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

 

 

 

 

 

 

Get a Stronger, Healthier Penis – Penis Health Plan

The Ultimate Training Plan for a Stronger, Healthier Penis

Power up your package and sexual performance.

By Jon Irwin

Published: Oct 25, 2022

This article is a repost which originally appeared on Men’s Health.

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

Our Takeaways:

· Exercises can be performed for better penile function.

· Regular, productive sexual activity is excellent for optimizing penile function.

· If you suffer from serious negative effects, please seek out medical professional assistance.

“Fitness Routine” usually conjures up whatever gets you more endurance or stronger muscles. But devoting a little time to a few routines and developing new habits can also result in a stronger, healthier penis. Think of it as Third Leg Day.

Peak-performing junk (penis, balls, prostate, and pelvis—the whole enchilada) puts bathroom breaks under your control and houses sperm that are both plentiful and swift. Whether you think your package is working great, struggling, or doing something in between, these tips will help you get your gear in gear.

How to optimize your package if you are basically fine

That means everything is working okay—you just want to keep it that way.

Raise the frequency

Men who had sex less than once a week had a higher risk of erectile dysfunction than guys who did it at least once a week, according to a study in The American Journal of Medicine, making it one of the most useful (and fun!) ways to keep your penis strong. Even better, DIY sex is good, too. If you’ve noticed that you have a hard time maintaining an erection or reaching orgasm without, say, watching certain videos on the Internet, then you might want to try an orgasm ban during sex, even for a day, says sex educator Lawrence A. Siegel. This shifts the focus away from the endpoint and toward pleasure in the moment.

Find the right stuff for your stuff

When jock itch is driving you nuts, bypass online advice to apply apple–cider vinegar, cocoa butter, or Vicks VapoRub—they can leave you more uncomfortable without helping—and start with an OTC antifungal cream (like Lotrimin). Then avoid repeat infections: Put those boxer briefs on carefully at the gym and treat athlete’s foot and sweaty shoes with an antifungal powder, says MH dermatology advisor Corey L. Hartman, M.D.

Wrap it

Rates of the most reportable sexually transmitted infections have surpassed prepandemic levels, according to the CDC. At last estimate, one in five people in the U. S. has an STI. If you’re convinced condoms are still nothing but barriers to pleasure, you haven’t checked out the market for a while. P. S. condoms are known for feeling as if there’s nothing there. Skyn condoms have a soft texture and are nonlatex.

How to optimize if you are sort of fine

“Sort of fine” meaning you have problems getting or keeping it up—and maybe bladder leakage. Things may also look slightly . . . off?

Add a daily workout

Treat your pelvic floor like the muscles it’s made of and do isometric contraction sets. These Kegels improve bladder control and “have been shown to allow men to control ejaculations and enhance orgasm,” says Jamin Brahmbhatt, M.D., an assistant professor of urology at UCF College of Medicine. Tighten the muscles that stop your pee midstream for 3 seconds, relax them for 3, and repeat 10 times. Aim for 3 sets a day.

Get that checked out

Pimples? Bumps? Rashes? Go to a doctor to figure out what’s going on. Yes, there are apps out there where you can take a photo of your stuff and get a diagnosis of what’s up, but MH urology advisor Elizabeth Kavaler, M.D., says that using an app to detect an STI is “totally crazy.” You can order an at-home STI test kit (LetsGetChecked.com, Everlywell), but if what you have isn’t an STI, the kit can’t tell you what the trouble actually is. Only a real live doctor can do that.

How to optimize if you are not fine

In other words, “not fine” is when you can’t maintain an erection. And the urge to urinate is all the time.

Bolster your bladder

If “drip” describes your latest bathroom trip, you may have benign prostatic hyperplasia, a usually innocuous yet annoying enlarged prostate gland. The good news is that there are many treatments after diagnosis. Talk to your doctor about saw-palmetto extract, a supplement that can reduce urinary symptoms for some men, says Dr. Kavaler. Prescription drugs and minimally invasive surgeries can also help.

Eliminate the negative

Having a hard time staying hard? Maybe it’s your attitude. Men with higher levels of suspicious jealousy concerning their mate tend to have higher levels of erectile dysfunction, according to research by Gavin Vance at Oakland University. One way to cut through the envy is with sensate-focus therapy, a technique that uses touch, like holding hands, to decrease anxiety and increase intimacy.

Seek treatment for ED

If you’ve ruled out pills due to side effects or preexisting conditions, consider injectables. Sounds scary, but intracavernosal injections do the same thing as pills—increase blood flow—and people who use them consistently have high satisfaction rates, according to a 2019 study. Just stay skeptical of shock-wave therapy, says Dr. Kavaler. Using high-frequency ultrasound to irritate the penis lining as a way to help new cells grow and increase blood flow is being investigated, but its marketing may be stronger than the evidence—at least right now.

