aerobic exercise is good for your health. It helps reduce cholesterol, blood pressure, and body fat in addition to decreasing the risk of death from coronary artery disease. Studies also show that aerobic exercise is also important for sexual health.

A study in Japan found that regular aerobic exercise improved sexual function in men aged 43-59. Another group of researchers in the U.S. showed that aerobic exercise—running, cycling, or swimming—improved sexual function in men aged 18-50. The potential for better sex life is excellent motivation to get more exercise,

When do men stop being sexually active?

If you think that people stop being sexually active when they get older, you would be wrong. Research shows that men have a sexual life expectancy well into their 70s. While it is true that sexual activity decreases with age, even the elderly are busy getting busy.

In fact, the 55 and older population has had a significant increase in sexually transmitted diseases (STDs) over the past few decades, including chlamydia, gonorrhea, syphilis, and HIV. While an increase in STDs may be alarming, it clearly indicates that both men and women keep having sex well into old age.

As men age, they tend to have less sex but have high satisfaction with their sex life. Aging and health can have significant effects on sexual function and satisfaction, but medical treatment and exercise can improve both sexual function and sexual satisfaction at any age. If you are concerned about decreased sex drive or sexual dysfunction, talk with your healthcare provider.

Resources:

1. BJU International. Assessment of male sexual function by the Brief Sexual Function Inventory.
2. NIH. Sexual Quality of Life and Aging: A Prospective Study of a Nationally Representative Sample.
3. StatPearls. Physiology, Testosterone.
4. Endocrine Reviews. The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications.
5. Mayo Clinic. Male hypogonadism.
6. The Journal of Clinical Endocrinology & Metabolism. Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels.
7. ENDOCRINE SOCIETY. Testosterone improves quality of life, sexual function, and delayed verbal recall in men with uncontrolled type 2 diabetes.
8. ISSM. Can prescription medications affect testosterone levels?
9. thebmj. Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing.
10. NHS. Low sex drive (loss of libido).
11. Mayo Clinic. High blood pressure and sex: Overcome the challenges.
12. MedlinePlus. Finasteride.
13. NIH. Sexuality in Ageing Male: Review of Pathophysiology and Treatment Strategies for Various Male Sexual Dysfunctions.
14. NIH. Increased incidence of depressive symptoms in men with erectile dysfunction.
15. NIH. Health benefits of aerobic exercise.
16. NIH. Regular aerobic exercise improves sexual function assessed by the Aging Males’ Symptoms questionnaire in adult men.
17. NIH. Exercise Improves Self-Reported Sexual Function Among Physically Active Adults.
18. EmergencyMedicineNews. STI Rate Has Doubled Among Senior Citizens.

5 Supplements For Better Sex – Erectile Dysfunction Supplements

5 Supplements That Can Boost Your Erection and Sex Life

Skip the shady “Boner Blaster 5000” and consider these instead.

by Elizabeth Millard, Zachary Zane and Ashley Martens   Published: Jun 30, 2023

This article is a repost which originally appeared on Men’sHealth

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Erection supplements are a multi-billion dollar a year endeavor.

‧ The supplement list below can go a long way towards helping your male enhancement goals.

‧ Certain supplements- like L-Arginine can be an alternative to erector drugs like Cialis.

It doesn’t matter what you call it—getting a boner, a hard-on, or wood—internet searches for stronger erections won’t stop. That’s especially true for people who are living with erectile dysfunction. It’s no surprise that the market for erectile dysfunction treatments is expected to reach 4.7 billion dollars in revenue by 2026.

There’s a big market for erection-boosting medications including Cialis and Viagra, especially given how easily you can access them via a prescription from your doctor and via telehealth companies like Hims and Roman that have them delivered to your door. But what about other options, like those over-the-counter supplements for a better sex life you see advertised on television or through random Instagram ads? Are those safe supplements for better sex and stronger erections?

Of the many supplements out there that claim to boost your erection and give you a better hard-on, many are dubious. There are significant dangers when it comes to “herbal Viagra,” explains Jamin Brahmbhatt, MD, a urologist and sexual wellness expert at Orlando Health. This term is used to describe the natural supplements advertised to boost your erection.

If you go to a convenience store and see something behind the counter with a name like “Boner Blaster 5,000,” it’s a surefire way to know a supplement is not legit. “Even if you buy them at a big retailer, and they seem to be made of ‘natural’ ingredients, be cautious,” he says. “No one is regulating this stuff.” That’s concerning. It’s not clear what you could be putting in your body and there’s always the chance it could harm your overall health—including your sexual health.

Is it all bad, though? Are any of these over-the-counter erection supplements safe and effective for your sex life? Surprisingly, yes, there are a few. Here is what to know about a few expert-approved sex supplements that are good for your health and your erectile health.

Omega-3s

Omega-3 fatty acids are a maybe when it comes to protecting your heart and your erections. The research goes back and forth about whether fish oil supplements are really helpful for the heart. If the scales tip toward them being helpful to your heart, then your erections may benefit as well, explains Brahmbhatt. That’s because heart-healthy changes are geared toward improving blood flow and increasing the size of blood vessels, he says.

Your penis has the smallest blood vessels in your body, meaning they’re easier to get clogged up. And impeded blood flow is bad for erections, so anything that improves blood flow is good.

At first, it might not make sense that many blood pressure medications list erectile dysfunction as a side effect, he adds. That’s because they modulate the way that blood vessels open and close, which can reduce flow overall, especially down south.

By contrast, omega-3 fatty acids can have the opposite effect because they lower inflammation that might be affecting blood vessels, while also reducing blood clotting. That can help boost your blood flow. While you can get your omegas from supplements, getting them from foods such as fatty fish is your best bet.

L-Arginine

L-arginine is an essential amino acid that can be good for both heart health and erectile issues, Brahmbhatt says.

In fact, a study in the journal Andrology found that patients with severe or complete erectile dysfunction had L-arginine levels that were significantly lower than that of men with milder forms of ED. L-arginine might help trigger the production of nitric oxide, a compound important in getting and maintaining erections.

