It's very desirable from a psychological and social point of view to keep healthy people, regardless of their age, happily and effectively making love. There should be no age turnoff for sex; you should be able to keep on having responsive intercourse as long as you can find somebody to do it with you. This is true whether you are in a long term relationship or not.
When a couple presents a complaint of middle-aged sexual letdown, a series of questions designed to illuminate the situation includes:
Sex is not a youthful prerogative. Males and females often turn off sex after fifty because they've been "told", implicitly or explicitly, to do so: a terrible, tragic waste. Panic, apparently, is what ends sex at middle age. Especially for men. The sexual response changes. A man finds out he can't do at 60 what he was doing at 30. So he thinks, "I'm finished!" He quits. When, actually, sexual experiences that can be just as good or better, if perhaps a little different, are awaiting him. Sure, you can't run down the road at 60 as fast as you can at 30. But you can take more time to observe the wildflowers and get to know more about them. What difference does it make, after all, if it takes you 30 seconds or three minutes to get a sensual reaction to a sexual overture?
For the aging male in addition to slower reaction time, there will be other changes. The drops of pre-ejaculatory fluid that appear at the tips of the eager penises of younger men may be absent. The older man can often maintain an erection after penetration and continue to thrust for much longer periods of time than younger men. Many a middle-aged woman is astonished to find herself at, say, 46, multi-orgasmic because her older partner keeps at it for such a long time. The ejaculation, when it does occur, is likely to have less seminal fluid than that of a younger man. If the older man is married to a younger woman who wishes to have children, this factor must be taken into consideration. The orgasm of the older male is usually of shorter duration (while the older woman's orgasm may be much extended). Sometimes he doesn't get that early-warning reaction, but ejaculates suddenly and unexpectedly.
This may be due to low testosterone production or to a long period spent with the penis in the vagina. Masters and Johnson vigorously opposed stopwatch sex, nevertheless offered clinical details such as, in the aging male, the expulsive contractions of the penile urethra are at 0.8-second intervals, and the aging man can only cast his seminal fluid from three to 12 inches. The older man may also get a rapid relapse in his erection - often within a few seconds. And he can't usually achieve a second erection, intromission, and ejaculate the way he could when he was twenty years old.
Both the aging male and his partner were counseled to recognize that these are variants which occur with maturity and are not to be thought of as failures. Unfortunately what happens is that when an aging man finds his flaccid penis slipping out of the vagina immediately after ejaculation he worries: "I'm getting to where I can't do it the way I used to! Maybe the next time I won't be able to do it at all." If he worries often enough, his fears may come true. Wives, equally worried, can also ruin the aging sex scene. They may get very upset if their husbands don't ejaculate at every session of lovemaking.
Masters and Johnson and later sex researchers and counselors reassured - and continue to do so - worried partners that a man doesn't necessarily have to ejaculate every time he has intercourse. For an aging man, three or four sexual experiences may be required for one ejaculation. The male should feel free to "ejaculate on his demand schedule", and with that kind of understanding, a healthy married couple should be able to function sexually well into the 80 year age group. Although it may be a little difficult to think about a couple - male age 66 and female age 62 - coming into therapy for sex failure, it is indisputably their right to be concerned. Masters and Johnson detailed such a case: Mr. and Mrs. A. had been married 39 years.
They had three children, the youngest 23 years old. All of the children were married and living away from home. They said they'd had a good sex life with both of them regularly orgasmic until they saved up their money and took a trip abroad. Many young couples report that their high moments of sexual encounter took place abroad or on a vacation when they were separated from domestic and job-holding responsibilities. For this aging couple, however, the rigidly scheduled pace of their vacation in Europe, far from turning them on, knocked them out. Racing from sightseeing bus to funicular railway to train to airplane and bedding down every few nights in a different hotel or inn completely exhausted the couple and disrupted their ordinary sex habits.
Mr. A. found he was in trouble. He took longer and longer to achieve an erection and, just before they returned home, he found he couldn't do it at all. He went to his doctor who pointed out that after all he was in his sixties and there was nothing that could be done. The couple, as Masters and Johnson put it, "accepted their fate." For four years. Then they got themselves referred to the Foundation, and shortly afterwards their sexual competence returned. Now at late 60 and early 70 they have intercourse once or twice a week. What's the lesson? To resist those travel posters if you're over 65? No. Just get educated as to what to expect from sex if you're over 65.
