Part 2: Proper Maintenance of Sexual Life and Sexual Function in Middle-Aged and Elderly Men
II. Changes in the Sexual Life of Middle-Aged and Elderly Men
Since middle-aged and elderly men experience a decline in sexual function due to aging, their sex lives will inevitably undergo corresponding changes, mainly in terms of frequency of intercourse, penile erection, and duration of intercourse.
1. Changes in the frequency of sexual intercourse
During one's prime years, sexual intercourse is more frequent. As one ages, testosterone secretion gradually decreases, libido gradually weakens, and the average number of sexual encounters per month gradually decreases. Of course, although testosterone secretion decreases significantly after age 60, some people still have a relatively high frequency of sexual intercourse.
This is because testosterone is an important factor influencing libido, but it is not the only factor; mental and psychological factors also play an important role in sexual function. In their past sexual experiences, various neural reflex connections have been established, and under appropriate sexual stimulation, a series of physiological reactions and changes can still occur during the sexual response cycle.
The following table, excerpted from "Practical and Concise Andrology," details the relationship between age and frequency of sexual intercourse (see Table 2).
Relationship between age and monthly frequency of sexual intercourse (number of times and percentage)
Age: 20-, <1 time 0, 1 time 0, 2 times 6, 3-4 times 11, 5-6 times 49, 7-8 times 34, 9-10 times 115, 11-15 times 64, 16-20 times 63, 21-25 times 33, >25 times 42, Total 417
30-, <1 time 0, 1 time 0, 2 times 6, 3-4 times 20, 5-6 times 66, 7-8 times 42, 9-10 times 130, 11-15 times 71, 16-20 times 69, 21-25 times 31, >25 times 22, Total 457
40-, <1 time 3, 1 time 3, 2 times 13, 3-4 times 50, 5-6 times 99, 7-8 times 46, 9-10 times 127, 11-15 times 65, 16-20 times 34, 21-25 times 12, >25 times 10, Total 462
50-, <1 time 9, 1 time 27, 2 times 60, 3-4 times 109, 5-6 times 123, 7-8 times 31, 9-10 times 52, 11-15 times 8, 16-20 times 4, 21-25 times 4, >25 times 4, Total 431
60-, <1 time 53, 1 time 59, 2 times 104, 3-4 times 61, 5-6 times 23, 7-8 times 8, 9-10 times 4, 11-15 times 2, 16-20 times 0, 21-25 times 0, >25 times 0, Total 314
70-, <1 time 15, 1 time 16, 2 times 14, 3-4 times 7, 5-6 times 2, 7-8 times 1, 9-10 times 0, 11-15 times 0, 16-20 times 0, 21-25 times 0, >25 times 0, Total 55
80---, <1 time 4, 1 time 2, 2 times 0, 3-4 times 0, 5-6 times 0, 7-8 times 0, 9-10 times 0, 11-15 times 0, 16-20 times 0, 21-25 times 0, >25 times 0, Total 6
Total visits: <1 visit 84, 1 visit 107, 2 visits 203, 3-4 visits 258, 5-6 visits 362, 7-8 visits 162, 9-10 visits 428, 11-15 visits 210, 16-20 visits 170, 21-25 visits 80, >25 visits 78, Total 2142
2. Changes in penile erection
As men age, the degree of penile erection gradually weakens. Japanese scholars reported that 86% of men aged 60-64 have penile erections, 72% of those aged 65-69, 64% of those aged 70-74, 58% of those aged 75-79, and only 40% of those over 80 years old have erections.
3. Changes in the duration of intercourse
As men age, the duration of intercourse in most middle-aged and elderly men gradually shortens. However, some scholars have summarized the changes in the duration of male intercourse into four types through surveys: (1) the duration of intercourse gradually increases with age; (2) the duration of intercourse gradually decreases with age; (3) the duration of intercourse gradually increases in youth, and then gradually decreases in middle and old age; (4) the duration of intercourse does not change significantly throughout life.
The following table, excerpted from "Practical Concise Andrology," details the relationship between age and duration of intercourse (see Table 3).