In addition, “L-Arginine is a peripheral vasodilator via a pathway similar to PDE5 inhibitors [those include Cialis and Viagra]. Vasodilation is associated with increased blood flow and thus possibly better erections,” says Peter Tsambarli, MD, assistant professor of urology at RUSH University Medical Center in Chicago.

L-arginine is found in most protein-rich foods such as red meat, poultry, beans, and dairy products, according to according to the Mayo Clinic, which has marked it as generally safe but cautions people who take blood pressure meds to talk to a doctor first.

This is good advice for any supplements if you’re on blood pressure medications, Brahmbhatt says. That’s because a product like L-arginine can reduce your blood pressure—which is great if it’s a bit too high, but not if you’re already bringing it down with meds. In that case, you may see a sudden and dramatic drop in pressure that could cause you to faint, or in extreme cases, have a stroke.

If you’re not on those meds and want to try the amino acid, Brahmbhatt suggests starting at a dose of about six grams a day to see how you tolerate it. In some people, the supplement can cause side effects including nausea, abdominal pain, diarrhea, and bloating.

L-Citrulline

In addition to L-Arginine, L-Citrulline may help with stronger erections. This is because L-Citrulline is converted in the body to L-Arginine, explains Tsambarli. L-Citrulline can also aid in the production of nitric oxide. “Nitric oxide is involved in vasodilation (widening and opening up of blood vessels) which can begin and maintain the erectile response,” says Michael Eisenberg, MD, professor of urology at Stanford Health.

A 2001 study published in Expert Opinion Pharmacotherapy states that “NO is the principal agent responsible for relaxation of penile smooth muscle.” (FYI, penile erection is a vascular phenomenon that directly results from smooth muscle relaxation along with arterial dilation and venous restriction.)

Vitamin D

Some studies suggest that men with vitamin D deficiencies are more likely to have erectile dysfunction, says Brahmbhatt. That may be because low levels of the vitamin are associated with diseases like hypertension, coronary artery disease, and peripheral vascular disease. Basically, blood flow issues that affect your system can also raise your risk of ED.

Although you can get some vitamin D from foods including salmon and eggs, along with sunshine, most people in the U.S. are lacking the vitamin, especially if you live in the northern part of the country, says Brianna Elliott, R.D., a coach at nutrition counseling service EvolutionEat.

She adds that the longer you maintain low levels, the more effects you might see, including potential ED. But how much you should take is a moving target. The National Institutes of Health recommends 600 IU, while the Endocrine Society suggests much higher levels of up to 2,000 IU daily.

“This would be a good topic for your next doctor visit,” Elliott says, noting that it’s easy to test for vitamin D levels, and from there, you can get a recommendation about dosage amounts based on that information.

Folic Acid (B9)

Another supplement that is good for overall health and wellness, including erectile health, is folic acid or B9. Some research has linked improvement in sexual performance with folic acid supplementation, which lowered levels of the amino acid homocysteine, explains Tsambarli. “Homocysteine levels were previously found to be higher in men with ED than their counterparts who were not suffering from ED.”

The bottom line on sexual supplements?

Despite the fact that there are some supplements that may help with erections to a certain extent, supplements are not held to the standards of pharmaceuticals. Always choose supplements with a third-party verification, like NSF or USP. “I always attempt to temper expectations when utilizing supplements for sexual performance,” says Tsambarli.

In general, here’s the best possible “supplement” you can take for your sex life: lifestyle changes. A healthy diet, regular exercise, good sleep habits, and lower stress levels all go a long way toward improving your health, as you’ve heard a million times.

“Overall health and sexual health are closely related,” explains Dr. Eisenberg. “Thus, anything that benefits heart health can also benefit sexual health. A good diet, exercise, and maintaining a good body weight can all help [as well].”

“Diet and exercise have consistently outperformed supplements and have a significant and reliable impact on sexual performance,” says Tsambarli.

“It’s definitely easier to stop at the gas station and get some shady supplement that makes promises about boosting your libido or increasing your girth,” Brahmbhatt says. “But play it safe, skip that junk, and do what’s proven to help your sex life: healthy lifestyle habits.”

 

 

 

Men’s Health: Dos & Don’t Of Diet For Better Fertility In Men

This article is a repost which originally appeared on DOCTOR NDTV

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

The ability of a person to reproduce naturally is referred to as fertility. When a man’s chances of getting his female spouse pregnant are poor, this is known as male infertility. Usually, it depends on how good his sperm cells are. Infertility can sometimes be related to sexual function, and it can also occasionally be related to the quality of the semen.

Male fertility really depends on a healthy sperm count. Sperm count can be affected by a variety of elements, such as nutrition and way of life. You can increase sperm count and overall fertility by incorporating particular nutrients into your diet. We’ll look at some fundamental dos and don’ts that have been demonstrated to have an impact on sperm count below.

Dietary do’s & don’ts to boost fertility in men:

Do’s

  1. Eat a balanced diet that includes plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats.
  2. You certainly already know that vitamin C can strengthen the immune system. According to some research, consuming antioxidants like vitamin C may increase fertility.
  3. Cut back on processed and fast food, as they contain high levels of unhealthy fats, sugars, and artificial additives that can negatively impact fertility.
  4. Increase your intake of antioxidants such as vitamin E, and selenium, as they can help protect sperm from damage.
  5. Fertility in both men and women can benefit from vitamin D. Another vitamin that might raise testosterone levels is this one. Men who were vitamin D deficient had a higher likelihood of having low testosterone levels, according to one observational study.
  6. Fenugreek is an appreciated herb for both cooking and medicine. Supplements containing fenugreek have been demonstrated to considerably raise testosterone levels.
  7. One of the foundational elements of male fertility is getting adequate zinc. Additionally, taking zinc supplements may prevent the lower testosterone levels linked to overdoing it on high-intensity exercise.
  8. Ashwagandha is a herb used for medical purposes which can be added to your diet. According to studies, ashwagandha may increase testosterone levels, hence enhancing male fertility.

