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By Dr David Delvin
PUTTING MALE SEX
PROBLEMS RIGHT
Last month we looked at female sex problems in the
retirement age group and this month, well it’s the turn of the
chaps!
Minor sexual difficulties are extremely common in the
over-50s and some major problems can rear their ugly heads too.
But with a bit of determination and some help from your
partner and your doctor – the majority of these difficulties can
be sorted out.
So don’t suffer in silence, you can have a
fulfilling and happy sex life if you want to.
Read on……….
The effects of age, illness and tiredness and pills
There’s no doubt that as
men grow older, they get more tired.
They’re also more liable to illness and they usually have
to take more pills. Unfortunately all these things can easily affect their sex
lives. How?
Well it’s like this:-
*
Tiredness
makes it very difficult for a man to summon up much interest in sex;
it also makes it difficult for him to get an erection when he wants
to.
*
Illness also affects
both libido (sex drive) and the ability to get an erection.
In particular painful illnesses this can really put a block
on your love life (try being romantic when your arthritis is playing
up);
*
Pills prescribed by
a doctor can seriously interfere with sexual activity
- for instance, many prescription drugs can interfere with
the mechanism of erection, while others can make it quite difficult
to climax.
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Problems
with the arteries
Another obstacle for more
mature men is this: most British males over the age of about
25 have already started to develop some deterioration of their
arteries, that is the tubes which carry blood from the heart to the
rest of the body. By
the age of 50, most of us have quite extensive arterial
degeneration. If we are
lucky and have kept ourselves fit, this ‘furring up’ of the
arteries may cause no trouble for many years.
But in an awful lot of guys, some degree of blockage of the
blood flow to the penis occurs. The likely result of this is impotence (‘erectile
dysfunction’). This
is much more likely to occur in smokers since smoking damages the
arteries pretty badly.
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Men whose potency isn’t
quite what it was are often very worried about their male hormones.
They think that they must be producing less testosterone (the
male sexual hormone). Very
frequently, they come into my consulting room depressed and weeping
and saying things like ‘I’m obviously not a real man any more,
doctor’. But in the
vast majority of cases, their fears are quite unjustified.
As a rule, their hormone levels are perfectly OK and they
don’t need hormone treatment. Some other kind of therapy will usually put them right.
Most regrettably certain private sex clinics in London
and elsewhere, have promoted the idea that fellows have sex
difficulties are probably suffering from lack of male hormone.
The clinics term this ‘the male menopause’. Frankly, I regard this viewpoint as a load of old nonsense!
Please be very wary of any private clinic where they want to
sign you up for a course of hormone treatment costing thousands of
pounds. Several of my
patients who are of retirement age have told me that they were
ripped off by outfits of this type.
In these places, the white-coated consultant who interviews
you may not actually be a doctor at all – he is actually a
salesman. You have been
warned!
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Now let’s look at the
problems which may affect the mature man.
The ones I am going to deal with are:-
*
Erectile Dysfunction
(still often referred to as ‘impotence’);
*
Premature
ejaculation;
*
Inability to climax;
*
Soreness and pain;
*
Lessened amount of
fluid;
*
Lessened power of
ejaculation;
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Let’s examine each of these six problems in turn,
here goes:-
1.
ERECTILE
DYSFUNCTION ('E.D.' OR 'IMPOTENCE')
Erection problems
are increasingly common after the age of 50, but they’re not
inevitable. A good
statistic is that at the age of 70, no less then 70% of men are
still potent. However,
that does of course mean that 30% aren’t.
So what are the erection problems in the retirement age
group? Here are the
common ones:-
*
Psychological
difficulties
– these are actually much commener in the younger males than the
older ones. However, such difficulties do occur in the voer-50
age group. Depression, stress, anxiety and sheer exhaustion
can easily put a damper on your erection. Also, in this age
group, it is common for widowers to have trouble getting an
erection, when they start a new relationship. The reason -
because deep down they feel guilty about 'being unfaithful' to the
deceased wife. Commonsense counselling will often sort this problem
out.
*
Artery
problems
- as I have
mentioned above most men do get a certain amount of deterioration of
the arteries (the tubes which pump blood round the body) as they get
older. If this
degeneration affects the arteries, which put blood into the penis,
then there will probably be difficulty in ‘getting stiff’. Very fortunately this type of E.D. responds well to Viagra
and other drugs (see below). Also
giving up smoking is a good idea.
*
Diabetes
– Regrettable 'sugar diabetes', which is now extremely common in more
mature people, can often affect the potency. Improving the
control of your diabetes may help. But happily around 60% of
men can be 'put right' with Viagra or one of the other drugs listed
below.
