23. Sexual hygiene for older men: Manifestations of sexual aging and avoiding common misconceptions.

Sexual hygiene for elderly men

Signs of male sexual aging

Sexual aging refers to the decline in reproductive capacity and sexual function caused by aging and the aging of reproductive organs, as well as physiological and psychological reasons.

Based on different stages of growth and development, a person's life can be divided into several different periods. Internationally, those over 65 years old are considered to be in the pre-old age stage, while in my country, the modern age division is 45-59 years old for the pre-old age stage and 60-89 years old for the old age stage. With the progress of science, the average lifespan of humans has generally increased.

The decline in male fertility and sexual function does not begin in old age, but rather as early as middle age. However, the decline is very slow and gradual, often going unnoticed until old age.

So, what are the main signs of male sexual aging?

Changes in sex hormones in the body

In men, testosterone levels in the blood generally decrease to below normal after age 55, but the decline is slow, and some testosterone secretion may still occur around age 90.

atrophy of sexual organs

This manifests as a reduction in testicular volume and sperm production. Reports indicate that between the ages of 40 and 50, fructose in semen decreases, while the number of heterosexual sperm increases and their motility weakens. Increased penile fibrosis and vascular sclerosis also occur. Erectile dysfunction in old age is partly due to degenerative changes in the penile veins.

Changes in sexual activity

A man's libido and sexual function can be maintained into old age. Men aged 60-80 can still have normal sexual intercourse. Some cases of erectile dysfunction are caused by psychological factors; some people, consciously or unconsciously, believe they have lost their sexual function as they age. Therefore, the degree and speed of any decline in sexual function in old age are influenced by morphological, physiological, and psychological factors.

The sexual behavior of older men also changes significantly: slowed sexual response, decreased erectile function, erectile dysfunction without preejaculation, short duration of orgasm, only 1-2 strong contractions during ejaculation (compared to 4-6 in younger men), penile flaccidity within seconds after ejaculation, prolonged refractory period between erection and orgasm, ejaculation not always occurring during intercourse, and even in cases of ejaculation, the amount of semen is reduced.

Changes in sexual desire

As people age, the need to express love solely through sexual intercourse diminishes, and mutual caressing and embracing between spouses often play a more important role in the sex lives of older adults.

Avoiding Misconceptions about Sexual Function in the Elderly

In my country, many elderly people aged 50 to 60 are deeply bound by and influenced by outdated ideas, viewing sexual behavior as a shameful and taboo subject. This is especially true after their children grow up, when they feel that marital sexual relations should cease once their children reach adulthood. This leads to psychological resistance, aversion, and feelings of inferiority towards sexual activity. This psychological aversion profoundly affects the sexual behavior of elderly men.

Sexuality has historically been a taboo subject, rarely explored, especially by older men. Even today, many misunderstandings and prejudices persist regarding the sexual abilities and behaviors of older men. Some believe that "sexual function disappears after old age (e.g., after 60), or is extremely weak"; others believe that openly admitting or expressing sexual desire in old age is "improper," as if sexual pleasure is no longer allowed for the elderly; still others believe that engaging in sexual activity in old age will severely deplete one's vitality and is detrimental to health and longevity.

According to survey data, more than half of men over 60 years old still maintain a good sex drive, while the other half experience a decline in sex drive, but only 10% have lost all sex drive. The common belief that older people have lost interest in sex is not true.

As men age, although sperm production and androgen secretion gradually decrease, sperm production does not stop, only the quantity decreases and the frequency of sexual arousal decreases. These changes in sexual function with age are normal physiological phenomena. It is important for older men to understand some basic sexual knowledge, as this is crucial for their physical and mental health and family happiness. Older men should adjust their sexual techniques according to the characteristics of these changes to prevent sexual dysfunction.

In short, older men still have considerable sexual function and sexual desire, and they have every right to enjoy the sex life and sexual pleasures they deserve, just like young people.

Characteristics of sexual life in the elderly

Like other life activities, sexual activity has different characteristics at different ages. Understanding these characteristics is beneficial for harmonizing marital relationships and dispelling unfounded doubts about sexual function.

Due to physiological and sexual aging, older adults experience a decline in both the speed and intensity of their responses to sexual stimulation. This is mainly manifested in the following ways: 1. The time required for penile erection is prolonged. After stimulation, the penis does not immediately become erect but requires a considerable period of stimulation to gradually achieve and maintain an erection. The duration of the erection is also shortened, generally lasting only a few minutes. This phenomenon is normal and nothing to worry about. 2. The rigidity of the erection decreases; it is often hard but not firm. 3. Pre-ejaculate secretions decrease, and ejaculation does not necessarily occur with every sexual encounter. In cases where ejaculation does occur, the semen volume is reduced, ejaculation feels weak, pleasure is diminished or blurred, and the rhythmic contractions are not clearly felt. The penis becomes flaccid within seconds after ejaculation.

The direct cause of male sexual desire is the presence of androgens secreted by the testes. However, the arousal of sexual desire is extremely complex, involving many conditioned and unconditioned reflexes. For example, appropriate stimulation of the genitals, stimulation of erogenous zones, and visual, olfactory, auditory, and even sexual thoughts can all trigger sexual desire. As people age, the secretion of sex hormones decreases, reducing the direct causes of sexual desire, thus a decline in libido is inevitable. However, in addition to physiological factors, human sexual activity is also significantly influenced by mental, psychological, and social factors, which is the biggest difference between humans and animals in sexual activity. Married elderly men have decades of sexual experience; due to accumulated experience, their sexual desire and function do not decline as drastically as commonly imagined. Moreover, the decline in sex hormones in elderly men is very slow and balanced.

Sexual arousal in the elderly differs from that in youth. Young people have stronger sexual desires, often triggered by mere imagination or visual, olfactory, and auditory stimuli. However, with age, this ability gradually declines and disappears imperceptibly. Indirect stimulation no longer arouses sexual desire; instead, full-body caresses and direct stimulation of the genitals are necessary to induce an erection. The desire for skin-to-skin contact tends to increase in the elderly, possibly as a compensatory mechanism for reduced sexual activity.

Therefore, older men should strengthen their preparations before sexual intercourse, including mutual caressing and stimulation of the genital area, which can help satisfy their sexual desire to a certain extent. Mutual caressing and embracing between spouses often play a more important role in the sexual experience of older men.