Savage Love: Unplugged - Dan Savage is frequently interesting and enlightening, and here's discussion on how to (and how not to) introduce the idea of male butt-play to your wife. Useful if you (like redacted earlier) were feeling stressed and needed some intimate massages downstairs.

Although, as I've been enjoying Dan's column for 10 years now (fnarrr...), the surprise for me was the 50yo guy still having sex twice every week after 15 years and kids!

Latest advice from the good doctor ...

Vacuum Erection Devices: What You Should Know

I remember seeing adverts for these things in the back pages of Razzle back in the '80s ... well, wadda ya know ... sounds like they actually work! So if you need a simple method to give yourself a lift on your birthday, this should definitely be your first port of call, before popping blue pills or injecting directly into your old man!

If you're new to this thread, have a look around the doctor's blog for some interesting and informative articles, and start here >> What To Expect of Your Erections As You Age…20’s, 30’s, 40’s and Beyond

Another excellent article this week, from the good dick doc -

Bouncing Balls: Understanding Positional Changes of Your Testes - A complaint voiced frequently by my middle-aged patients is that their testicles hang loosely ...

The first time I heard about this phenomenon was actually by comedian Joan Rivers making reference to guys over the age of 50! And yep, sure enough ... yet another thing added to our 'male menopause' list !

Man Kegels: What You Don’t Know (But Should) - including a gym-style workout routine. These really aren't talked about enough ... If you (occasionally) experience urinary post-void dribbling, weak ejaculations or erectile dysfunction, then your pelvic floor muscles need strengthening.

Exercising your Pelvic Floor Muscles (PFM) = Functional Fitness, for improved:

• Urinary control (improve incontinence issues and dribbling)
• Sexual performance (rigidity, durability, control)
• Bowel control

You 2 are both fitter than me and (a bit) older - I need to up my game ... and my kegels!

I'm an avid Dan Savage follower, and this recent reader 'letter' fits well here ...

I have a piece of advice I'd like to share with your readers. I'm a 56-year-old gay man. From my 20s though my 40s, I was as sexually active as often as it was possible for me to be. I loved sex and sought it every chance I got. It made me feel alive!

Then just as I was about to enter my 50s, I started to have erection problems. I could still come, but a spongy dick is ego-deflating. Not wanting to accept what was going on, I talked to my doctor about it. I've tried Levitra, Cialis and now Viagra, as well as a host of cock rings. Not much of anything seems to help. I miss my sex life, and I miss the confidence that came with it. I didn't expect this, nor did I plan for it. It’s a lonely feeling.

That's why I think it's important for your readers to understand the following: Have all the sex you want and that you can while you can (so long as you’re not hurting anyone or putting anyone at risk). Don't put those sexual fantasies on the back burner. Don't stay in a relationship that stifles you sexually! You owe it to yourself to experience what you want to experience today. Don’t take tomorrow for granted as tomorrow might have something else in store for you.

Take home: this happened in his late 40s, ED meds didn't help, and it certainly wasn't a case of: use it or lose it (as he was, and he still did).

There was also a Guardian letter yesterday >> My husband and I haven’t had sex for 10 years. Can we start again?

I am 60, and my husband is 62. We have not had sex for nearly 10 years and my husband states that he can’t see us ever having a sex life again. Is it possible for a man who has completely lost his sex drive to rediscover it?
>> sometimes men stop wanting to have sex because they are experiencing a problem such as erectile dysfunction ... caused by solvable psychological issues – depression, stress ... or an undiagnosed medical condition.

I think much more emphasis needs to be placed on cardio-vascular issues. Erectile dysfunction acts as a canary-in-the coalmine, and should really be included as part of the standard male health checkup.

Erectile dysfunction in bed ? Do you still get overnight erections and morning wood?
Yes, then your cardio is OK (work on psychology, go slow, set the scene, don't stress over not always achieving orgasm).
No, then it's a cardio warning (increase exercise and eat healthy).

For me, there were definite changes over 1-2 years, in my early 50s. The spontaneous daytime wood and occasional wet dreams continued annoyingly throughout my 40s, whereas now I don't usually wake with morning glory, and I'm certainly no longer drilling holes in any mattress.

