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Use It or Lose It - Sex as You Age as a Man

Having sex as you age to stay healthy and enjoy life

climbing in Joshua Tree
The author climbing 'Where Two Deserts Meet' (5.8) in Joshua Tree, February 2021.

Last year I played When I’m Sixty-Four on my birthday. I have been listening to that Beatles’ song since I was 14, wondering how I would be when I finally arrived to that age. Now, fifty years later, I think I would surprise my former self if he could see what I have become. I still free-dive, like I did when I was a teenager, although I prefer to play it safe and use scuba if I can. I ski the double-black diamond slopes and I lead 5.8 rock-climbing routes. I just retired from a moderately successful scientific career and I am starting a new one as a writer. None of that is in the Beatles’ song - I do a bit of pulling weeds from my garden, but I don’t have grandchildren sitting on my knees.

Who could ask for more?

And I am still a sexual being. That’s what I want to talk about in this article, in the hope that it could help other men as they age.

Women age differently from men, particularly when it comes to sex. They go through menopause. I will address that in another article.

Testosterone keeps you healthy

Some people talk about andropause, the male equivalent of menopause, but changes in sexuality with age are hardly comparable between men and women. While menopause is a drastic change in female hormones taking place in a couple of years, men experience a gradual decrease in testosterone.

In the 90s, it became fashionable in politically correct circles to call testosterone a poison, an underhanded way to put down men. The argument behind this was that, because testosterone mediates aggression, it was to blame for the increased violence of men and for their abuse of women. However, this science paper (Albert et al., 1993) argues that, unlike what happens in other mammals, aggression in humans is ‘defensive aggression’, found in both sexes and all ages, and therefore independent of testosterone. Fortunately, calling testosterone a poison seems to have gone out of fashion lately.

In reality, testosterone is key for men’s health, both physical and mental. As we age, it helps us maintain bone density, muscle mass, strength and mobility (Rodrigues Dos Santos and Bhasin, 2021; Snyder et al., 2018). It also has effects on the brain - when we lack it, we may lose motivation and may even become depressed.

And, of course, testosterone is what keeps alive our sexual desire. As our testosterone declines with age, we feel less attraction for women (or men, if you are gay) and less desire to have sex. We may also have fewer spontaneous erections, and they may be weaker and last less.

Given all that, you may think that an easy solution might be to get some testosterone injections. However, doctors are weary of doing this for fear that testosterone might increase the risk for cardiovascular disease and prostate cancer. A large study (Snyder et al., 2018) that documented the many benefits of testosterone administration in a large sample (788 men) of older men (~72 years old), also detected an increase in plaques in the coronary artery.

The link to prostate cancer is much weaker, however. Another scientific paper (Slater and Oliver, 2000) shows that the observed correlation between testosterone and prostate cancer is indirect: it is because men with high testosterone tend to be more sexually active and catch more sexually transmitted diseases, which are a direct cause of prostate cancer.

Hence, unless your levels of testosterone are pathologically low, it is better to avoid testosterone injections.

Cultivating desire

To be safe, it is better to maintain healthy levels of testosterone by natural means. This includes the usual advice for good health: avoid being overweight, sleep well, reduce stress and exercise regularly. Having sex and masturbating go a long way to maintain your testosterone levels and prolonging your sex life.

Some people may disagree with this. Many of us have had the experience of having to go without sex, or even masturbating, for several days, and that increases our sexual desire. Doesn’t this mean that our testosterone increases as well?

One scientific study (Kraemer et al., 1976) used a sample of 20 young men (20-28 years old), who kept a diary of their sexual activity for two months and gave blood samples every two days to measure their testosterone levels. The study found that testosterone increased every time they had sex. Moreover, testosterone levels fell after three days of sexual abstinence, indicating that sexual abstinence lowers testosterone.

Another study (Jannini et al., 1999) examined 83 men that were treated for sexual impotence with medication or psychological or mechanical therapy. Those who achieved sexual activity had increased levels of testosterone, but not those who remained impotent.

Putting all this together, we can conclude that staying sexually active as you age not only keeps your sexual drive alive but also improves your physical and mental health by making your body produce more testosterone. Sex also releases other hormones and neurotransmitters that improve our health, like oxytocin, adrenaline and endorphins.

As my title says, when it comes to sex as you age, it’s use it or lose it.