Relationship between age and duration of sexual intercourse (minutes) (number of times)
Age: 20-, <4 points 9, 4-6 points 83, 7-10 points 98, 11-15 points 52, 16-20 points 87, 21-30 points 36, 31-60 points 45, >60 points 19, Total 432
30-, <4 points 10, 4-6 points 81, 7-10 points 104, 11-15 points 64, 16-20 points 98, 21-30 points 36, 31-60 points 47, >60 points 28, Total 472
40-, <4 points 12, 4-6 points 77, 7-10 points 103, 11-15 points 64, 16-20 points 91, 21-30 points 45, 31-60 points 47, >60 points 26, Total 469
50-, <4 points 14, 4-6 points 104, 7-10 points 88, 11-15 points 40, 16-20 points 89, 21-30 points 39, 31-60 points 43, >60 points 43, Total 464
60-, <4 points 18, 4-6 points 89, 7-10 points 60, 11-15 points 28, 16-20 points 66, 21-30 points 33, 31-60 points 24, >60 points 19, Total 341
70-, <4 points 6, 4-6 points 8, 7-10 points 4, 11-15 points 4, 16-20 points 13, 21-30 points 7, 31-60 points 6, >60 points 7, Total 55
80-, <4 points 1, 4-6 points 0, 7-10 points 3, 11-15 points 1, 16-20 points 1, 21-30 points 0, 31-60 points 0, >60 points 0, Total 6
Total number of visits: <4 minutes 70, 4-6 minutes 442, 7-10 minutes 460, 11-15 minutes 253, 16-20 minutes 445, 21-30 minutes 196, 31-60 minutes 212, >60 minutes 142, Total 2239
III. Approaching the Sexual Life of Middle-Aged and Elderly People Correctly
How long can a man maintain his sexual function? Research shows that most men under 80 years old still have the ability to have sex. The authors of *Practical Concise Andrology* report data from a Chinese survey, indicating that 80% of men under 69 years old still have the ability to have sex, and 70% of men under 79 years old still have the ability to have sex.
The Kinsey Report, based on data from a US survey, found that only 5% of men over 60 were completely unable to have sexual intercourse, and only 30% of men over 70 were completely unable to. The Kaneko Eiju Report, based on data from a Japanese survey, found that only 12.8% of men aged 65 to 80 were unable to have sexual intercourse. Chinese scholars, through histological examination of the testes of elderly men, found that the testes of men over 70 still had spermatogenic function, and the interstitial cells showed no significant abnormalities.
Therefore, there is a medical basis for the fact that most people under 80 years old still have the ability to have sexual intercourse. In fact, in longevity regions of the world, it is not uncommon to see centenarians impregnating women, and there are even cases of 120-year-old men who can still have children, demonstrating that the potential of human sexual ability is quite considerable.
However, with age, the sexual function of middle-aged and elderly people gradually declines. For example, there are greater physiological fluctuations in sexual function, decreased libido, weakened erectile function, reduced frequency of intercourse, reduced ejaculation volume, and prolonged refractory period, etc.
It's important to have a correct understanding of these physiological phenomena to avoid mistakenly believing one has erectile dysfunction, causing anxiety, or even leading to a loss of motivation and the development of sexual dysfunction. The spouses of middle-aged and elderly men must also understand these natural changes during their husbands' aging process and provide positive support to ensure a more harmonious sex life.
For age-related diseases that can lead to erectile dysfunction, such as arteriosclerosis, hypertension, diabetes, neurasthenia, emphysema, chronic renal failure, menopausal syndrome, etc., active prevention and treatment should be carried out. For drugs that can reduce sexual function, such as antihypertensive drugs, antipsychotic drugs, sedative-hypnotics, antiandrogens, etc., their use should be avoided as much as possible, especially long-term use is not advisable.
It is important to emphasize that the most significant change in sexual function among middle-aged and elderly individuals is that prolonged avoidance of sexual activity will cause serious damage to sexual ability. This is known as disuse atrophy of sexual function. While this basic principle of disuse atrophy exists in many physiological functions of the human body, it is particularly pronounced in the sexual function of middle-aged and elderly individuals.
A middle-aged or elderly man who has not had sexual intercourse for a long time often finds that his penis cannot achieve an erection when he attempts to resume sexual activity. Similarly, middle-aged or elderly women who have not had sexual intercourse experience greater vaginal atrophy than women of the same age who are still sexually active.
Therefore, for middle-aged and elderly people, the emphasis should be on normal sexual activity, that is, having sex regularly over a long period of time, rather than abstaining from sex for an extended period. In daily life, the wife's misconception that she should no longer have sex due to old age, or the hormonal changes after menopause leading to sexual apathy or aversion, often affect the couple's normal sexual life.
Therefore, scientific principles should be explained to middle-aged and elderly couples to help them break free from the constraints of traditional ideas and establish scientific sexual concepts. For women experiencing vaginal dryness and difficulty with intercourse after menopause, oral estrogen or topical ointments can be used to improve vaginal lubrication.
Studies have shown that men with robust physical constitutions have better libido and sexual function than those with weak constitutions, highlighting the importance of overall health for maintaining sexual function in middle-aged and elderly men. Therefore, it is essential to strive for emotional stability, a regular lifestyle, sufficient sleep, proper nutrition, and consistent exercise.
At the same time, appropriate vitamin supplements can be taken, such as vitamin B₁₂ which helps maintain penile erection, and vitamin E which helps maintain the physiological function of the gonads. Taking these measures can not only maintain the physical health of middle-aged and elderly people, but also maintain good sexual function into old age.