Ignoring the ridiculous x3/day teenage years, following the 'new relationship energy' stages, my libido would happily settle around the x3/week mark, for decades, whereas nowadays I'm definitely at the x3/month stage (much to mrs driver's relief!).

During a 1-hour session even in my late 40s, it was always Thor's hammer from the first kiss to the wash, whereas nowadays there's definite waxing-and waning that wouldn't even support a bath towel.

Sex and the Middle-Aged Male - The Natural Physiology of Male Sexual Function with Aging

the facts and fiction of erectile dysfunction
Myth: Erectile Dysfunction Only Happens After a Certain Age
Myth: Erectile Dysfunction Is Always Psychological
Myth: Erectile Dysfunction Can Only Be Treated By Viagra
(these will be good SEO for Google!)

I’ve only just read this post, very honest, I can totally relate too. I thought mine was down to stress caused by personal issues like being cheated on and divorce etc. Nice to read I’m not alone.

You are lucky that you have a wife/partner to have gone through this with. As a single man in his late 50’s meeting a new partner is now fraught with difficulties and worry about whether everything works without chemical help.

A lot of women aren’t very understanding...I suggested Viagra to one lady who took massive offence that being with her wasn’t sufficient to get things working and no amount of telling her it’s a natural thing for men of my age on occasions to have issues would calm her down.

Another lady I met online still had the libido of a teenager which was great but the pressure to keep up was enormous and after many barren years nursing my late girlfriend through cancer it was all too much and I sadly had to say goodbye to her.

I know in a later post you said you wouldn’t take Viagra but as a single guy who wants to make an impression on a new partner it’s almost essential, as it’s not an easy conversation to have early on in a new relationship.?

Yes, us men really should be talking more about these things, hence the thread. ?

Thanks for your honesty too, and a shame you've been meeting less than understanding women. With Viagra so often mentioned in popular conversation, it's weird that women don't expect to meet any men who take it ? Maybe it's this - women remember "new relationship energy" with their ex-husband, have kids, then libido slides, divorce in their 40s. Then they kinda expect new relationships to be as 'perky' as when they were dating in their 20s.

From what you said, makes me wonder how many men must pop a blue pill on their date (in the off-chance) and the women have no clue, especially in the early months. It's easy to nip to the loo early in the evening, and swallow a Viagra.

But having said all that, I do understand how some women do not feel attractive/sexy enough if they can't get their man hard (or to finish). That seems to be a common issue, but from the man's side we know it's nothing to do with their sexiness. Again, if they are thinking back to the men in their 20s who never had this problem, they can easily think the issue is now theirs due to their appearance. Especially so if they are venturing out into the dating world after a decade (?) in a sexless marriage, and are raring to go again, to prove to the world.

I'm sure there are many women dating who are less bothered about the physical side of a relationship. Things change a lot for women after menopause (that's for another thread!) and many women say they are happy with a cuddle and a cuppa. And whilst penis-in-vagina sex is great, it's not the be-all/end-all, with most women unable to orgasm from it alone, and of course the availability/usage of sex toys is so much more common these days (we even started with them in our 50s!)

For me, there's definitely no stress or performance anxiety with my wife of several decades. And weird how quickly things did change over 1-2 years. I eat healthy and sleep well, am not overweight and have normal BP/cholesterol, but I don't exercise as much as I should, especially during lockdown (although my changes happened before then). So many people these days are overweight - overall body fitness has a huge bearing, so jogging (and walking quickly) will be a big cardio help. And when you add in all the men on anti-depressants, it's a wonder that anyone over 40 can still get it up at all!

Out of interest ... Prescriptions for sildenafil (commonly sold as Viagra) >>

• 2004 = 1.0 million
• 2006 = 1.0 million
• 2013 = 1.4 million
• 2014 = 1.7 million
• 2016 = 2.9 million

So assuming 2 prescriptions would on average give enough tabs for the year (?) that's well over a million men taking it regularly. Likely, most of these men are 40+, so it's a significant % of older men.

Yes mate we should be talking more about it, but it’s not the sort of thing you discuss with mates at the pub or work is it? I worked in an all male environment for years and we were all roughly the same age...there was always the one bloke who boasted of his prowess and staying power and conquests and that makes it awkward to say anything different...

