Posts Tagged ‘erectile dysfunction’
Adult Sex Ed Month: HuffingtonPostLive, AASECT conference, and a new senior sex book
June has been declared Adult Sex Ed Month (#AdultSexEdMonth) by Ms. Quote(@GoodDirtyWoman on Twitter) who blogs at A Good Woman’s Dirty Mind. This idea caught on, and this month, hundreds of posts designated #AdultSexEdMonth from sex educators and bloggers appeared all over the Internet. View the list with links here.
In my world — advocating for senior sex and educating about older-age sexuality — every month is Adult Sex Ed Month. This month has been particularly fruitful.
This month, I participated in a Huffington Post Live event titled “How Old Is Too Old To Have Sex?” with fellow panelists Ashton Applewhite, Walker Thornton, Sidney Schwab, and Ken Solin, hosted by Abby Huntsman. Of course the answer to the question in the title is obvious to us (though not obvious to Abby, until we raised her consciousness), but you’ll find the discussion interesting even though you know the answer! Watch it here:
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The annual conference of the American Association of Sexuality Educators, Counselors
and Therapists conference always makes my brain swell with new information and ideas from sex educators who are trailblazers in the field. Counselors, therapists, sex educators in community or medical settings, and other people who care about your sexual knowledge and enrichment gather to learn from the leaders. Then people like me come home and spread it around – to people like you.
As always, it was impossible to attend all the sessions of interest, and there’s no way I can share all of the 25 pages of single-spaced notes that I took on my laptop, no matter how many blog posts I write. But here are some highlights and tips that are especially relevant to our age group:
- Some sexual issues are psychological; some are medical or physiological. But even when it’s a medical issue, a sex therapist can be important to help you work with whatever is going on. Medical sexual issues affect your sense of self and your relationship. “Any pharmacotherapy for sexual dysfunction should occur within the context of sex and relationship therapy.” (Ricky Siegel)
- One more good reason to quit smoking: Nicotine has been shown to decrease blood flow to the penis and increase venous outflow from the penis — in other words, less ability to get and maintain an erection. (Ricky and Larry Siegel)
- Women with vulvar or vaginal pain have a difficult time getting the pain diagnosed and treated effectively. Possible causes of pelvic pain are varied, and with the wrong diagnosis (or no diagnosis!), the wrong treatment follows. Look for a three-pronged approach: a sexual medicine physician, a pelvic floor physical therapist, and a certified sex therapist, such as used by the Summa Center for Sexual Health in Akron, Ohio. (Kimberly Resnick Anderson)
- Pelvic floor physical therapists are trained to do internal evaluation of the pelvic floor muscles — evaluating muscle function, strength, tone, and any points of tenderness. Regular physical therapists are not trained to do this. (Amy Senn)
- Men with low libido: Anxiety, mood, relationship, and religious factors affects libido. “First know what’s going on in the relationship before throwing medication at it.” (Larry Siegel)
- “Nerve sparing” prostate surgery is “a bit of a misnomer.” Erectile nerves on the outside of the prostate are very difficult to see and avoid during surgery. “The prostate is deep in the pelvis, and they go pushing around with stainless steel instruments. If cauterizing instruments are anywhere near nerves, it damages them for life. Nerves recover from the pushing and pulling – it takes a long, long time. Nerves go into shock and stop sending message to blood vessels to relax and let blood in.” (Anne Katz)
- “Sexual arousal requires healthy blood flow for everything else to work. Otherwise, nothing happens. Take a 15 minute walk with your partner before sex. It will prime the pump.” (Ellen Barnard)
- After treatment for female genital cancer, using a vibrating wand internally will reduce scar tissue. “Vibration directly to the scar tissue starts breaking up that scar tissue, allowing it to expand, become more comfortable, and allow penetrative sex if we want it.” (Ellen Barnard)
- After cancer treatment, start getting to know “what is”: “What feels good? What doesn’t feel good? What’s numb? What’s painful? How does arousal happen? What does it take? How does orgasm happen and feel? When during the day do I have energy?” (Ellen Barnard) You need to learn this for yourself before you can teach your partner. (JP: This applies to aging in general, also.) A Woman’s Touch has excellent educational brochures for both men and women online at no cost, for example, Healthy Sexuality After Cancer. Visit www.sexualityresources.com, see the Educational Brochures link in the upper left hand corner of the menu bar for a complete selection.
