Sex at the retiree level


  • Ask Dr G
  • Sunday, 20 Oct 2013

Q:You are doing a great service in your column and the advice you give is always tempered with kindness plus humour. I am a woman in her fifties with very much to be thankful for in regards of sexual wellbeing. Although menopausal, my sex life and libido is at its peak.

My partner is in his mid-sixties, medically and physically very fit.

The only problem is that I sometimes worry that our exertions during sex may be too much for him.

Will this extended activity be one day too much for him? Is it advisable to carry on such exertions at this age? We make love about twice a week and truly enjoy this sexual and loving bond.

I love and appreciate him but I can't help having this niggling feeling of over-indulgence.

Lucky

A: It is absolutely delightful to receive your email. I am humbled to learn you think I have contributed to the community and elated you consider my sense of humour not too “dry” for some.

Talking about “dryness”, most people will assume post-menopausal ladies will have a decrease in sexual desire due to dryness and thinning of the vaginal lining due to the decrease of estrogen. On the contrary, recent survey demonstrated only 6% of the 45-65 year old women detest sex after menopause. Fifty-five percent of the ladies are definitely up for it. Interestingly, 16% of the ladies actually said they would be more interested in sex if they had new partners. Perhaps we should call this the “Demi Moore phenomena”.

In fact, many studies have found that women enjoy better sexual health passed menopause and continue to do so for a long time. This is perhaps due to the fact women are glad to be able to quit worrying about contraception and the children.

The other aspect may be due to the enhanced love making experience and skills they had built up with the partner over many years of loving relationship.

Of course, I can empathize with your concerns, whether your sixty-year-old husband may be able to keep up with your “peak performance”. Worry not, do not under-estimate the physical state of a fit 60-year-old man.

In fact recent studies in Malaysia revealed couples have sexual intercourse on average of twice a week in the under-40’s age group, and this may be reduced to 6 times per month beyond the age of 40. Therefore, the frequency of twice-weekly sexual encounters that you are experiencing is totally normal.

Journal of American Medical Association (JAMA) also recently highlighted physical exertion such as sexual intercourse every once in a while may not be such a good thing. This is associated with small but increase risk of cardiac arrest. On the contrary, men who have regular exertions during sexual intercourse will have 45% less risk compared with those with episodic exertion. Interestingly, one study also identified most cardiac or cardiovascular events occur between 6am and noon in men with triggers such as sexual intercourse.

So, I hope you continue to feel blessed and lucky amongst the majority
of the ladies who either maintain or have enhanced sexual experience after menopause. Continue to indulge life, perhaps keep it nocturnal!!

Q: I am a 27-year-old dude who experienced sexual intercourse for only second time a week ago (my first was a year ago!!). In my recent encounter, fortunately was more enjoyable as I had to opportunity to be in control. However, with such an advantage,

I still was only able to achieve orgasm within 5 minutes (my first a year ago lasted only 2 minutes!).

I would like to seek your professional advice on ways to improve the interval of intercourse prior to ejaculation. I understand from your previous responses to other "e-patients", I am safe from being diagnosed with premature ejaculation. Please do correct me if I am wrong.

I also believe that I suffer from phimosis.  I am unable to fully retract the foreskin over the glans penis when it is erected. I am able to do so at other times, i.e. not erected. Appreciate if you could shed some light on this matter as well.

Semi-Satisfied Dude

A: Thank you for your questions and the reminder emails. Indeed I have
not forgotten nor discard your concerns. I am simply overwhelmed by many questions to answer.

Many may find it hard to believe (Including myself!)


Anyway, for a 27-year-old man who just had two sexual encounters and ejaculated between 2-5 minutes, I would hardly diagnose you with Premature Ejaculation (PE), with any stretch of imagination.

The International Society of Sexual Medicine defines PE as a sexual dysfunction characterized by decrease interval of intercourse (around one minute), lack of control and increase bothersome facing such impairment. This is based on men having such problems with regular sexual encounters for at least six months. I think two encounters one year apart hardly counts.