The lady I met was exactly as you described...she had been in a sexless marriage and when she came out of it discovered sex toys and online porn etc I would go to hers on a Saturday afternoon and she would be expecting 2-3 times before bed, again at bed time, during the night (if we woke up) and once or twice Sunday morning ? I would go home like a dried out husk and always felt huge pressure to try and perform, it was a new relationship and therefore not easy to discuss, and as blokes don’t talk about it you think everyone else can still carry on like that. In the end, she wasn’t getting what she wanted from me and I was feeling under too much pressure from her (I started making excuses not to see her) and things ended ? I did meet her afterwards and we talked it all through, which is what we should have done earlier.. I’ve heard from her again recently and the menopause has hit and she isn’t interested in that side at all now. Makes me wonder if it was all a pre menopause thing anyway.

As for Viagra...I did used to sneak some with me when I went to see her, I found even a small amount did the job, but after previous experiences I was embarrassed to tell her. I’m not overly keen on the side effects with a full or even half tablet so tended to quarter one.

Holy crap, I'm not sure I was up to that level of performance at my peak decades ago let alone recently!!

I really like the honesty and openness in this thread, thanks for sharing guys ?

After 30 years of marriage, I started having difficulties about a year ago with maintaining an erection and finishing during sex. I tried viagra (well not viagra actually, can't remember which one) but that didn't help that much. I ended up seeing a therapist for about 10 sessions over the summer where we talked through lots of stuff.

He recommended reading this book ("Coping with Erectile Dysfunction: How to Regain Confidence and Enjoy Great Sex: How to Regain Confidence & Enjoy Great Sex") which I found very interesting and helpful.

Other than my age (55), there seems to be a strong psychological element for me with me getting worried that I wouldn't be able to finish which became a self-fulfilling prophecy. I started practicing mindfulness and a bit of meditation which helped. I have a level of performance back now but I'm not back to how I was over a year ago which is disappointing.

I don’t know how I managed it either. As a young 20 year old no problem but at 59 no way without chemical assistance.

I think a huge amount of it is psychological The more you worry the worse the problem. I was getting really frustrated with starting ok and losing my erection mid session. (Why? Never happened when I was younger) and as you say it becomes a self fulfilling prophecy and even if you are in the moment and not thinking about it there is probably a tiny section at the back of your mind worrying away and that bit often wins.

I do find that viagra, or even a small amount does help...a whole tablet and the side effects can be quite painful and also very obvious afterwards, so no hiding the you have taken one! If you found viagra doesn’t work, try some different ones, there are plenty available to try and different strengths from the 2.5mg daily maintenance dose (minimal side effects) to the 10mg glass cutter strength.

I tried taking to my GP who just told me to go home and relax and all would be ok. Then tried again with a female locum GP who was fantastic and recommended trying viagra, her theory was that if you used it and it worked then you gradually lessen the amount and your body gets it’s act together and eventually you can maintain an erection without assistance. It kind of worked but I think you need to be in a regular relationship without any performance/size/staying power worrries of a new relationship.

At my age now that’s the awkward part of meeting someone...that first time and if things don’t work will she be offended and worried it’s her...and also women tell their mates everything so you know it will be everywhere!

I’ll look at that book, but might not buy it on Amazon as occasionally my Mum uses my account to buy some bits!

Yes, I'd say that's exceptional ? ... new relationship energy levels for your 20s. You did great ! ?I can't imagine there are that many women who are that horny (... or maybe I'm just refusing to imagine !) With internet dating, you can lay all that out with text (and voice) chats before you even meet, to make sure you're both on the same page.

At any age, 3 times/day max has been plenty for me - not that I couldn't manage more, but it starts to feel much less enjoyable. I've always preferred alternate days, even in the early months, which gives me best physical enjoyment out of each session. I'd say that my dick muscle actually aches, and I've never enjoyed morning sex as much at all (for some reason).

And lets not forget all the friction ... didn't you get sore? Or were you using plenty lube? At x3/day, (or even a long session) we both get those tiny 'splits' in the skin that sting when you wash with soap!

I tried Viagra ... but that didn't help that much ... psychological, getting worried that I wouldn't be able to finish, which became a self-fulfilling prophecy. I have a level of performance back now but I'm not back to how I was over a year ago which is disappointing.

Welcome to the group, we're all friends here. ?