The huge news this month for me as a senior sex educator was an invitation from Cleis Press to write a book for them: The Ultimate Guide to Sex after Fifty! I’m thrilled to have a new book to write on my favorite topic, and I’m proud to be part of the fabulous Ultimate Guide collection of sexuality guidebooks. You can be sure you’ll hear more about my new endeavor as it unfolds.
Meanwhile, if there’s a topic you want to be sure that I cover in this new book, please either post it as a comment here or email me. I love to hear from you. I’m too busy to promise to answer all your questions in detail, but I try to acknowledge your email and point you in the right direction. I admit sheepishly that I have about 400 unanswered emails waiting. If one of these is yours, I thank you for your patience! (I do give private, educational consultations answering your questions by phone or Skype for a modest fee — email me for more info about this.)
Vacuum Erection Devices
The Rapport Classic is a 2-½ inch clear plastic tube of good quality. The whole length is just over 8 inches. At one end is a manual pump to take the air out of the tube. At the other end is a part that fits snugly to the tube and for insertion of the penis. Surround the penis with a large amount of gel lubricantfor a good vacuum seal. (Both the Revive and the Rapport come with a tube of surgical gel lubricant, which works very well.)
The Encore Revive is similar to the Rapport and works much the same way, with two main differences: The Encore Revive comes with both a manual pump which you us e either one-handed like the Rapport or two-handed for more leverage, and with a battery powered pump. It also has a cock ring release that makes the final step almost automatic and releases the vacuum pressure at the same time. It also has a release valve if you decide not to complete the process.(Note from Joan: I am sad to tell you that my friend, sex therapist David Pittle died December 2017. We value his sex toy reviews. Read his other reviews here.)
Erectile Dysfunction: Michael Castleman Talks to Men

8/18/11 update: I’m bringing this older post to the top because it answers so many of the questions about erectile dysfunction that my readers are asking. Michael Castleman is also one of the experts in Naked at Our Age and I respect his knowledge and ability to convey important information simply and compassionately.
So many readers–both male and female–have been asking for information about erectile dysfunction that I asked Michael Castleman, a sex educator, counselor and journalist specializing in men’s sexuality to answer some questions. His interview starts here and continues here.
Q: Explain erectile dysfunction (ED) and why it happens.
MC: Only a small fraction of men from age 45-60 have true ED. A larger but still modest fraction of men over 60 have true ED. True ED is the inability to raise an erection despite vigorous extended hand massage of the penis. True ED is usually the result of a medical problem, either a problem with the nerves that control erection, or more likely, narrowing of the arteries that carry blood into the penis. Like the arteries of the heart, the arteries into the penis can become narrowed by atherosclerotic plaques. Causes of plaque formation: heart disease, diabetes, smoking, high blood pressure, high cholesterol, high-fat diet, sedentary lifestyle. In other words, all risk factors for heart disease are also risk factors for ED. In addition, ED can be caused or aggravated by stress and anxiety, which constrict the arteries and limit blood flow into the penis.
Q: What about men who are capable of erections, but they’re less reliable than they used to be and require more stimulation?
MC: While only a fraction of men over 45 experience true ED, just about every man experiences what sex therapists call “erection dissatisfaction” (EDis). After 45 or 50 or so, men with EDis can still raises erections, but they don’t rise as quickly as they used to. They no longer rise from fantasy alone–seeing an attractive woman or some erotic scene. Men begin to need direct penis stimulation by hand or mouth. When erections rise, they may not look/feel as firm as they were in the man’s 20s. They may also droop from minor distractions, anything from donning a condom to hearing a motorcycle roar up the street.
The good news is that EDis is a normal and natural part of aging. If older erections wilt a bit, hand massage and/or oral stimulation bring them back up again–IF the man remains relaxed and patient with himself. If the man gets stressed and anxious, this reduces the likelihood of a return to fullish erection.