Don’ts

  1. Avoid or limit foods that are high in saturated and trans fats, such as red meat, fried foods, and baked goods, as they can decrease sperm count and motility.
  2. Reduce intake of soy products. Soy is abundant in isoflavones which causes an oestrogenic effect that drops the levels of testosterone.
  3. Avoiding consuming predator fish such as tuna and swordfish. These fish are high in mercury which can negatively affect our reproductive health and lead to fertility issues.
  4. Reduce your caffeine intake, as high levels can negatively impact sperm quality.
  5. Avoid or limit alcohol intake, as excessive consumption can decrease testosterone levels and impair sperm production.
  6. Avoid smoking and exposure to secondhand smoke, as they can damage sperm DNA and decrease sperm count.
  7. Don’t skip meals, as it can negatively affect hormone levels and overall sperm health.
  8. Foods in cans and tins are lined with a substance called bisphenol (BPA). Since bisphenol mimics oestrogen in the human body, it can have consequences akin to too much soy.

Follow these dietary dos and don’ts to improve your fertility and increase your chances of conceiving.

 

Depression and erectile dysfunction: The link, causes, and treatment

What to know about depression and erectile dysfunction

Medically reviewed by Nicole Washington, DO, MPH — By Mary West on November 14, 2022

This article is a repost which originally appeared on MEDICAL NEWS TODAY.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our takes:

‧ There are many potential causes of Erectile Dysfunction (ED).

‧ Anxiety and emotional stress appear to be common underlying factors.

‧ Medical professional assistance is available for treating ED.

Research has shown that there is a link between the two conditions. If a person has depression, they have a higher risk of developing erectile dysfunction (ED).

The above information comes from a 2018 review published in The Journal of Sexual Medicine.

Researchers do not fully understand the connection. However, theories suggest the underlying causes may include sexual performance anxiety or antidepressant side effects.

If a person with depression experiences ED, their doctor may prescribe a medication such as sildenafil (Viagra). Alternatively, they may recommend trying a different antidepressant.

Read on to learn about the symptoms of ED, how depression can cause it, treatment options, and more.

Signs and symptoms of erectile dysfunction

The signs of ED include‧:

‧ ability to get an erection only sometimes, despite a desire to have sex

‧ inability to get an erection at any time

‧ ability to get an erection, but being unable to sustain it throughout sex

Can depression cause erectile dysfunction?

Research from 2018 evaluates 49 studies to determine the relationship between depression and ED. It finds that a person with depression was 39% more likely to have ED than a person without depression.

Experts do not fully understand the factors that underlie how depression may cause ED. However, the current theories include:

‧ Behavioral: Depression involves negative thoughts and low mood. Either or both can lead to performance anxiety that hinders erectile function.

‧ Antidepressants: Many people with depression take antidepressant medications to manage their symptoms. However, these medications can cause low libido and inhibit the ability to have or maintain an erection.

‧ Low testosterone: The male hormone, testosterone, plays a key role in sexual performance. As such, low levels often correlate to ED. There is an association between depression and low testosterone levels in men.

The previously mentioned 2018 review also finds that people with ED are 192% more likely to have depression. This means that the link between depression likely goes both ways. For example, a person with depression may have ED for the reasons listed above. Similarly, a person with ED may also be more likely to experience depression.

Low self-esteem, self-consciousness about sexual performance, and other negative thoughts could contribute to depression in people with ED.
Other causes

There are a wide variety of factors besides depression that can cause ED. They include:

physical health conditions, such as:

‧ type 2 diabetes

‧ high blood pressure

‧ heart and blood vessel disease

‧ multiple sclerosis

‧ Peyronie’s disease (curvature of the penis)

‧ chronic kidney disease

‧ surgery for bladder cancer

‧ injury to the penis or pelvic area

certain medications, including:

‧ antidepressants, such as fluoxetine (Prozac)

‧ blood pressure drugs, such as atenolol (Tenormin)

‧ tranquilizers, such as diazepam (Valium)

‧ antiandrogens (medications that block the effects of testosterone), such as bicalutamide (Casodex)

‧ appetite suppressants, such as phentermine (Adipex-P)

Mental health factors can also increase a person’s likelihood of ED. In addition to depression, these include:

‧ anxiety

‧ low self-esteem

‧ fear of sexual failure

‧ stress

‧ guilt about certain sexual activities

Treatment options

Treatment for ED and depression includes medication, lifestyle changes, and psychotherapy. The treatment a healthcare professional recommends depends on the underlying cause of a person’s symptoms.

Medications for erectile dysfunction

Older research from 2001 explains when depression and ED occur simultaneously, treating one condition may improve the other. The findings indicate that treating ED with Viagra can alleviate the issue and lead to a notable reduction in depression.

Despite this, the research did not investigate how long the improvement lasts.

Doctors commonly prescribe Viagra for ED. It works by relaxing the muscle and increasing blood flow to the penis during sexual arousal. Other medications in the class include:

‧ vardenafil (Levitra)

‧ avanafil (Stendra)

‧ tadalafil (Cialis)

Additionally, if a person has low testosterone, a doctor may prescribe supplemental hormones.

Another treatment option that can trigger an erection is alprostadil. This comes in the form of an injection (Caverject) or a suppository (Muse).

Medication change for depression

A study from 2017 notes that sexual dysfunction is a common side effect of many antidepressants. For that reason, changing medication can help. Low libido and difficulty maintaining an erection are common side effects of antidepressants. However, some medications are less likely to have these effects.

The study’s authors recommend the following antidepressants for people who consider sexual functioning important:

‧ desvenlafaxine (Pristiq)

‧ trazodone

‧ vortioxetine (Trintellix)

‧ vilazodone

Lifestyle changes

Lifestyle changes may also reduce symptoms‧ of ED. These changes include:

‧ stopping smoking, if applicable

‧ eating a nutritious diet

‧ exercising regularly

‧ maintaining a moderate weight

‧ limiting or stopping recreational drug use, if applicable

Psychotherapy

The following psychotherapy interventions may help a person manage the emotional and psychological effects of depression and ED.