Interesting that your experiences with Viagra (or equivalent) are so much different. I do remember reading that while Viagra can make you hard, it doesn't actually make you horny of course, so there are several mechanisms at play.
Try not to be disappointed, as it's great that you've regained some of your former glory. It would be interesting to see if a few months of cardio (jog/cycle) would help a bit more, along with a healthier diet shift (more fruit & veg, zero fried).

Prostate Enlargement Demystified - another great article from the good dick doc, with discussion of milder symptoms not often detailed online. Thankfully, I'm still at the low end of the enlargement symptoms, and still don't need to get up in the night to pee. Hopefully I can maintain this level for another decade!

More Than an Apple a Day: Preventing the Most Common Diseases - excellent 1 hour video lecture on eating healthy to reduce disease. There's also a full text transcript (7500 words) with relevance to this thread >>

Erectile dysfunction is present in up to 30 million men in the U.S., and approximately 100 million men worldwide.

Who cares, though? We’ve got Viagra. The problem is, pills just cover up the symptoms of vascular disease, and don’t do anything for the underlying pathology. Erectile dysfunction and coronary artery disease can be thought of as two manifestations of the same disease—inflamed, clogged, and crippled arteries.

In fact, 40% of men over 40 have erectile dysfunction. Placing them at nearly 50 times the risk of having a cardiac event, like sudden death. Nearly a 5,000% increase in risk!

We used to think of erectile dysfunction in younger men (20s-30s) as ... psychological ... But, now were realizing it’s the early signs of vascular disease. A man with erectile dysfunction (even if they have no cardiac symptoms) should be considered a cardiac patient, until proved otherwise.

The reason even young men should care about their cholesterol level is that hardening of the arteries can lead to softening of the penis later in life. Your cholesterol level in your 20s-30s can predict your sexual functioning later in life.

... Viagra affects an enzyme in two places in the body: the erectile tissue of the penis, and the retinas of the eyes. If you experience sudden loss of vision, the advice is to stop taking Viagra and call a doctor ... (if you can still find your phone!)

The take-home message is a simple equation: ED stands for early death. It’s survival of the firmest.

Latest from the good dick doc -

What You Don’t Know About Testosterone (But Should) - and more about Testosterone Levels.

Can be, although personally I stop drinking water about 1.5hrs before bedtime, so for me that's fairly consistent.

I also usually avoid all caffeine after about 5pm, as this can have an effect too - caffeine is a diuretic of course, and also apparently has a long half-life (so remains in the body for hours).

I only drink coffee in the morning and certainly have to go more often than drinking water/coke etc

I scored 4. Thankfully my bladder's fine, had a wee test last year.

Today I was at Royal Papworth hospital talking to two heart surgeons about how they were going to sort out my hypertrophic cardiomyopathy (HCM). Looks like open heart surgery in 3 to 6 months.

Had my first real head cold of the last few years and boy I don't miss them at all. Started feeling poorly last Thursday and over the weekend and now the body is trying to expel the phlegm and I've been racked with coughing which is giving me headaches and draining all energy. Luckily I'm able to work from home, so can keep on with editing and Teams meetings. Did a couple of COVID tests and both came back negative, so there's that. Always hearing people coughing and sniffing in the street and in shops and I always mask up, but it was bound to happen sometime.

Yes! So many people with colds and flu-y symptoms these last few months.

Myself included, with an ear infection (blocked Eustacian tube), sinus discomfort, 'scratchy' throat, and the occasional massive sneeze! ? The weirdest symptom was a sort of dull headache that ... get this ... seemed to extend down into my upper chest! ? Weird!

I honestly think I've had more days feeling 'off' in the last 3 years than the previous 30 combined!

I had a doozy of a chest infection over Xmas that took ages to clear up. My mum had one too, and she's quite advanced in years. In fact the first long lockdown was very good for her - she's quite prone to chest infections, getting them regularly, and when covid kept us all indoors she didn't cough for a year. She felt great, and as soon as social distancing limits shrank she started again. My recent one was also very painful because whenever I coughed my left thigh bleeding well HURT; the worst pain I've known since I had an infected foot in the early 80s. I'm assuming it was a nerve thing, but I worry when it twinges occasionally. Also since about Xmas I've been pestered with what I'm assuming is tinnitus, a high-pitched electronic whine that has been constant. Not at a level to really annoy me, but I'm on a waiting list to have my hearing checked.