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Most men over 40 don’t have erectile dysfunction, but their erections change. Between age 40 and 50, most men notice that their erections aren’t what they used to be. They no longer rise spontaneously from erotic fantasies or the sight of a cute waitress’ cleavage. The penis must be fondled to produce wood. When erections rise, they may be less firm, and minor distractions may cause wilting, even during handjobs, fellatio, and intercourse.

These changes can be unnerving. Some men jump to the mistaken conclusion that they have erectile dysfunction (ED) and run to their doctors for prescriptions. Others decide that sex is over, and “retire” from it, often to the chagrin of their partners. But many post-40 erection changes are not ED, and even if ED develops, there are still plenty of ways to enjoy great sex and fabulous orgasms. Here are 10 things every man—and every heterosexual woman—should know about older penises.

ED means no erections during extended masturbation

The American Urological Association says that ED is “the inability to achieve or maintain an erection sufficient for satisfactory sexual performance.” That’s absurdly vague. If you define “an erection” as what you see in porn, and “satisfactory sexual performance” as porn sex—instant, rock-hard erections that last forever—then most men over 40 have ED. What is ED, really? For practical purposes, it means that a man not under the influence of alcohol or any of the many other erection-impairing drugs cannot raise an erection during extended masturbation.

Most older men suffer not ED but erection dissatisfaction

If you can raise erections during masturbation, you don’t have ED. You probably have erection dissatisfaction.

Older men’s erection changes are normal and inevitable. Men who develop them closer to 40 usually have chronic medical conditions: diabetes, obesity, heart disease, high blood pressure. Or they’ve spent decades living unhealthy lifestyles. They smoke, don’t exercise daily, imbibe more than two alcoholic drinks a day, have chronic stress, and eat a diet high in saturated fat, that is, meat and/or cheese.

Erection changes can be postponed but usually not prevented by embracing a healthy lifestyle, falling madly in love, and making love not late a night (especially after a big dinner with cocktails and wine) but in the morning or afternoon when most men have more energy.

In addition to an unhealthy lifestyle, anxiety—everything from job and money troubles to family and relationship problems—can be toxic to erections. Anxiety triggers the fight-or-flight reflex that sends blood away from the central body, including the penis, out to the limbs for self-defense or escape. Less blood in the central body means less blood available for erection. Erection dissatisfaction is upsetting, but try to accept it. It’s normal. If you become anxious, erections become less likely.

Good ways to minimize anxiety include a hot shower before sex, and during lovemaking, deep meditative breathing, a slow pace, and lots of sensual touch all over.

Some erection changes are due to lengthening refractory period

The refractory period (RP) is the period of time from ejaculation/orgasm until men can raise their next erection. In teens and young adult men, RP may be short, less than 30 minutes. But as men get older, it lengthens. By the time men hit 40, it may be several hours or longer. Meanwhile, many men masturbate frequently, some daily, some more than once a day. If men over 40 stroke a few hours before partner sex, they may still be in their RF, which can make it difficult to raise firm erections. Consider not masturbating for 12 to 24 hours before partner play. This means scheduling sex in advance. Sex therapists almost universally recommend this for long-term lovers, but some people prefer spontaneity. I’m with the sex therapists. Older couples are usually happier with scheduled sex—and for men who stroke frequently, managing RP can help with erection.

Erection dissatisfaction can enhance lovemaking

The dark cloud of erection changes has a silver lining. Young couples often develop conflict because most young men become aroused faster than most young women. Young men are often all finished before young women have even become interested in genital play. Post-40 erection changes slow men’s arousal so their erotic pace more closely matches women’s. A slower pace allows plenty time for kissing, cuddling, and whole-body massage, all essential to most women’s enjoyment of sex—and firm erections. From this perspective, erection dissatisfaction can actually be a gift.

Healthy lifestyle helps postpone erection dissatisfaction and ED

Erection depends on robust blood flow through the penis. Anything that impairs circulation increases ED risk: smoking, diabetes, sedentary lifestyle, high cholesterol, heart disease, being overweight, high blood pressure, more than two alcoholic drinks a day, daily consumption of meat and/or cheese, and fewer than five daily servings of fruits and vegetables. Avoiding these risk factors does not prevent post-50 erection changes, but it helps postpone ED.

Erection drugs don’t produce miracles

Erection drugs improve erections in around two-thirds of men, so they don’t work for one-third. In addition, when they work, they don’t produce porn-star erections. Over time, many men need larger doses, but as dosage increases, side effects become more likely, notably, headache and nasal congestion. Finally, the drugs have no effect on arousal, so men may raise chemical erections but not feel particularly interested in sex. Many men feel disappointed with the drugs. Fewer than half refill their prescriptions.

If you no longer have intercourse, you don’t need erections

There’s another reason men forgo erection drug refills. With age, intercourse usually drops out of the erotic picture. Between men’s erection issues and post-menopausal women’s vaginal dryness and atrophy (tissue thinning), intercourse can become uncomfortable or impossible, even with lubricants. Many older couples jettison intercourse in favor of mutual massage, oral sex, and sex toys. Most men assume that erections are necessary for sex. For natural reproductive sex, yes, but for sexual pleasure, no. Men can enjoy fabulous sex without erections.

Men can have great orgasms without erections

That’s right, you don’t need an erection to have an orgasm. Different nerves govern erection and orgasm. Even if erection nerves become severed, often with paraplegia, or prostate cancer surgery, orgasm nerves usually remain intact. In an erotic context filled with kissing, cuddling, fondling, massage, oral, and sex toys, a man with a semi-erect or even flaccid penis can enjoy orgasms as intense as any he ever experienced with major wood.

The drugs work best combined with sex therapy

Several studies have shown this. There’s more to satisfying sex than a hard penis. Relationship issues are crucial, especially if sex has been a sore point or if the couple hasn’t had much for a while. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists, the Society for Sex Therapy and Research, or the American Board of Sexology.

After 60, ED is not inevitable, but it’s likely

What proportion of men eventually develop ED? Various studies have come up with different findings, but for my money, the best research is an Australian study that tracked several hundred men over 65 for more than a decade. Nine percent had no ED, 91 percent, occasional ED, 54 percent, mild chronic ED, and 37 percent moderate to severe chronic ED. So ED becomes, if not inevitable, quite likely. That’s the bad news. The good news is that from age 40 to 65, as men get used to erection dissatisfaction and how to cope with it, they’re preparing for more problems later.

Gentlemen, no matter how old you are, no matter how Mr. Happy does or doesn’t function, you can still enjoy great sex, volcano orgasm, and sexual satisfaction.

You may also be interested in reading my book Sizzling Sex for Life.

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