‧ Sex therapy: This involves counseling partners about their relationship or sex-related concerns.

‧ Cognitive behavioral therapy (CBT): This helps a person identify unhelpful thoughts and develop healthier ways of responding to challenges.

‧ Mindfulness therapy: This mental exercise consists of focusing on the present moment.

When to contact a doctor

If a person thinks they may have ED, it is a good idea to make an appointment with a doctor.

Additionally, people should seek medical attention if they have symptoms of depression. The sad feelings associated with depression last weeks and months, not days.

If they have suicidal thoughts, they should get immediate medical attention.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

Ask the tough question: “Are you considering suicide?”
Listen to the person without judgment.
Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
Stay with the person until professional help arrives.
Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Summary

People with depression are more likely to have ED, and ED is also associated with higher rates of depression. Symptoms of ED include being unable to attain and sustain an erection long enough to have sex.

If a person has both depression and ED, treating one condition is likely to improve the other. Medication and psychotherapy interventions, such as mindfulness, may help someone manage both conditions.

Sources:

Chokka, P. R., et al. (2017). Assessment and management of sexual dysfunction in the context of depression.
https://journals.sagepub.com/doi/10.1177/2045125317720642
Liu, Q., et al. (2018). Erectile dysfunction and depression: A systematic review and meta-analysis.
https://www.jsm.jsexmed.org/article/S1743-6095(18)31007-5/fulltext
Lue, T. (n.d.). Erectile dysfunction (ED).
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
Overview – clinical depression. (2019).
https://www.nhs.uk/mental-health/conditions/clinical-depression/overview/
Seidman, S. N., et al. (2001). Treatment of erectile dysfunction in men with depressive symptoms: Results of a placebo-controlled trial with sildenafil citrate.
https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.158.10.1623
Walther, A., et al. (2019). Association of testosterone treatment with alleviation of depressive symptoms in men.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2712976

Sexual Stamina: 10 Tips to Last Longer

Kristopher Bunting, MD

Updated on October 17, 2022

This article is a repost which originally appeared on healthnews.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Whether you have problems with premature ejaculation or you simply want sex to last longer, there are many ways to last longer in bed. Making sex last longer can involve maintaining an erection for longer, delaying ejaculation, and reducing the time to achieve another erection after ejaculating. There are a variety of ways to improve your sexual stamina and make sex more satisfying for both you and your partner.

Key takeaways:

‧ There are many ways to improve male sexual stamina, including medications and sexual techniques. Increased foreplay and emotional intimacy may also improve sexual performance.

‧ Medications for erectile dysfunction and premature ejaculation can improve stamina and sexual performance.

‧ Controlling sexual stimulation by using numbing sprays or gels, certain sexual positions, and other techniques can help men control when they orgasm.

How long should sex last?

Ideally, sex should last for as long as you want it to. Many people think of sex as penetration, but it can (and should) involve much more. Research shows that the average time until ejaculation during penetrative sex is between 5 and 6 minutes. For most people, achieving orgasm is the goal of sex. While 5 minutes of penetration (or less) will get many men where they want to get to, it takes longer for women to climax from penetration alone. So, how can you make sex last longer?

Foreplay

There is more to sex than just penetration and orgasm. Foreplay is important for mutual arousal; it gives you and your partner time to stimulate yourselves and each other. Take time to use all of your senses to get excited and prepare for the main event.

Kegel exercises

Kegel exercises can help both men and women strengthen pelvic floor muscles, improving continence and sexual function. A strong pelvic floor can help you control when you ejaculate.

Work on your relationship

Sex is both physical and mental. Both the body and the mind need to be stimulated and aroused to enjoy sex. Emotional intimacy plays a role in sexual arousal, especially in long-term relationships. Research has shown that emotional intimacy is linked to sexual desire. Furthermore, good communication in a relationship is linked to improved sexual satisfaction and decreased sexual dysfunction. Communicating sexual needs with your partner can improve sex and may help you last longer.

Medication

Medications used to treat erectile dysfunction (ED) and premature ejaculation (PE) can also improve sexual stamina. Commonly used antidepressants such as Prozac (fluoxetine), Paxil (paroxetine), Celexa (citalopram), and other drugs that raise serotonin levels in the brain can help delay ejaculation. While this can be an unwanted side effect for some, it can help people with PE have more control over when they orgasm.

ED medications can help some men recover more quickly after ejaculating and may improve sexual performance in men without erectile dysfunction. Viagra (sildenafil), Cialis (tadalafil), and other erectile dysfunction medications improve blood flow to the penis. This allows men with mild to moderate ED to have firmer, longer-lasting erections. Remember, these are prescription medications; you should not take them without first being evaluated by a doctor. They can have extremely dangerous interactions with other medications, including nitrates taken for chest pain or amyl nitrate and amyl nitrite (poppers) taken recreationally.

Reduce stimulation

Topical anesthetics are used to treat PE and can help men delay orgasms. A variety of topical numbing creams, sprays, and personal lubricants are available that reduce stimulation of the penis, including condoms with numbing lubricant. However, these can cause skin irritation and discomfort in some people, so check with your partner before using a topical anesthetic.

Other ways to reduce penile stimulation and delay orgasm include wearing a condom and using more lubrication. Wearing a condom not only helps prevent sexually transmitted diseases and unwanted pregnancy, but it can also decrease stimulation of the penis, especially thicker condoms. Using lubrication during sex can reduce friction and stimulation.

Techniques to delay orgasm

There are a variety of techniques that can be employed to help delay orgasm and ejaculation. Techniques recommended for people with PE include the squeeze technique (gently squeezing the head of the penis for several seconds) and the start and stop technique (stop penile stimulation for 30 seconds). Other techniques include pausing and taking a deep breath or shifting your focus away from sexual sensations during sex. In other words, slow down and take a moment to rest before you reach orgasm.

Masturbating before sex can help delay ejaculation, but timing is important. Practicing edging, bringing yourself to the brink of orgasm while masturbating, can help you learn how to recognize when you are about to orgasm and allow you to practice techniques to delay orgasm.