You are not a dirty old man

The problem that many heterosexual men have as they age is that, when their wives or female partners go through menopause, they lose their sexual desire. It doesn’t happen to all women, of course. For many, sexual desire stays the same or even increases after menopause. But when it goes the other way, it can certainly be a problem. Your wife has every right to become asexual, but doesn’t mean that you need to follow her there. Not only your sexual life has an enormous value by itself, but it may be critical to keep you healthy and help you fight aging.

Perhaps this is the time to consider non-monogamy? “But I am too old for that!” you may say. After many decades in a monogamous relationship, how are you going to join the dating scene again? Well, yes, it may take some work, some negotiating with your spouse, and some shifting of attitudes, but it is entirely possible. I have done it, although I have to admit that I draw on many years of experience being polyamorous.

The first thing you need to do is to fight against is the ageism embedded in this society that tells you that old men have no business being sexual, and even less dating younger women. That makes them “dirty old men”, creeps bend on exploiting women for their own sick pleasure. Because women only like young men with six-pack abs, right? What makes you think they’d want to have sex with somebody like you? Haven’t you look in the mirror recently?

Please don’t fall into that trap. You have a lot to offer women. Like experience, lack of judgment, empathy, sense of humor, wisdom and compassion. If you look around, you’ll see that a lot of younger men are not all that hot. And many of them do not know how to treat women right. If you take care of your body by eating well and exercising -which you should do anyway, if you want to avoid an early grave-, your body may be quite attractive despite of your age. And if you have learned to be patient, wise and compassionate, that may be exactly what lots of women are looking for.

Just don’t go around with an exploitative mentality. Be ready to take no for an answer. Be flirty and seductive, ask politely, and move on if they reject you.

You will probably date older women, with bodies that have endured the same ravages of time as your own. Give them the same respect and compassion that you expect them to give you. Learn that sex happens on a higher plane, more mental than physical, where pleasure, humor and connection can be found beyond mere physical appearances.

If dating doesn’t work for you, or you want to stay monogamous, then masturbate. Do it intentionally, not mechanically, dedicating to it time, energy and attention. Maybe it’s time to move on from your cock to other parts of your body, like your nipples or your prostate. The best orgasms of your life may still be in your future… who knows?

Don’t be shy to use pornography to keep your sexual desire alive. The sexual tension it awakens may also increase your testosterone. However, I found that good erotic literature works best to light the fire in my imagination.

Who is afraid of the big, bad Viagra?

Another strange contemporary myth is that medication to treat erectile dysfunction is unhealthy, ineffective, or somehow politically incorrect.

None of that is true.

I don’t have erectile dysfunction. I started thinking about using Viagra reading the book Master of O, a BDSM erotic novel by Ernest Greene. In it, a dominant man takes Viagra before a kinky scene to impress his submissive with a powerful, long-lasting erection. The idea had its appeal, so asked my doctor for a prescription. I was quite impressed with the results, and so were my lovers.

It is not true that Viagra is a sexist drug that only benefits men. Heterosexual women who like stiff cocks have lots of reasons to sing its praises.

Here is the scientific background. Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil) belong to a group of drugs called phosphodiesterase-5 (PDE5) inhibitors. PDE5 is an enzyme that breaks down cyclic-GMP, a nucleotide that acts as a second messenger inside cells. In humans, penile erection is maintained by blood filling the corpus cavernosum, two large bodies in the stem of the penis. This requires cyclic-GMP, so when it is degraded by PDE5 the erection is lost. Thus, PDE5 inhibitors are able to increase the intensity and duration of an erection. They have no effect on the brain and therefore do not increase sexual desire. In fact, without an additional sexual stimulus, PDE5 inhibitors do not produce an erection.

Still, feeling your cock getting rock-hard is quite an effective psychological stimulus, for you and for your sex partners. The effect of PDE5 inhibitors can be felt within two hours. In my experience, the effect of Cialis lasts two days or even longer. These drugs generally have mild side effects, but these can be serious in people with cardiovascular or eye diseases, so they should not be taken without consulting with a doctor. I recommend that you stick to the lower dose that produces an effect.

I don’t think that PDE5 inhibitors produce dependence - meaning that they become necessary for an erection. Quite the opposite: by repeatedly filling your corpus cavernosum to its full capacity, they may help keep your penis from shrinking as you age.


Old age is an inevitable fact of life. Ultimately, we all need to accept our irreversible decline. But, as living creatures, it is almost an obligation to fight it all the way to our death. I find beauty in this tension between acceptance and struggle. I cling to life even as I know it is futile and that I will lose in the end. Life is a process. Death is the only destination. And what better way to express the love of life than to have sex?

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