Many (most?) older men are unclear on the distinction between true ED and EDis. Many mistakenly think they have ED when they experience the normal age-related erection changes of EDis. Now EDis can be disconcerting. I’ve been a sex educator for 30 years. I knew all about what happens to erections after 50. But when those changes started happening to ME, I found them unnerving. P.S. Erection medication (Viagra etc) helps treat EDis. In fact, most men who take erection drugs don’t have true ED. They have EDis.
Q: Many men fear that they can’t please a woman without an erection, or they give up on sex altogether. Is an erection necessary for sex?
MC: Of course not. As you know, women’s pleasure organ is the clitoris. Many women prefer cunnilingus to intercourse. Surveys show that only 25% of women are reliably orgasmic from intercourse, no matter how vigorous or how long it lasts. So women know that an erection and vaginal insertion are not necessary or sufficient for sexual pleasure and orgasm. But many men DON’T know this.
Q: How did men’s sexual education skip that important concept that women’s orgasms are based on clitoral stimulation, and that most women don’t need penis-in-vagina penetration for their pleasure?
Most men get most of their sex ed from pornography. Porn is totally penis-centered. Porn actors have monster cocks, which makes normally endowed men feel they’re “too small.” Mainstream porn includes a bit of massage and cunnilingus, but it’s mostly about sucking and fucking, so that’s what men come to believe sex is all about.
I’ve spent my life as a sex educator and counselor trying to persuade men that they’ll have better sex and get better reviews from women if they ditch their preoccupation with their penis and focus instead on leisurely, playful, whole-body, massage-based sensuality. But compared with porn, which is viewed overwhelmingly by men and is by far men’s #1 source of sex ed, the combined voices of every sex expert on earth amount to a little whisper in the hurricane of porn porn porn.
Here’s where I plug my book, Great Sex. Its message to men: If you want great sex, if you want women to sing your praises as a lover, stop trying to imitate porn. In fact, do the opposite of what you see in porn. Not only will she be happier, you will be, too. You’ll enjoy sex more and have fewer sex problems–more cooperative erection and better ejaculatory control.
Michael Castleman, M.A., is the author of twelve books, including Great Sex
: The Man’s Guide to the Secrets of Whole-Body Sensuality and Sexual Solutions: For Men and the Women Who Love Them. From 1991-95, he answered the sex questions submitted to the Playboy Advisor. Visit his website about sex after midlife, http://www.greatsexafter40.com//.
Man, 82: “I don’t know how to approach a lady friend for sex”
I’m 82, I can get an orgasm but can’t get a firm erection. I don’t know how to approach a lady friend of 65 for sex. I’m afraid to reveal my problem. What can I do?
— Russ
Russ, by all means, talk to your lady friend about your situation. Frankly, I’m sure she’s assuming that you do have erectile difficulties at age 82, and she’s not bringing it up, leaving it up to you to decide when or how much to disclose.
Fortunately, you are capable or orgasms without erections. Many women don’t know this is possible, so you’ll be giving her good news. When you get to this point, please take matters into your own hands to show her exactly the kind of touch that you need. It may be difficult at first to do this, but understand that a woman can’t know how to please you unless you show her.
It used to be easy for us–as well as for you!–when an erection showed us that we were doing what you liked, and you pretty much liked anything we did! But now, both genders have changed in what works for us, and we all need to be more straightforward in communicating this with our partners.
As for her pleasure, are you aware that few women experience orgasms through intercourse alone? Our pleasure centers are our brains, our skin, and our clitoris — all of which are accessible without erections. I’ll be posting some techniques for giving women pleasure without an erection shortly, and I’ll have many more in my upcoming book, Naked at Our Age: Talking Out Loud about Senior Sex.
Since you’re not sexual yet with your lady friend, but you’d like to be, I hope you’re spending quality time with her, getting to know each other as friends, learning how to talk easily together. Let your inner “flirt” out at times, and see how she responds. Compliment her, take her hand, make eye contact, ask her questions about herself.
When you make casual, physical contact–taking her hand, touching her arm, leaning in closer to talk–be super sensitive to her reactions, especially her body language. When you lean in, does she match you, or pull away? When you touch her arm, does she slide it closer, or retract it? You can learn a lot about whether she feels sexual about you by how she reacts to these simple gestures.
I wish you well with your new relationship. I hope you’ll let us know how it develops!
– Joan