*
Alcohol – In quite a few older men, it is actually alcohol that is the cause
of their E.D. - hence the famous expression 'Brewers Droop'.
Giving up heavy drinking can make everything OK again.
*
Prescription
drugs
– A lot of the drugs which your GP prescribes can make you impotent.
The risk is greatest with some of the drugs for high blood pressure.
So if your doctor puts you on pills for 'high BP' and you suddenly
find that you can't make it anymore, then ask her to switch you to
one of the dozens of other blood pressure tables which are on the market.
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Treatments
for ‘E.D.’ - Sometimes
the treatment is fairly simple, for instance, stop drinking or stop
smoking or change your blood pressure medication.
Losing weight often helps too!
Counselling or psychotherapy can be very helpful when there
is an emotional problem. But what about medical treatment? This has been revolutionised in recent years, thanks to the
advent of drugs like Viagra. Here
is what’s available:-
*
Oral drugs –
Viagra and Uprima are prescribable in the UK now.
Viagra helps 80% of men, while Uprima helps slightly fewer.
But have side effects, and not everyone is suitable for these
pills. During 2003, a
new drug called Tadalafil (Cialis) will be released, it has a much
longer period of action than Viagra, but it can cause backache,
muscle pain and other side effects.
Also due for release fairly soon is Levitra, which is alleged
to work faster than Viagra.
*
Injections
– Injections into the penis (such as Caverject) given just before
love making work well, but are definitely not everybody’s cup of
tea.
*
Intra-penile
pellets – A little pellet containing the drug Alprostadil can
be inserted down the penis shortly before intercourse.
It will produce erection in a high percentage of men but talk
to your doctor about possible side effects.
*
Vacuum devices
– many older men use vacuum cylinders to help then get erect.
These devices ‘suck’ the penis so as produce an erection. One drawback is that the organ tends to feel rather cold and
look rather blue.
*
Rings –
Various brands of ‘penile ring’ are widely used – both with
and without vacuum devices. They mainly work by preventing some of the blood from flowing
out of the penis.
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2.
PREMATURE
EJACULATION
Premature
ejaculation is ‘coming too soon’.
It is extraordinarily common in younger males but by
retirement age, most men have learned to control their reactions and
‘last’ for pretty well as long as they like! However, if you do happen to suffering from ‘P.E’, it can
easily be cured. The
best treatment is a system of bedroom exercises, which you can do
with your partner. You
need to be taught by a sex therapist for instance at Relate.
If for some reason, the man can’t manage the above
treatment (say if his partner isn’t too helpful), then it is
sometimes possible to help him by prescribing a particular type of
anti-depressant drug, which lengthens the time take to climax.
Finally
a lot of guys try to treat their own P.E. by using the widely
advertised local anaesthetic sprays, which are supposed to
‘dull’ sensation in the penis.
Personally, I don’t recommend these, mainly because it is
possible to develop very painful skin sensitivity to the
ingredients.
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3.
INABILITY
TO CLIMAX
Regrettably,
difficulty in reaching orgasm is common in more mature men.
Research has shown that after the age of 50, the average time
taken to achieve climax gets steadily longer.
So a chap who could climax in six minutes when he was 40 may
find that it takes him 24 minutes when he is 70!
It
isn’t easy to provide medical help here.
What is important is to talk things over with your partner,
so that she understands that you are no longer as ‘highly
triggered’ as you once were.
Quite a lot of older couples reach an agreement that it’s
not actually necessary for the man to reach a climax on every single
occasion.
On
the other hand, many couples find that they can induce orgasm in the
man by employing sex aids (such as vibrators) – or even erotic
fantasies!
Finally,
please bear in mind that there are certain drugs prescribed by your
family doctor, which can make it difficult to reach orgasm.
In particular, various antidepressants, such as Prozac, are
notorious for preventing people form climaxing.
So a change of medication will often improve matters
dramatically.
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4.
SORENESS
AND PAIN
The skin of the
penis tends to get thinner and more easily damaged with age. So a
lot of over-50’s complain that lovemaking makes them red or sore
or causes them actual pain. A
very common additional factor is this – it is likely that the
mature man’s partner is not producing as much vaginal secretion as
she used to. So this
dryness can help to make the chap sore and red. In these cases, it
is important to use plenty of ‘sex lubricant’ – for more
details, see last month’s article.
If
added lubrication doesn’t solve the problem, what then?
The man should definitely see his GP or a dermatologist, to
find out whether he has any skin disorder – or whether there is a
mild infection, such as thrush (candida).
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5.