This story originally appeared in the November 2022 issue of Men’s Health.

Reference: Recent advances in the understanding and management of erectile dysfunction: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348436/

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.

 

How to Perform the Master Your Orgasms Exercise (from The Ultimate Guide To Male Enhancement)

The following is taken from Chapter 14: Ways to Treat Premature Ejaculation from The Ultimate Guide To Male Enhancement.

Edited for content

How to Perform the Master Your Orgasms Exercise

Many men never experience the full potential of pleasure they can receive from their sexual encounters. This little–known mental/sexual exercise will take you to levels of pleasure and control you never thought possible.

Step 1:
First, you must find a time and a place in which you will be COMPLETELY undisturbed for 20–30 minutes.

Step 2:
Lie back naked on your bed (or another comfortable surface) and encircle your penis with your thumb, index, and middle finger. Place your middle finger on the sensitive spot directly behind your penis head (glans.) Rub your penis or visualize until it becomes erect.

Step 3:
While maintaining the pressure behind the glans with your middle finger, close your eyes and concentrate as deeply as possible on visualizing yourself performing with the utmost confidence and completely stress free, and in feeling a slight bit of pressure behind the sensitive spot behind the glans. It’s the EMOTIONAL feel of performing in this manner you’ll want to be able to duplicate in real live sexual scenarios.

Mastering Your Orgasms Takes Time

At first, it will probably be difficult to concentrate deeply without a break in concentration for any length of time.  This is where the mantra “practice makes perfect” comes into play. It will probably take a dozen sessions or more of 20–30 minutes before you are able to achieve the very deep level of concentration necessary for this exercise to work.

After you master the technique, your ability to concentrate and focus will become so strong, you will be able to bring yourself to orgasm merely by keeping pressure behind the glans with your middle finger and
concentrating on the feel of the movement! Some very light rubbing is acceptable.  Some men have even reported multiple orgasms from following this technique!

Once you have mastered this technique, you will then be able to fully appreciate the pleasures of sex!

NOTE: Keep in mind some men will not be able to achieve orgasm without movement. If this describes your situation, once you come as close to climaxing as mere pressure and concentration will allow, you can jiggle your penis just enough to push you over the edge into climax.

The Ultimate Guide to Male Enhancement

13 health benefits of sex

13 health benefits of sex

Medically reviewed words Rosie Saunders, Dr Louise Wiseman MBBS, BSc (Hons), DRCOG, MRCGP

·10-min read

This article is a repost which originally appeared on yahoo!style

Edited for content

Not only does a healthy sex life boost levels of intimacy, affection and wellbeing in your relationship, according to science, but it’s also great for your physical and mental health.

And while we all know between-the-sheets action is a calorie burner – it can torch through calories equivalent to a 30-minute jog – there are so many great health benefits of sex that go way beyond energy expenditure.

With Tracey Cox, sex and relationships educator, and Mia Sabat, in-house sex therapist at Emjoy, we run through 13 evidence-backed health benefits of sex – plus, tips for fostering a healthy sex life:

13 health benefits of sex

Sex can be beneficial to your health in many ways, from boosting your immune function to reducing your risk of heart disease and supercharging your self-esteem. Here, we run through 13 evidence-based health benefits of sex, according to science:

1. Sex helps you sleep

During climax, the brain releases a hormone called oxytocin, which induces a relaxed feeling that helps you sleep better. ‘Great sex is one of the best cures for sleeplessness and insomnia – oxytocin is the hormone that promotes feelings of intimacy, and it jumps to five times its normal level during climax,’ says Cox. ‘It also makes you feel sleepy. While men drift off two to five minutes after orgasm, women usually take 20 to 30 minutes.’

2. Sex makes you look younger

Couples who have sex at least three times a week look more than 10 years younger than those who get frisky less often, according to research by Dr David Weeks, clinical neuropsychologist at the Royal Edinburgh Hospital. He adds, the pleasure from having sex is a ‘crucial factor’ in staying young. Additionally, having sex boosts blood circulation and causes your body to release endorphins, giving your skin a natural glow. Human Growth hormone (HGH) somatotropin is also released, which improves skin elasticity and fends off wrinkles.

3. Sex reduces headaches

Sex can be a powerful painkiller, especially for headache sufferers. A study carried out by the University of Munster in Germany found that sex can actually be more effective than painkillers when it comes to reducing headache pain. This is because sex triggers the release of endorphins – the body’s natural painkillers – into the central nervous system. The effect is so powerful, their research shows, that more than half of people who have sex during a headache experience an improvement in symptoms.