Try something different

There are many Tantric and Taoist sexual practices that can help control ejaculation and improve sexual pleasure for men and their partners. The “sets of nines” technique is an easy way to control mutual stimulation. It involves performing 9 sets of 9 controlled thrusts, beginning with 9 shallow thrusts, followed by 8 shallow thrusts and 1 deep thrust, then 7 shallow thrusts and 2 deep thrusts, and so on, ending with 9 deep thrusts. It is a simple technique, but it is very effective for controlling ejaculation and building up sexual excitement.

Certain sexual positions can help control ejaculation, especially positions that allow for grinding, as opposed to thrusting. Partner on top positions, the lotus position, and the Coital Alignment Technique can maintain constant stimulation for your partner while limiting stimulation to the penis from thrusting. Explore the Kama Sutra and other books for tips on which positions can help you control when you orgasm.

Get healthy

Overall health affects sexual function; eating a proper diet and getting enough exercise can improve your sexual health. Obesity, type 2 diabetes, high blood pressure, heart disease—all of these conditions can affect sexual function and they can all be improved or prevented through diet and exercise.

You can improve your sexual stamina

There are many ways for men to improve their sexual stamina. Foreplay, communication, and emotional intimacy can improve sex. Medications, condoms, and lubricants can delay orgasm and reduce stimulation. A variety of techniques can help men control when they orgasm, including techniques used for premature ejaculation and certain sexual positions. Give some of these a try and find out what works best for you.

Resources:

1. Urology Care Foundation. Premature Ejaculation.

2. The Journal of Sexual Medicine. Original Research—Ejaculation Disorders: A Multinational Population Survey of Intravaginal Ejaculation Latency Time.

3. International Society for Sexual Medicine. Women’s Orgasm Takes Longer During Partnered Sex.

4. Mayo Clinic. Kegel Exercises for Men: Understand the Benefits.

5. Journal of Social and Personal Relationships. The Associations of Intimacy and Sexuality in Daily Life.

6. The Journal of Sex Research. Couples’ Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis.

7. Cleveland Clinic. Premature Ejaculation.

8. International Journal of Impotence Research. Sildenafil Does Not Improve Sexual Function in Men Without Erectile Dysfunction but Does Reduce the Postorgasmic Refractory Time.

9. Nature Reviews Urology. Sildenafil Improves Sexual Function in Men Without Erectile Dysfunction.

10. Mayo Clinic. Erectile Dysfunction: Viagra and Other Oral Medications.

11. Circulation. Drug Interactions With Phosphodiesterase-5 Inhibitors Used for the Treatment of Erectile Dysfunction or Pulmonary Hypertension.

12. Journal of Sex & Marital Therapy. The Coital Alignment Technique (CAT): An Overview of Studies.

 

The Economic Impact of Erectile Dysfunction

The Economic Impact of Erectile Dysfunction

It starts in the bedroom, moves to the workplace, and ends with plummeting GDPs. Yes, erectile dysfunction has economic implications. Is that so hard to believe?

By Lauren Vinopal
Nov 19 2019, 5:02 PM

This article is a repost which originally appeared on Fatherly

Edited for content

Eric developed erectile dysfunction after he started taking the medication he needed to in order to manage symptoms of bipolar disorder. Far more concerned with his mental health than sex life, it took him a while to realize it was a problem. When he did, he thought it was only impacting his relationship with his wife. Then, like a cruel and flaccid Whac-a-Mole game, it started popping up in other places. It impacted his sleep, affected his appetite, and killed his motivation at the gym. Finally, it met him at work. Eric manages a substance abuse recovery facility and has the kind of mentally intense job that people tend to bring home with them. But when his ED started causing problems, the opposite happened — he unintentionally started to bring the stress of his home life into work. With less energy and competitive drive, he struggled to be present and available for his clients when he felt so vulnerable himself.

“It’s really hard to support others when you’re feeling vulnerable,” says Eric (he asked that his real name be held). “We at the center often speak openly and honestly, but erectile dysfunction (ED) is not something I bring up during group sessions. That is such an intimate detail might cloud how clients view me.“

At 36-year-old, Eric may seem young, but he represents the new face of ED. More men in their thirties and forties are developing ED, although the reasons for the uptick are not entirely clear. Whether it’s a side effect of psychotropic medications or other lifestyle factors like smoking and obesity, the fact is, ED is on the rise for younger men, and the costs incurred are just now being calculated. The clearest impacts are economic. Men with ED take more sick days and are generally less productive at work all around, compared to men who do not struggle sexually. Conservative estimates suggest that treatment costs upwards of $3 million in healthcare costs in the U.S. alone, but studies in America have not accounted for the loss of work. Studies in the UK suggest that ED more accurately costs $67.71 million annually when productivity losses are figured in. Adjusted for a larger population in the U.S. amounts to over $330 million. This is a very rough estimate that does not account for cultural differences, but it still likely adds up to a lot of dollars, a lot of dysfunctional dicks, and a lot of other, unknown costs.

“The unseen element of cost is the psychological toll that erectile dysfunction takes on men and their partners and their families,” says urologist Dr. Judson Brandeis. “ED causes depression which decreases productivity at work.  It also increases stress on marriages, relationships and families, the cost of which is massive.” How massive? Brandeis estimates the economic cost of ED is well over $5 billion.

And yet, on the other side of ED is a large and burgeoning cross-section of the pharmaceutical industry pedaling generally effective short-term drug solutions like Viagra to older and younger men alike. The global ED drug market was valued at $4.82 billion in 2017 and is projected to grow to $7.10 by the end of 2024. Experts attribute much of this growth to younger men with chronic conditions such as diabetes, cardiovascular disease, neurogenic diseases, and like Eric, psychological disorders, causing an uptick in sexual dysfunction diagnosis. Clearly, ED costs some men money, while it makes others a shit load of it. But the economic impact of ED is farther-reaching than the billions of dollars that surround the drug industry. The function of nearly half the penises in the world is inextricably linked to global economics. Call it the curved economy of dysfunctional dicks. Like it or not, it may impact us all.