LESSENED
AMOUNT OF FLUID
Many
men write to me because they are worried by the fact that they are
producing less sex fluid than they used to.
In fact, research shows that it is normal to produce a little
less from about age 50 onwards and do remember that the average
volume of semen is far less than many men imagine, even when you are
young. Last month, I
was involved in a ‘sex survey’ conducted during a national TV
programme. We asked
viewers to say how much fluid the normal male produces, many
respondents thought that the correct answer was ‘an egg-cupful’.
In fact, the correct answer is only a teaspoonful (5ml).
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6.
LESSENED
POWER OF EJACULATION
Again, a lot of more
mature guys ask my advice because they are concerned that ‘the
fluid doesn’t go as far as it used to, doctor’.
I am afraid that laboratory research in the USA, has shown
that it is absolutely normal for the ‘distance travelled’ to get
steadily less as you get older. For example, a younger man can sometimes with sufficient
stimulation, produce a ‘jet’, which ends up in his hair!
But once you are past 50, you are doing extremely well if
your fluid travels as inch or two.
This
is just a fact of life and there is very little that you can do
about it. However,
getting fitter and losing any excess weight may help.
Also, a number of my patients have found that if they do
‘pelvic muscle exercises’ for a few months, this seems to give
them a more powerful ejaculation.
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In summary then, most difficulties, which occur in
gentlemen of retirement age, can be helped.
I strongly advise you above anything else to try to talk to
your partner about anything that may be worrying you.
One or two other sexual problems are dealt with in the ‘Q
& A’ section below.
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Q I
am a widower, age 66. There
is a new lady in my life and I would like to marry her.
Alas, it looks as though I will need Viagra! Could I get this on the NHS?
A Sadly,
Viagra is only available ‘on the Health Service’ to men who have
one of a very limited list of conditions, for instance diabetes. This is not very logical but that is how it is.
However, there is no reason why you shouldn’t obtain Viagra
on a private prescription assuming that you are medically suitable
for it. Most chemists
will charge you about £7 for a tablet.
Q I
am 75 and intercourse is a little painful owing to the fact that my
foreskin is too tight. Am
I too old to be circumcised?
A Not
at all sir. But I would
advise you to go to an urologist (that is a urological surgeon). Why? Because it
is important that this quite tricky operation is performed by a
doctor who really knows what he is doing.
Q My
husband is due to have a Prostate operation next month.
Will this affect our sex life?
A Almost
certainly – the surgeon really should have discussed this with
your husband by now. The
crucial question is this. What
kind of Prostate operation is the surgeon going to do?
The more major types of operation are more likely to disrupt
the man’s sex life. But
all types of Prostate surgery are liable to have effects.
For instance, it is highly likely that your man will find
that his sex fluid no longer flows outwards but goes backwards into
his bladder.
I
think it is high time that the two of you had a chat with the
surgeon about what is likely to happen. If it’s difficult to get hold of him, ask your GP if
she knows what type of surgery is planned and what the effects on
your sex life will be.
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Q I
am sorry to say that my wife has just been diagnosed as having early
signs of Alzheimer’s. Are
there any drugs, which could help her?
A Sorry
to hear about this. There
are several drugs, which are believed to slow up the progress of
this condition. Unfortunately
some local authorities will not pay for them, because they are
expensive. At the
moment, the main ones are:-
·
Aricept;
·
Reminyl; and
·
Exelon.
They should really be prescribed by a specialist.
So if you want your wife to have the chance of trying one of
them, ask your GP if he will refer her to a consultant
psycho-geriatrician.
Q Like many fellows of my age, I get a very stiff neck, especially after
playing golf. Would it be worth buying myself a neck collar?
A
It would
certainly be worth a try, sir – especially as they only cost about
a tenner. They usually
come in three different sizes so ask the chemist to measure your
neck before you buy.
Q Is
there any harm in buying reading glasses ‘off the peg’ in shops?
I was always bought up to believe that you shouldn’t have
specs unless a doctor or an optician had prescribed them.
A Well,
it used to be illegal to sell glasses without a prescription.
But that silly law was abolished in the 1980s.
So nowadays it is perfectly OK to buy spectacles ‘off the
peg’ provided that they are just reading glasses.
Q I
am 61 and am thinking of taking up jogging again. Would it be safe
to start running long distances at my age?
A Perfectly
OK, but you should take it easy to start with.
A good idea is to limit yourself to just running a mile on
each occasion, during the first couple of weeks.
Also please make sure that you have good thickly cushioned
jogging shoes in order to protect your knees and hips from the
recurrent thumping of your feet on the ground.
Finally, avoid running on hard surfaces, grass is best for
ageing joints!
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