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.

Since you are obviously very attracted to your other half, the most important thing you can do to sustain an active sex life is to continue to keep yourself in good health. Research by Stacy Tessler Lindau at the University of Chicago, which looked at the relationship between health, ageing and sexual activity, found that by the age of 55, men in very good or excellent health had gained an average of five to seven years of sexually active life over men of a similar age who were in poor or fair health.

Being married to a younger woman is also good for you. Research by Sven Drefahl at the University of Stockholm found that having a younger spouse was very beneficial. Although healthcare support as you age may be one important aspect, Drefahl also found that having a younger wife had positive psychological and sociological benefits for men.

It is also worth remembering that you are not going to grow old unilaterally. As your younger wife climbs on to the hormonal rollercoaster that precedes menopause, you may find that her interest in sex declines, and at a certain point, your appetite for sex may even surpass hers. Tessler Lindau's research found that, overall, older men were much more likely to be sexually active than older women. In people aged 75-85, for example, 39% of men were sexually active compared with 16.8% of women, and 71% of those men reported having a good-quality sex life.

The next five or ten years will present challenges, but being open about problems as they occur gives you the best chance of solving them. You may find that you need to be the one who takes the lead, though. Although women are generally better at seeking medical help, this is not the case when it comes to issues that are specifically to do with sex. Tessler Lindau's study found that women were much less likely than men to have discussed sexual problems with a doctor. Focus on worrying less, talking more, and seeking solutions for sexual difficulties if and when they arise. Age-gap relationships present some challenges, but there is no reason for sex to be one of them.

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