Aug 282015
 
Patrick-4

Patrick OConnor

Patrick OConnor would have had on the 25 of September his 90th birthday. Only in a view words I would like to remember him.

He was not tall, but through his mind he was a great person with a lot of talents in very different fields. He had also a lot of problems, beside his illness at the end of days, he had to suffer the loss of his longterm partner Andrew.

Just thinking on him gives me comfort, that I was lucky to get to know such a wonderful and good person – RIP

 

Sep 162013
 

Male sexual functioning

Dr. Olson,

My partner is several years older than I am.  Sometimes I feel like he might not be attracted to me because he doesn’t get an erection every time I rub his penis. 

Unsure

Dear Unsure,

Unless your fifteen years old, most men won’t get an erection every time their penis is touched, no matter how much we enjoy it, and the older you get, the less likely it is.

All men are going to have difficulty from time to time getting erect, but most erectile dysfunction is psychological.  Once a man has had some difficulty, he begins to become an observer rather than a participant in sexual activity.  Instead of enjoying sex for its pleasure, he begins to worry about losing his capacity to function sexually.  “Will I get it up?  Will I maintain it if I do get it up?  Will I be able to get off?”  All of this destroys the pleasure of the event.

Through the years I have treated many men with this problem, but most of the problems could be eliminated if men – young and old — just had a better understanding of normal male sexual functioning.

Masters and Johnson wrote Human Sexual Response following about ten years of laboratory work and building upon the work of Kinsey before them.  They described the stages of human sexual function that revolutionized our understanding of sexual response and erased years of thinking in Freudian terms about “neurosis.”  The stages for men and women are parallel:

  • Stage 1 – Arousal
  • Stage 2 – Plateau (Commonly referred to as “edging”)
  • Stage 3 – Ejaculatory inevitably (A point of no return)
  • Stage 4 – Refractory period/Recovery (The time before one can begin to become aroused and erect again.

Masters and Johnson made what at the time was an astonishing discovery:  Women are capable of multiple orgasms while men typically are not.  The discovery empowered women to take charge of their own sexuality.

Very young men can progress through these stages very quickly and the recovery time is very short.  As one ages, the stages become drawn out.  Older men may be distracted during the “arousal stage,” and it isn’t uncommon for them to lose their erections.  And it usually takes more to get there in the first place, often not only a sexual thought, but also direct physical stimulation.

What often happens is that a man who loses his erection during the arousal phase begins to worry, and worry becomes a tremendous anti-aphrodisiac.  Sometimes the partner recognizes the loss of erection and begins to work harder to force it back, putting pressure on the flaccid man and further complicating the problem.  If a man begins to think, “I really need to become erect again,” you can be fairly certain he won’t.

Masters and Johnson’s revolutionary finding was what was described as “sensate focus exercises.” They found an 80% cure rate for sexual dysfunction using this technique.  Now we jump immediately to Viagra or Cialis (at $30 a pill) for a “guarantee’ that this won’t happen, when what really needs to happen is better communication between the couple.

Sensate focus exercises basically say, “Back off.  Go back to playfulness in love-making.  Make love in slow time.”  In the process what they are doing is to try to get the man out of his state of worrying to focusing just on the pleasure of touch.

Sex can be pleasurable without erections and without ejaculation when seen in a broader context.

Men who understand male sexual functioning can actually see this as an opportunity that comes with aging.  Those who successfully understand this can appreciate sex in a much broader context of romance and cuddling and kissing, slow sex.  Far too many men think that sex is just about chasing ejaculation but sex can be pleasurable without erections and without ejaculation when seen in this broader context.

It is also important to recognize that while older men may have diminished sex drive, erectile function, and ejaculatory volume, studies show that sexual satisfaction can remain high.  In other words a satisfactory sex life for an older man is not contingent upon successful sexual functioning in those first three domains.

So here are my recommendations:

  • Don’t use your partner’s penis as a measure of your self-esteem.  Find more reliable and dependable ways to do that.
  • If he fails to show arousal or loses his erection, don’t push it.  Keep your hands off his penis!  Find other ways to give him physical pleasure.  Use some good lotion and touch him on non-genital areas of his body.
  • Recognize that he may be completely satisfied with your love-making but never be able to “prove” it to you by having a fully erect penis.
  • You can learn from him that slow love-making is ultimately often more gratifying than slam-bam sex.
  • Search the internet for “Sensual Massage and Sensate Focus Exercises”.
  • Talk to each other about sex.  What do you like?  What don’t you like?  What do you want more/less of?  Sex should be about communicating your feelings to one another both physically and verbally, and not a contest to prove you love each other.
  • Don’t depend on a pill to solve the problem.

Loren A. Olson MD

You can read also a very interesting book by Dr Olson “Finally Out”