🍆 💸 🍆 💸

In the past, the most common cause of erectile dysfunction was getting old. As people age, cells in their heart muscle degenerate, valves that control blood flow become thicker and stiffer, and circulation generally slow. Heart health declines, therefore erection health does too, so it has always made medical sense why this would be an issue for retired men in their seventies, rather than men who make up 66 percent of the workforce. However, ED is diagnosed mostly primarily based on patient reports, meaning it’s an honor system, and that’s how a lot of secondary ED diagnoses in younger men are made. Secondary ED, or mild to moderate ED, affects roughly 10 percent of men per decade of life, meaning 30 percent of men in their thirties, 40 percent of men in their forties, 50 percent of men in their fifties, and so on.

Erections depend on blood flow and are inescapably linked with cardiovascular health, so when younger men are unhealthy, they’re more likely to experience ED. In the past, lost productivity at work has been linked to those health problems, and ED was just considered another symptom of an unhealthy lifestyle. A recent study of 52,697 men indicates there may be more to it. Researchers analyzed data from the 2015 and 2016 National Health and Wellness Surveys, which included men ages 40 to 70 from Brazil, China, France, Germany, Italy, Spain, the UK and the U.S. who experienced some form of erectile dysfunction within the past six months of the study. While there was an expected correlation between ED and other health problems like hypertension, dyslipidemia, diabetes, and depression, when scientists controlled for this, men with ED were still worse at their jobs compared to men who felt fine about their sexual performance. Men who experienced symptoms missed more work (7.1 percent compared to 3.2 percent), went to work sick more often (22.5 percent compared to 10.1 percent), experienced greater levels of productivity impairment (24.8 percent compared to 11.2 percent), and scored lower on tests that measure overall mental and physical performance.

“It’s destructive in a workplace situation because men are competing over things that actually have nothing to do with their productivity. Your masculinity being threatened makes you less productive.”

If men’s physical health wasn’t the reason they were struggling at work, then there is something about their professional prowess that is connected to their sexual one. Unsurprisingly, experts suspect a person’s views of masculinity may be responsible for this. Research shows men who cannot perform sexually report a diminished sense of being a man, increased depression, decreased self-worth, embarrassment, and fear of being stigmatized, and the more they believe in traditional masculine norms, the worse they feel as a result of ED.

“This can lower their self-esteem and motivation, even causing physical symptoms such as headaches and lowered immunity,” couples therapist Elisabeth Goldberg explains. When ED goes untreated some men end up feeling worthless. “This is a serious risk factor for depression, leading to missed work days, inability to stick to deadlines, and anger management difficulties with coworkers.”

In the workplace, economist and author Marina Adshade thinks this low self-esteem can take a different turn. Rather than being demotivated by their ED, men become aggressive — in a sense motivated to make up for what they perceive as a masculine failure with a ratcheted-up sense of (usually male on male) competition in the workplace.

“It’s destructive in a workplace situation because men are competing over things that actually have nothing to do with their productivity,” says Adshade. This manifests in ways that may sound familiar: Not being willing to ask for help, not being able to work as part of a team, and not being able to negotiate and compromise. “In the modern workplace, these are real assets. If those are compromised because your masculinity is being threatened, it would make you less productive.”

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It’s impossible to entirely separate men’s health from erectile dysfunction. Even when studies control for a number of health conditions that cause ED, they do not rule out the possibility that smoking, drinking too much, gaining weight, and being generally unhealthy contributed to missed days and lost productivity for men who did not have diagnosable illnesses.

“It’s a chicken or the egg thing,” says urologist Dr. Jamin Brahmbhatt. “Is it the lifestyle choices that lead to erectile dysfunction or is it erectile dysfunction that lead to the lifestyle choices?” This is a question that may have unsatisfying answers. If lifestyle factors cause ED, it could take years to course-correct — losing weight, quitting smoking, getting back on track health-wise.

Why wait when you can take a little blue pill? While men patiently address varying degrees of underlying health issues, drugs like Viagra represent the closest thing to a catchall solution to a widespread problem. The very success of Viagra may come from the fact that, pending no pre-existing heart conditions, these medications are a generally effective and low-risk solution in the short-term. Aggressive advertising campaigns and direct to consumer healthcare companies that discreetly deliver erection pills door to door have helped reduce stigma and educate men on their ED treatment options. And when Pfizer lost exclusive rights to making Viagra in 2017, this gave rise to a number of generic options and market competition that brought costs down, making it even more affordable and accessible for consumers. ED drugs are a temporary but very effective workaround while men address other underlying health problems that cause sexual dysfunction. Of course, they come with hidden costs.

Everyone might be better off if guys are just fine with whatever they’re working with, even if it doesn’t work every time.

Ironically, medically-induced erections may lead to infidelity. ED is linked with a significantly higher risk of infidelity for men, because they blame their current partner for their performance issues, instead of underlying health, psychological, or relationship problems. “They turn to someone new in a frantic effort to prove their manliness, and rationalize that if they can perform with someone other than their spouse, then it must be the spouse’s fault,” says Goldberg. When it doesn’t, damage done, men can ignore the obvious and use ED drugs like Viagra to help make this warped reality a reality.

Infidelity has economic consequences. The affair itself costs about $450 a month, or $2,700 an affair total, which lasts about 6 months on average. It doesn’t sound like much, but that doesn’t account for time lost to the affair and, of course, the fact that many affairs lead to divorce. While infidelity does not cause divorce directly, it does remain one of the most commonly cited reasons for splitting, about 37 percent of the time. In Goldberg’s clinical experiences, ED can cause marriage problems that lead to divorce without causing infidelity as well.

The average divorce in the U.S. costs $15,000 per person but can vary depending on how drawn out and contentious it is. Research shows divorced men tend to have higher rates of smoking, substance abuse, depression, and worse health overall following divorce, all of which lead to increased absences and decreased productivity at work, which slows economic growth overall. Other studies estimate that the family income of parents who divorce and stay divorced for at least six years falls up to 45 percent.

