Urology, Uro-oncology and Sexology Update

17 Age 50-60: Sex is still important to you and your desire is still there but is typically diminished. Your erection is still respectable and functional, but not the majestic sight it once was, and touch is often a necessity for full arousal. Nighttime and morning erections become fewer and further between. The frequency of intercourse declines while the occurrence of losing the erection before the sexual act is complete increases. A more dribbling-quality ejaculation occurs with diminished volume and force, begging the question of why you are “drying up.” Orgasms are less intense and at times it feels like nothing much happened—more “recracker” than “reworks.” Getting a second erection is difcult, and you nd much more delight in going to sleep rather than pursuing a sexual encore. Sex is no longer a sport, but a recreational activity… sometimes just reserved for the weekends. Age 60-70: “Sexagenarian” is quite the misleading word… more apt a term for the 18-30year-old group, because your sex life doesn't compare to theirs—they are the athletes and you the spectators. Your testosterone level has plummeted over the decades, probably accounting for your somewhat diminished desire. Erections are still obtainable with some coaxing, but they are not ve-star erections, more like three stars, suitable for penetration, but not the rigid agpoles of yonder years. They are less reliable, and at times your penis suffers with “attention decit disorder,” unable to focus and loses its mojo prematurely, unable to complete the task at hand. Spontaneous erections, nighttime, and early morning erections become rare occurrences. Climax is not so climactic and explosive ejaculations are a matter of history. At times, you think you climaxed, but are unsure because the sensation was frankly un-sensational. Ejaculation is down to a mere dribble. Seconds?… no thank you… that is reserved for helpings on the dinner table! Sex is no longer a recreational activity, but an occasional amusement. Age 70-80: When asked about his sexual function, my 70-something-year-old patient replied: “Retired… and I'm really upset that I'm not even upset.” You may still have some lingering sexual desire left in you, but it's a far cry from the re in your groin that you had when you were young. With physical coaxing and coercion, your penis can at times be prodded to rise to the occasion, like a cobra responding to the beck and call of the ute of the snake charmer. The quality of erections has noticeably dropped, with penile fullness without the rigidity that used to make penetration such a breeze. At times, the best that you can do is to obtain a partially inated erection that cannot penetrate, despite pushing, shoving, and manipulating. Spontaneous erections have gone the way of the 8-track player. Thank goodness for discovering that even a limp penis can be stimulated to climax, so it is still possible for you to experience sexual intimacy, although the cli-“max” is more like a cli-“min.” Age 80-90: You are now a full-edged member of a group that has an ever-increasing constituency—the ED club. Although you as an octogenarian may still be able to have sex, most of your brethren cannot; however, they remain appreciative that at least they still have their penises to use as spigots, allowing them to stand to urinate, a distinct competitive advantage over the womenfolk. Compounding the problem is that your spouse is no longer a spring chicken and because she has likely been post-menopausal for many years, she has a signicantly reduced sex drive, vaginal dryness, and perhaps medical problems that make sex downright difcult, if not impossible. If you are able to have sex on your birthday and anniversary, you are doing much better than most. To quote one of my octogenarian patients in reference to his penis: “It's like walking around with a dead sh.” Age 90-100: To quote the comedian George Burns: “Sex at age 90 is like trying to shoot pool with a rope.” You are grateful to be alive and in the grand scheme of things, sex is low on the list of priorities. You can live vicariously through pleasant memories of your days of glory that are lodged deep in the recesses of your mind, as long as your memory holds out! When and if you do get an erection, you never want to waste it! UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE

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