What I’d tell my 25-year-old self about sex – and how it has improved for me with age

On his 55th birthday, New York-based writer and sex therapist Ian Kerner reflects on his sex life and explains why men don’t need to let ageing get in the way of their desire

I know for a fact that tonight I’m going to get lucky: I’m definitely going to have sex. According to a study published in the Archives of Sexual Behavior, the average American has sex 54 times a year, which roughly translates to once a week with a couple of extra times thrown in for special occasions. And today is my birthday. I’m turning 55. And like all my birthdays for the past 20 years I’ve been married, my bonus present is sex. Maar, special occasion or not, given that I’m pushing up in years this is a good moment to take stock of how my sex life has changed over time – and what I’ve learned as a sex therapist about how other men age through the life-cycle.

First off, I love sex. Always have, always will. And contrary to the previously cited study which notes declines in the frequency of sex as we age (those in their 20s had sex an average of about 80 times per year, compared with about 20 times a year for those in their 60s), if anything, my appetite for sex has increased.

Lifestyle (diet, exercise, managing stress, not smoking, limiting alcohol) plays a big role in counteracting those declines. I also had my testosterone levels checked recently as part of an overall health exam. My levels are consistent with a guy my age, but the problem is, I never had them checked consistently, so I don’t really know what my baseline is. Testosterone levels are very individual and idiosyncratic: even at the age of 25, one man’s low could be another man’s high, so I wish I had done this more regularly.

While my appetite for sex remains strong, my eyes are often bigger than my stomach. Sure, like many men, I’m still able to metabolise a sexual cue quickly. For example, my wife gets out of the shower and I get a tasty glimpse of her, I see it and feel it in my genitals. That’s how it’s always been. But the truth is, I now have to conserve my resources.

Although some things about sex have changed, certain aspects have stayed the same. For example, I’ve always struggled with early ejaculation, the most common of all mechanical “male-functions”. And contrary to stereotypes, it’s not just a young man’s problem. Although I haven’t encountered the issue of erectile impairment yet, it’s not uncommon as men age for sexual problems to stack on top of each other. Gelukkig, age-based erectile dysfunction is a perfect opportunity to start taking with a medication such as Viagra (if you roughly know when you’re going to have sex) or Cialis (if you want to maintain some spontaneity and the erectile dysfunction isn’t severe).

These meds actually do what they’re supposed to do, with few, if any, side effects. But some men don’t want to acknowledge that they’re no longer a young stud so they’re resistant to “little blue pills”, even when they might be taking meds for all sorts of other ailments. To me this is silly: if I have to put my sexual function on one side of the scale and my sexual ego on the other, the former definitely outweighs the latter.

Aan die ander kant, I’ve always known that certain drugs produce sexual side effects (like SSRIs for depression and anxiety that are known to inhibit desire, challenge erections, and make orgasms harder to attain), so I’ve resisted taking them. But just as many of my patients can’t make the trade-off of sexuality over sanity, as I age I can’t avoid certain medications either. Lately I’ve had to take a pill that reduces an enlarged prostate and makes urinating less of a stop-and-start ordeal.

So as I turn 55, I wish I could speak to my 25-year-old self and give him a bit of advice:

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