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The various impacts of erectile dysfunction can be boiled down to this: Men have unhealthy expectations for how they should perform sexually. “It’s every day in my office, and you can thank the adult film industry for that,” says Brahmbhatt who admits that he spends more time managing men’s impractical sexual expectations than he does writing prescriptions for Viagra.

In a strange way, this psychology echoes in Adshade’s economic research. In her work she stumbled on a global penis size distribution map, a dataset compiled by a doctoral student to look at how a country’s average penis sizes related to their Gross Domestic Product. Although the findings were not published in a peer-reviewed journal, they indicated that there was a u-shaped relationship between penis size and economic growth. The slowest growing and least developed countries had both the biggest and smallest penis sizes on average, but the fastest-growing economies had average ones. Adshade suspects that this was because these were the men who had less to prove in terms of their masculinity, and lead more productive, economically rich lives as a result. While this does not speak to erectile dysfunction directly, it says everything about the economic impact of how men feel about their dicks. Men don’t need to have the biggest or best penises in the world to succeed — in fact, that may be bad for the economy too. But everyone might be better off if guys are just fine with whatever they’re working with, even if it doesn’t work every time.

“ED causes depression which decreases productivity at work.  It also increases stress on marriages, relationships and families, the cost of which is massive.”

“It really comes down to how men measure their self-worth,” Adshade says. “Men tend to measure their self-worth by their ability to not only perform sexually but please their partner,” Goldberg adds. “Low-self worth has major consequences”

For Eric, a man who is deep in erectile dysfunction and working on finding a way out, this is easier said than done. For him, Viagra has not been the quick fix it can be for some and he’s working with a urologist to figure out a solution without disrupting his medication regimen. He’s doing pretty much everything he’s supposed to, and it’s still not easy.

“Being a newly-single male back on the dating scene, dealing with ED has been tumultuous, to say the least,” he says. “The toll it takes on men’s confidence is quite drastic. It’s almost as if our masculinity is taken away.”

Understanding male sexual health: More men now reporting low sex drive, Peyronie’s disease, finds study

Understanding male sexual health: More men now reporting low sex drive, Peyronie’s disease, finds study

Scientists found that earlier, more men were diagnosed with erectile dysfunction and premature ejaculation.

Myupchar July 20, 2020 22:17:59 IST

This article is a repost which originally appeared on Firstpost.

Edited for content

Male infertility is a topic that is rarely discussed. However, doctors have seen an increase in the number of male patients coming to sexual health clinics to seek help in recent years. Doctors have seen that different sexual health problems are being reported by men which were not prevalent before, also indicating more awareness and openness regarding male sexual health.

Different male sexual health problems

A study published in the journal International Journal of Impotence Research on 1 July 2020 stated that there has been a switch in the sexual problems which males complain about now.

The scientists accumulated complete data of 2,013 patients who were continuously evaluated by a sexual medicine expert between the years 2006 to 2019. The scientists found that 824 patients were assessed for erectile dysfunction, 369 patients were diagnosed with curvature of the penis (Peyronie’s disease), 322 patients had premature ejaculation, 204 suffered from low sex drive and the remaining 294 had other sexual dysfunctions.

In this study, the scientists found that earlier, more men were diagnosed with erectile dysfunction and premature ejaculation. However, more recently, men have been diagnosed with low sexual desire and Peyronie’s disease.

With the successful treatment options for erectile dysfunction such as Viagra and Cialis and awareness, men have been reporting more about other sexual dysfunctions as well.

Cap-Score: A test to find out sperm quality

Male infertility is one of the major reasons behind the increasing numbers of in-vitro fertilization (IVF) cases throughout the world. Earlier tests like semen analysis, also called seminogram, were done to find out the quality and ability of sperm to fertilize. However, due to the lack of an appropriate diagnostic test for evaluating the fertilizing ability of men, most of the infertility cases get classified as idiopathic or unexplained.

In a recent research article in the journal Reproductive BioMedicine Online, scientists from various universities in the US used Cap-Score to test the sperm capacitation of males.

Sperm capacitation is a natural process where the spermatozoa (motile male sex cell) changes its shape to be able to penetrate and fertilize the female egg. The Cap-Score is a test which determines the percentage of sperm that undergoes capacitation in a certain amount of time. Usually, 35 percent of sperms of a man with normal fertility would undergo capacitation.

In this study, the scientists took the sperm samples from 292 patients and tested their ability to reproduce with the help of traditional sperm analysis test and Cap-Score. Out of these patients, 128 couples became pregnant after three cycles of Intrauterine Insemination (placing sperm inside a woman’s uterus to facilitate fertilisation).

The scientists found that those with high Cap-Score were able to fertilize more efficiently and resulted in a higher number of pregnancies. The scientists also found that men who constantly questioned their fertility showed impaired or reduced capacitation ability.

Benefits of Cap-Score over traditional sperm analysis

Scientists found that traditional semen analysis is unable to identify impairments in fertilising ability, which typically leads to a diagnosis of idiopathic infertility. The scientists found that unlike the traditional semen analysis, capacitation is a better test which helps in determining whether or not there would be a successful generation of pregnancy.

Both these studies indicate that with better awareness of male sexual health issues, men choosing to report as well as get treatment for these diseases, and with the widespread adoption of better sperm analysis tests like the Cap-Score by the medical community, male sexual dysfunction and infertility can be better addressed globally.

For more information, read our article on Low Sperm Count.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Male Sexual Worries: Trends in the Post-Viagra Age

Male Sexual Worries: Trends in the Post-Viagra Age

TOPICS: Urology

By European Association of Urology July 18, 2020

This article is a repost which originally appeared on SciTechDaily

Edited for content

Trends in reasons for visiting a the San Raffaele sexual health clinic. Credit: This diagram appears with the permission of the authors and the International Journal of Impotence Research. The EAU thanks the authors, and the journal for their cooperation.

