As many as 30 million American men suffer some form of sexual dysfunction, according to estimates of the Nation Institute of Health. The majority of these men are over the age of fifty-five. After eliminating the effects of physical illness and some medications, the number of men with dysfunction increases with age. One cause of this is that testosterone output diminishes with age.
See Erectile Dysfunction - See Male Menopause

When a man fails to reach an erection he tends to get very anxious and starts reevaluating what it means to be a man. Occasional failure to reach an erection is quite common and should not be source of concern. For women, failure to reach an orgasm may result in the same kind of preoccupation.

Sex education in the United States until about forty years ago was non-existent. Young women and men learned about sex in the locker rooms. Women were subjected to a constant tirade or warnings about getting pregnant, picking up a venereal disease or "being wronged" by men. Everyone knew that "Holding hands was the firs step to getting pregnant." Women could not even think about the pathways to abortions without terrible anxiety. Then, of course, an abortion was not easy to come by. Frequently, it involved traveling to another country where abortion laws were less strict.

Again, we start at the beginning. The adolescent notion of erections is that any real man should be able to get an erection any time of the day or night without much provocation. This myth persists, in spite of considerable evidence to the contrary, and it lurks in the mind of most seniors. With age, however, erections generally occur only at the right time and place, and with the right partner.

When counseling couples with sexual dysfunction it is easy to determine that sex is the first element of the relationship that suffers when there is a breakdown in communication. When couples start to repair things, sex is the last element to return to the relationship. When one or both members of a pair are troubled with depression or stress then sex becomes almost impossible. See Men's Health

A second generalization is that men are quite willing to accept all of the responsibility for failure to get an erection. A more useful answer can be found by tracking the interaction between a man and woman. We look for behaviors that facilitate or impede the growth of intimacy.

Women learn early in life how to turn men off. If they are tired, stressed or just plain uninterested in sex, most women know how to put a quick end to sexual overtures. Men also know how to do this with a partner who is more sexually active than they are. So, once these problems are out of the way, where is the pathway to sexual activity? The world is full of men and woman who feel inadequate about their sexual ability. More often than not it is the partner who is turning them off in some subtle way.  See The Menopause Experience

As always, the first step is open, intimate discussion. Both people have to show some interest in improving their sex life. These discussions must focus on such subjects as "what can I do to please you more?" and vice-versa. Some couples have never had such conversations. One partner gets sexually active and the other just goes along to get it over with. It is easy to see that sexual dysfunction is quite common when things go on this way. Women who just go along also have great difficulty in reaching a satisfying orgasm.     See Women's Health

If a couple can't work their way through all of this because of embarrassment, lack of knowledge, discomfort, or preoccupation with illness, then they should think about getting good-quality professional help. This step will at least open the way to intimate conversation.

Most sex manuals will advise couples not to make an effort to strive for satisfying sex too quickly. They suggest that the partners start learning to enjoy physical and emotional intimacy and sensual pleasure without necessarily proceeding to full intercourse, and see what develops. This is generally good advice. However, the climate of the relationship must allow for each partner to be able to say "I like it when you do this", or "I don't like you doing that", or "give me a massage all over", or "What would you like me to do?" In a surprising number of cases making the effort to develop the relationship, improve communication, and explore ways of pleasing each other leads to satisfying sex.

Striving for sensual satisfaction is a good place to start. The right music, the right perfume, the right lighting and all of the other pleasurable smells, touches and visual sensation helps a lot. If sometimes this whole thing sounds like a big production, well it is. Unfortunately, if sexual interest has declined over a period of time then it takes as lot of effort and time to get things back in gear.

It is easy to forget the rituals of courtship. One or both members of pair can start with little presents from time to time and remembering what the partner likes for entertainment and enjoyment. Find the right foods to prepare or the right restaurant to make a reservation. All of these little things help to create a climate for intimacy.

Many couples report that living out fantasies is very sexually exciting. For example, a man goes to a bar and soon a woman comes in. He goes through all of the motions of "picking up" an unattached woman, who is in fact his wife. Both people can really enjoy this. It takes a little work to recall sexual fantasies
Or invent new ones that are sexually stimulating and then figure out how to put them in action.

Unfortunately, if a relationship has deteriorated to the point where there is very little affection or caring between the partners, there is need for some more general discussion. The conversation can build around "What can I do to be a better person for you?" If nothing of value comes out of such a discussion both people have to question why they stay in the relationship.

Many partners in relationships are quite comfortable without sex. The couple know each other well, enjoy being together, and one or both of them know that they don't want to live alone, or face the family, children and community after a separation. Also, there is always someone there to call on in time of trouble or illness. Also, neither of them wants to be on the open market and go through the process of learning again how to act as a single person with other seniors. Separation would lead, to religious, financial, and estate problems, and so on. Relationships like this can continue indefinitely, until something happens that causes a reevaluation.

Some couples arrive at the notion that each partner should be free to pursue sexual activity outside of the relationship. This kind of decision relieves a lot of pressure. Both men and women seek out younger partners and often same-sex partners. Actually, second marriages tend to be better than first marriages except they are shorter.

There are a host of other issues that contribute to sexual dysfunction. Age differences between partners become more important as a couple ages. Religious and long established ethical constraints prevent people from speaking easily, or considering options in their relationship. See Health & Aging

If you have these problems, you already know there are no simple steps to correcting lifelong attitudes and feelings. However, seeking out corrective emotional experiences can help considerably. Corrective experiences some about from putting yourself into new situations that are emotionally challenging. You can seek out and maintain contact with people who have similar concerns. Begin to explore bringing your problems into conversations with compatible people. You can start a group, or, find one that is already in existence. Whatever level of risk you are willing to take is a good start.

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