Does sexual activity decline with old age? Is this because of lack of ability or lack of opportunity. The decline in testosterone production is quite steady, from the age of 20 onwards – there is no sudden point at which old age takes effect, and in fact after the age of 60 the rate of decline eases off. So at 90, barring any other morbidity a man can still have an erection and enjoy sexual intercourse with his spouse.
The decline of sexual activity does seem to follow the same pattern as testosterone, that is after a time it levels out and remains constant. But there are so many other factors affecting sexual performance in the older male, that it is unlikely that the testosterone level exercises a major influence. The amount produced even right to the end of life is usually adequate for sexual activity.
Infact, at any time after puberty, sexual response and activity probably come to depend more and more on the higher centers of the brain – the hypothalamus and on the autonomic nervous system rather than on the testosterone production.
Most of my patients who complain of sexual decline have other co-existing chronic illnesses, like hypertension, diabetes, asthma, Chronic Obstructive Pulmonary Disease (COPD), Cardiac failure, cirrhosis of the liver, etc, for which they have been on medication for more than 10 years. One of them was on methyl dopa(aldomet) for almost 2 years which resulted in erectile dysfunction, I changed his medication and after 2 weeks he came back, smiling from molar to molar reporting progress. He even told me jocularly that I had saved his marriage.
The physical degeneration of aging naturally slows down the processes of sex, semen production, erection and ejaculation, all these take more time and more stiimulation. The need and ability for orgasm declines. All this continues from early stage, but as men get older some new factors appear.
Poverty may lead to poor nutrition, with a resulting loss of energy, and specifically sexual energy. And decline or disease in non – sexual bodily functions may make it difficult to perform sexual roles. Nevertheless, a healthy and fit person should be capable of some sexual activity at any age.
The main causes of declining sexual activity may often be psychological. The percentage of men suffering from total impotence increases slightly through the middle years, and more rapidly as old age is reached. In old age, physical factors are certainly involved. Yet one major cause of total impotence, at any stage of life, seems to be psychological. It occurs more often in those who have been sexually anxious, and for whom age provides a safe and valid excuse for ceasing sexual activity.
In addition the psychological trauma experienced by a male in middle age, when coming to terms with his life’s work and expectations, may lead to depression, disappointment and self doubt, and this can sometimes affect future sexuality.
So talk to your doctor, if you have sexual difficulties. Always be medically guided.
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