Some headaches occur as a result of sexual activity and this should be discussed with your doctor.

4. Sex relieves stress

Given that so many mood-boosting chemicals are released during sex, it makes sense that getting frisky can act as a natural, powerful stress-reliever. In one rodent study, having sex daily for a fortnight caused cell growth in the hippocampus, the part of the brain that keeps stress levels under control. And in a similar human study, people who had daily intercourse for two weeks experienced a reduction in stress-related blood pressure.

5. Sex promotes healthier food choices

Believe it or not, sex can help to curb sugar and fat cravings. How? By lowering levels of the stress hormone cortisol, which stimulates fat and carbohydrate metabolism for fast energy, promotes insulin release and impacts blood sugar levels. This trifecta of actions not only boosts your appetite, but leads you to crave sweet, high-fat foods, which are typically lower in nutrients.

6. Sex boosts immunity

Research from Wilkes-Barre University found that the intimacy of sex stimulates the body to produce Immunoglobulin A (IgA), an antibody that forms a barrier against a cold. People who have sex more than once or twice a week, they found, have more of these antibodies than those who are less sexually active. Obviously in the unusual context of covid – awareness of symptoms of infection is important in making decisions about intimacy.

7. Sex eases period pain

At the moment of climax, the uterine muscles contract and send pain-relieving and mood-enhancing endorphins to the brain. These act as a natural painkiller, and help to ease menstrual cramps, depression and irritability associated with PMS. The muscle contractions that occur when you orgasm may also help to relieve tension in your uterus, providing relief from cramps.

8. Sex reduces prostate cancer risk

The prostate is important in the male reproductive system – it produces the alkaline components of semen, which help to protect the sperm. Research from Harvard found that men who ejaculate on a regular basis – defined as five times or more each week – are less likely to develop prostate cancer.

9. Sex boosts heart health

The less frequently you have sex, the higher your risk of heart disease, according to an observational study spanning more than 1,000 men published in the American Journal of Cardiology. Compared to men who reported having sex a minimum of two or three times per week, men with sexual activity of once per month or less were 45 per cent more likely to be diagnosed with cardiovascular disease.

10. Sex increases self-esteem

Having sex can help boost self-confidence and develop a more better positive attitude about yourself. ‘Never underestimate the power of confidence,’ says Sabat. ‘Expressing what you want clearly and without fear is one of the most desirable things you can do, especially while being intimate with another person. Love the power of your body and acknowledge that you deserve to experience pleasure. Doing this will help you to communicate with more clarity and confidence.’

11. Sex boosts libido

The more frequently you have sex, the more likely you are to want to do it again. This is because getting frisky prompts your brain to release dopamine, a neurotransmitter involved in the motivation and reward process. And among women specifically, sex boosts estrogen levels and blood flow, which increases the desire for sex.

12. Sex improves memory

Getting intimate may boost your brain function by stimulating areas of the brain that are associated with memory. In a long-term study by the University of Wollongong, frequent sexual activity was found to be associated with better performance in a short-term memory test. This research is supported by the findings of a study by Manchester University, which revealed that sexually active adults have better brain power.

13. Sex enhances sperm quality

Ejaculating every day for seven days improves men’s sperm quality by reducing the amount of DNA damage, according to research by the European Society of Human Reproduction and Embryology. As well as seeing ‘substantial and statistically highly significant’ changes in the quality of the sperm, ‘in addition, we found that although frequent ejaculation decreased semen volume and sperm concentrations, it did not compromise sperm motility and, in fact, this rose slightly but significantly,’ said lead author Dr David Greening.

10 tips for a healthy sex life

Having regular sex may bring about a variety of health benefits, but being able to communicate and experience sexual satisfaction is key to making the experience pleasurable. Here, we run through 10 tips for a healthy sex life:

1. Connect with self-pleasure

Make time to get to know yourself – self pleasure is still a form of sex. ‘Every sexual experience begins within ourselves, and masturbation embodies this experience,’ says Sabat. ‘Beyond stimulating our sex drive, self-pleasure allows us to connect with our minds and bodies to focus on our desires and sexuality. This helps us to better communicate our needs and preferences, and ultimately engage in a more fulfilling sexual experience.’

2. Talk to your partner

Talk openly with your partner before entering the bedroom to establish consent, work out what you are both comfortable with, and what you’d like to explore, Sabat recommends. ‘Not only is consent always key, but ensuring you talk openly about your preferences gives everyone involved time to decide if they do, or do not, want to explore a specific type of sexual activity,’ she says.