Scientists report a change in why men seek help for sexual problems, with fewer men complaining about impotence (erectile dysfunction) and premature ejaculation, and more men, especially younger men, complaining about low sexual desire and curvature of the penis (Peyronie’s disease).

Presenting the work at the European Association of Urology (virtual) Congress, after recent acceptance for publication, research leader Dr. Paolo Capogrosso (San Raffaele Hospital, Milan, Italy) said:

“Over a 10 year period we have seen a real change in what concerns men when they attend sexual health clinics. This is probably driven by greater openness, and men now accepting that many sexual problems can be treated, rather than being something they don’t want to talk about.”

The success of erectile dysfunction treatments such as Viagra and Cialis, and the availability of new treatments, means that men facing sexual problems have now have treatments for sexual problems which weren’t available a generation ago. Now researchers at San Raffaele Hospital in Milan have studied why men come to sexual health clinics, and how this has changed over a 10-year period.

In what is believed to be the first research of its kind, the scientists questioned 3244 male visitors to the San Raffaele Hospital Sexual Health Clinic in Milan over a 10 year period (2009 to 2019), and classified the main reason for the visit. They found that the number of patients visiting with erectile dysfunction problems increased from 2009 to 2013, then started to decrease.

There were comparatively few patients complaining of low sex drive or Peyronie’s disease in 2009, but complaints about both of these conditions grow from 2009 to the end of the study. In 2019 men were around 30% more likely to report Peyronie’s disease than in 2009, and around 32% more likely to report low sexual desire.

The amount of men complaining of premature ejaculation dropped by around 6% over the 10-year period. The average age of first attendance at the clinical also dropped, from a mean of 61 to 53 years.

“Erectile dysfunction is still the main reason for attending the clinic, but this number is dropping, whereas around 35% of men attending the clinic now complain of Peyronie’s disease, and that number has shown steady growth,” said Paolo Capogrosso. “Our patients are also getting younger, which may reflect a generational change in attitude to sexual problems.”

Dr. Capogrosso continued “We need to be clear about what these figures mean. They do not indicate any change in the prevalence of these conditions, what they show is why men came to the clinic. In other words, it shows what they are concerned about. The changes probably also reflect the availability of treatments; as treatments for sexual conditions have become available over the last few years, men are less likely to suffer in silence.”

These are results from a single centre, so they need to be confirmed by more inclusive studies. “Nevertheless there seems to be a growing awareness of conditions such as Peyronie’s disease, with articles appearing in the popular press*. In addition, we know that the awareness of this condition is increasing in the USA and elsewhere, so this may be a general trend,**” said Dr. Capogrosso.

Commenting, Dr Mikkel Fode (Associate Professor of Urology at University of Copenhagen), said:

“Although these data are somewhat preliminary as they stem from single institution they are interesting because they allow us to formulate several hypotheses. For example the drop in men presenting with erectile dysfunction may mean that family physicians are becoming more comfortable addressing this issue and that the patients are never referred to specialized centers. Likewise, the simultaneous drop in age at presentation and increase in Peyronie’s disease and low sex drive could indicate that both men and their partners are becoming more mindful to optimizing their sex lives. I will be very interesting to see if these trends are also present in other centers around the world.”

Dr. Fode was not involved in this work, this is an independent comment.

References:

* “Trends in reported male sexual dysfunction over the past decade: an evolving landscape” by Edoardo Pozzi, Paolo Capogrosso, Luca Boeri, Walter Cazzaniga, Rayan Matloob, Eugenio Ventimiglia, Davide Oreggia, Nicolò Schifano, Luigi Candela, Costantino Abbate, Francesco Montorsi and Andrea Salonia, 1 July 2020, International Journal of Impotence Research.

** “The Prevalence of Peyronie’s Disease in the United States: A Population-Based Study” by Mark Stuntz, Anna Perlaky, Franka des Vignes, Tassos Kyriakides and Dan Glass, 23 February 2016, PLOS ONE.
DOI: 10.1371/journal.pone.0150157
PMCID: PMC4764365

Erectile dysfunction pills can permanently distort vision

Erectile dysfunction pills can permanently distort vision

By Hannah Frishberg

This article is a repost which originally appeared on the NEW YORK POST

This little blue pill is giving men a big blue — or sometimes red — problem: colored vision.

Erectile dysfunction drugs can lead to prolonged retinal dysfunction, a new case study published Friday in the journal Frontiers in Neurology found.

“Sildenafil, also known as the little blue pill or Viagra, is a common medication for men who need a little downstairs perk-me-up,” begins a press release for the report, published by Turkey’s World Eye Hospital, “but Turkish researchers noted a pattern of male patients whom (sic) took the pill suffering from all sorts of visual disturbances.”

Study authors report patients experienced blurred vision, light sensitivity and color-vision disturbances, including “intensely blue colored vision with red/green color blindness” after taking the highest recommended dose of Sildenafil, which was originally developed as a treatment for high blood pressure.

“For the vast majority of men, any side effects will be temporary and mild” after taking Sildenafil, says study author Dr. Cüneyt Karaarslan. “However, I wanted to highlight that persistent eye and vision problems may be encountered for a small number of users.”

In the 17 case reports included in the study, all men were still experiencing side effects when they arrived at the clinic 24 to 48 hours after taking the drug. For some, the symptoms required 21 days to clear up, although in past case studies, patients’ vision has been found to be forever changed.

“He definitely showed some permanent damage to his vision,” ophthalmologist Dr. Richard Rosen tells CNN of a 31-year-old who began seeing red after he took a high dose of an ED medication. The man was the subject of a case report co-authored by Rosen and published in 2018.

Karaarslan believes the side effects are due to a small subsection of men being unable to break down the enhancement drugs. The reason the eye is impacted is not fully understood, Rosen tells CNN, but has something to do with a pair of sister enzymes. One of the enzymes is found in blood vessel walls and can affect the other enzyme, which helps process light within the eye. The one that impacts blood vessel walls is inhibited by the drug’s active ingredient.

“No one knows exactly how this happens,” says Rosen. “We just know there’s a crossover.”