The trauma of Mr. A's sudden sexual changeover could happen to a much younger man. It's just that aging men - and their aging wives - are more prone to this kind of panic. The panic knocks them out and it's hard to recover both confidence and competence. Older couples just don't accept what other authorities have told them - that sex ends at female menopause. But some do, of course.
Masters and Johnson detailed a wry case history that involved a woman patient who was non-orgasmic until she was in her mid-fifties. This woman married at age 30 and had three sons and a daughter but she was never fully orgasmic. She reached the plateau level of sexual excitement but could never really make it to orgasm. Otherwise she and her husband were happy and compatible. They consulted different sex experts to no avail and finally signed themselves to making the best of it. Then one of their sons got married. Observing the powerful physical attraction between their son and his bride, they decided to get help. Their problem was easily resolved.
The wife reached orgasm from masturbation and went on, from there to good sexual responsiveness with her husband. Meanwhile he learned something about ejaculatory control. They were sent for therapy by their doctor. They had wasted nearly quarter of a century.
Another aging woman patient gave this history: She was brought up in an all-woman family. The father had separated from the mother at an early age. The embittered mother told her three daughters all men were "no-good". The younger daughter - who eventually became the Masters and Johnson client - married a kind, decent guy and had two sons. Her husband was the only man she had ever dated socially. When the second son married and "emptied out" the home, the wife told her husband she was through with sex and requested separate rooms.
The husband's doctor, however, persuaded the wife to accompany the husband in therapy. The physician told the wife that her husband's mental and physical health was at stake. The wife came into the Foundation angry, distrustful, and not very cooperative. To her own amazement she soon began to understand the information, to perform in therapy, and very soon became fully responsive sexually. She was 57 years old and her husband 63. It has been said that the sexual problem of an aging man is the fear that he can't do it - however, of course he may find he suddenly knows how to last longer in bed, which is an added bonus - and the sexual problem of an aging woman is the feeling that she shouldn't do it. Oddly enough these fears and taboos are reinforced by the attitude of the younger generation - that enlightened group in their teens and twenties who have firmly claimed sexually active freedom for themselves, but deny it to their parents and grandparents.
The idea that the postmenopausal woman can't maintain a high sex reaction level is a folk taboo. Mark Twain, in his earthy Letters from the Earth, compared man to the candle and woman to the candlestick. He said that although the candle burns down and droops, the candlestick never loses its readiness for receptivity. But like the response of the aging male, the receptive aging woman comes on a little more slowly. The older woman's vaginal lubrication may take four or five minutes to develop, while ten or fifteen years ago she might have been ready for penetration in fifteen seconds.
In their chapter on the aging woman Masters and Johnson made the fascinating statement that the vagina is a potential rather than actual space. What they mean is that it's deflated and has the potential to expand large enough to accommodate a baby's head or the largest penis. When a young woman is sexually stimulated, her vagina promptly expands to accommodate the penis. The vagina of an older woman becomes smaller and less elastic and may take a little longer to contain the penis. The inside walls of a young woman's vagina are corrugated like a tin roof; the inside walls of an older woman's vagina become thin and smooth.
There is a slight reduction in the size of the clitoris but it responds in exactly the same way as in a younger woman. Women aged 50 to 70 years report that their orgasms change. They have four or five such contractions at orgasm rather than the eight to twelve reported by orgasmic younger women. Some older women report severe pain in orgasm. Sometimes it's said to be in the lower abdomen or it zooms down the whole length of the vaginal barrel, into the vulva and even down one or both legs. It's called a uterine spasm and apparently many cases can be helped by hormone replacement therapy.
Hormone replacement therapy may well be helpful in supporting or repairing dysfunction of the aging vagina. Irritability and pain in the bladder and urethra are a common problem with menopausal women, and there is an immediate - sometimes inconvenient - need to urinate directly after coitus. Some women have unhappily told about helplessly voiding while enjoying sex. Hormones also aid the aging woman who notices a change in the tissue structure over her mons, or pelvic arch. It gets soft and flabby. It has nothing to do with how she diets or exercises. The administration of sex hormones helps many women to return to a more active sex life. But what also seems clear is that regular sexual activity - with or without a partner - keeps up the production of natural hormones. It seems that older people are progressively becoming more uninhibited and more proficient at sex and that we're enjoying it more.