3. Learn about erogenous zones

An erogenous zone is an area of the body that has heightened sensitivity, which may elicit a sexual response when stimulated. ‘Everyone has unique parts of their body which they love being touched, or gain arousal from,’ says Sabat. ‘You’d be surprised where you can find them – but the best places to start are often sensitive areas like the lips, neck and breasts.’

4. Bring erotica into the bedroom

To spice things up, why not talk to your partner about exploring different kinds of erotica together? ‘I recommend couples engage with audio erotica because, when listening, each individual can engage with their own fantasies, preferences and turn-ons, while still connecting over the same storyline or narrative,’ says Sabat.

5. Explore your biggest organ

Your skin, of course! ‘The skin is a highly responsive organ, and finding new ways to stimulate it can be very arousing,’ says Sabat. ‘Consider investing in new materials that will play on your sense of touch. This could be anything from leather and silk to latex or sensory lubricants. Just be careful of any allergies and introduce objects to both of your bodies in a responsible way.’

6. Try a new location

Sex doesn’t have to stay between the sheets, says Sabat. ‘Next time you’re feeling more adventurous, try taking it to the kitchen, bathroom, or even the hallway – these new locations will mean you have to work out new positions while enjoying the excitement of a new situation,’ she says.

7. Grab a toy

Sex toys can be used to complement both penetrative and oral sex throughout your experience – and they don’t need to be focused on penetration to create pleasure, says Sabat. ‘If your partner is open to bringing items like leashes, feathers, whips, and bondage toys such as handcuffs into the bedroom, bringing toys that focus on stimulating external areas into the bedroom can often lead to a more fulfilling sexual experience,’ she adds.

8. Engage with your fantasies

We all have fantasies, Sabat says, so it’s important to embrace them without shame. ‘Not only do fantasies increase sexual desire and arousal, but they let us explore facets of our sexuality that can often be forgotten or neglected,’ she says. ‘In fact, they can even help you to become more creative in the bedroom. While not every fantasy should be acted upon, discussing the parts of the fantasy that make you most excited with your partner can lead to healthy conversations about your sexual needs.’

9. Try different positions

Inject a sense of adventure into your bedroom antics by trying out different positions. ‘We often fall back on techniques that we know will result in orgasm – be it specific types of stimulation, favourite positions, or repeating the same moves over and over again,’ says Sabat. ‘Trying new positions helps us to experience intimacy in different ways. Explore new angles by using pillows, or mix things up by switching roles – if you’d normally be in control or on top, why not let your partner take the reins?’

10. Communication is key

Every sexual encounter is different, even if it’s happening with the same person, says Sabat. ‘What matters is that you learn your partner’s preferences and desires, and focus on communicating what you do and do not like,’ she explains. ‘Not only will this lead to more pleasure for you both, but it helps us reject the stigma that one partner is responsible for the other’s pleasure. Remember that sex is a shared experience, with shared responsibility. Communicate with your partner, feel empowered by your desires and let go.’

Last updated: 10-09-2020

Premature Ejaculation, What Is It?

Premature Ejaculation

What Is It?

Published: February, 2020

This article is a repost which originally appeared on Harvard Health

Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition.

As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.

Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.

Symptoms

The key symptoms of premature ejaculation include:

  • Ejaculation that routinely occurs with little sexual stimulation and with little control
  • Decreased sexual pleasure because of poor control over ejaculation
  • Feelings of guilt, embarrassment or frustration

Diagnosis

Premature ejaculation is diagnosed based on typical symptoms. To understand your problem, your doctor will need to discuss your sexual history with you. Be frank and open. The more your doctor knows, the better he or she can help you.

If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation.

Expected Duration

Sometimes, premature ejaculation goes away on its own over weeks or months. Working to relieve stress or other psychological issues may help the situation to improve.

Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period. Effective treatment is available.

Prevention

There is no known way to prevent premature ejaculation. However, you should consider the following advice:

  • Maintain a healthy attitude toward sex. If you experience feelings of anxiety, guilt or frustration about your sex life, consider seeking psychotherapy or sexual therapy.
  • Keep in mind that anyone can experience sexual problems. If you experience premature ejaculation, try not to blame yourself or feel inadequate. Try speaking openly with your partner to avoid miscommunication.

Treatment

Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the “squeeze technique” is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.

Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil).

Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose.

Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.

When To Call a Professional

Speak with your doctor if you consistently ejaculate before you want to. Remember, one instance of premature ejaculation does not mean that you have a condition that requires treatment. Your doctor may refer you to a sex therapist if premature ejaculation is causing major problems in your sex life or personal relationships or if you would like to consider behavioral therapy.

Prognosis

Many men experience a brief period of premature ejaculation, then improve on their own. Even for men who require medical treatment, the outlook is usually good.

Additional Info

American Society for Reproductive Medicine
https://www.reproductivefacts.org/