Interval of intercourse, as you have pointed out, can be partner, situational and sexual positional dependent.

Essentially, the biggest sexual organ in your body (I mean your brain) is having constant battle of stimulation and inhibition of the ejaculation center, during sexual activity.

This is determined by numerous neurotransmitters, including dopamine and serotonin. With advancing age and experience, you begin to be able to control you state of arousal and hence the natural neurotransmitters can enhance or shorten your interval of intercourse.

Of course, there is a small possibility that you may still suffer from

PE, despite gaining more sexual experience in the future.

This is not uncommon as it can affect up to one in three men in Asia Pacific region. There are medications that can increase the availability of serotonin in your neuro-synapses.

This will in turn increase and enhance your sexual experience. For you, I think it is too early to rush into treatment.

As for your foreskin, you may have a mild degree of phimosis, as you are able to retract it when the penis is flaccid. Majority of such tightness can be overcome with increasing sexual activities (self or non-self induced). If the situation become painful or the foreskin begins to crack, I think you may need to have circumcision.

So, Dr. G’s advice is: be patience, explore and experience. We have all been through it before!

Q:I'm a male age 38. I have been having ejaculating withouterections for some times. I also have encountered difficulties with erection recently.

Truthfully, even the erection I am getting is semi-rigid and unsustainable. Most of the times, it is less than 5 minutes. I also find it difficult for me to get aroused.

It is difficult to predict when I can get erections & the morning stiffness is definitely less frequent than what I used to encounter in the past.

My testosterone level is also down, it is below 10 when I had checked a few months ago.

Are there any pills or any other medicines that I can take to solve my problems?

Mr. M.

A:You have just described the classic presentation of erectile dysfunction (ED). Essentially, this is a condition described as inability to achieve or maintain erection for satisfactory intercourse in most of the sexual encounters.

Some clinicians may misdiagnose you having Premature Ejaculation as you may ejaculate before you desire.

However, since many ED sufferers find it difficult to maintain the erection. They will rush through sex to sustain the erection and ejaculate quickly. Of course, there is always that possibility of double trouble!!

What worries me the most is the fact that you are only 38 and give a clear description of ED.

There are numerous studies that outline such sexual dysfunction as an early sign of a “broken heart”. To be truthful, an Australian study actually highlighted increase in cardiovascular event of 50 times more, compared to someone who has ED in later part of life.

The degree of ED you experience is also worrying. According to erectile hardness score (EHS) you are probably 2 out of 4. In some countries, the hardness is compared to the texture of a peeled banana.

The worse degree of the ED is likely to associate with worse cardiovascular status.

I strongly suggest you to see a doctor to have you diabetic, lipid profile checked out. You should also monitor you blood pressure on regular basis.

Some clinicians may even advocate for you to see a cardiologist to do a stress test. Only if you get all the clearances, would I suggest for you to start treatment.

So, M. Get serious and get yourself checked out. You never know, the presentation of the early ED might have saved your life.

Q: I am 62 would like to know if Calcium supplement is it advisable to take because when I take it I get an unpleasant taste.

I also experience pain when I exercise, especially when bending on my left a get a pain, which I never had before. Any calcium supplement you can recommend.

Thilaga

A: As you may know, I am a urologist and don’t  usually deal with calcium supplement nor muscular skeletal problems. However, I never decline a lady’s question.

I am not a big fan of supplement and definitelywould ask you to stop taking it. I genuinely think the Malaysian diet should have sufficient supply of Calcium.

Failing that, I would suggest for you to drink milk or get some sunshine.

I am rather worried about your pain when you exercise and bend to the left. This may be due to something more serious as osteoporosis is usually painless.

Therefore, I recommend for you to see an expert (Orthopedic surgeon) to get yourself checked out.

 

The views expressed are entirely the writer's own

 

 

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