Sex File: Will I be able to satisfy her as I get older? 

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Q. My wife is 15 years younger than me. We stay fit together and have always had an active sex life. Now I am in my late 60s I am concerned that my libido is going to decline and that I won't be able to satisfy her. Am I right to worry?

A. I suspect that you may be confusing libido with sexual function. It is a common error. Libido describes your appetite for sex, whereas sexual function is your capacity to get and maintain an erection. If you remain in good health and you continue to be attracted to your wife, your libido will not decline, although your level of sexual function might. After the age of 40, a lot of men begin to notice that they are not quite as firm as they once were. It is a very common problem, and the risk increases incrementally with age. The Massachusetts Male Aging Study found that roughly 50% of men at 50 years old were affected by some form of erectile dysfunction, increasing to 70% by the age of 70. In the past, septuagenarians didn't necessarily have high expectations, but the arrival of PDE5 inhibitors such as Viagra, Cialis and Levitra have raised the bar.