Sex education in the United States until about forty
years ago was non-existent. Young women and men learned
about sex in the locker rooms. Women were subjected to a
constant tirade or warnings about getting pregnant,
picking up a venereal disease or "being
wronged" by men. Everyone knew that "Holding
hands was the firs step to getting pregnant." Women
could not even think about the pathways to abortions
without terrible anxiety. Then, of course, an abortion
was not easy to come by. Frequently, it involved
traveling to another country where abortion laws were
less strict.
Again,
we start at the beginning. The adolescent notion of
erections is that any real man should be able to get an
erection any time of the day or night without much
provocation. This myth persists, in spite of
considerable evidence to the contrary, and it lurks in
the mind of most seniors. With age, however, erections
generally occur only at the right time and place, and
with the right partner.
When
counseling couples with sexual dysfunction it is easy to
determine that sex is the first element of the
relationship that suffers when there is a breakdown in
communication. When couples start to repair things, sex
is the last element to return to the relationship. When
one or both members of a pair are troubled with
depression or stress then sex becomes almost impossible.
A
second generalization is that men are quite willing to
accept all of the responsibility for failure to get an
erection. A more useful answer can be found by tracking
the interaction between a man and woman. We look for
behaviors that facilitate or impede the growth of
intimacy.
Women
learn early in life how to turn men off. If they are
tired, stressed or just plain uninterested in sex, most
women know how to put a quick end to sexual overtures.
Men also know how to do this with a partner who is more
sexually active than they are. So, once these problems
are out of the way, where is the pathway to sexual
activity? The world is full of men and woman who feel
inadequate about their sexual ability. More often than
not it is the partner who is turning them off in some
subtle way.
As
always, the first step is open, intimate discussion.
Both people have to show some interest in improving
their sex life. These discussions must focus on such
subjects as "what can I do to please you
more?" and vice-versa. Some couples have never had
such conversations. One partner gets sexually active and
the other just goes along to get it over with. It is
easy to see that sexual dysfunction is quite common when
things go on this way. Women who just go along also have
great difficulty in reaching a satisfying orgasm.
If a
couple can't work their way through all of this because
of embarrassment, lack of knowledge, discomfort, or
preoccupation with illness, then they should think about
getting good-quality professional help. This step will
at least open the way to intimate conversation.
Most
sex manuals will advise couples not to make an effort to
strive for satisfying sex too quickly. They suggest that
the partners start learning to enjoy physical and
emotional intimacy and sensual pleasure without
necessarily proceeding to full intercourse, and see what
develops. This is generally good advice. However, the
climate of the relationship must allow for each partner
to be able to say "I like it when you do
this", or "I don't like you doing that",
or "give me a massage all over", or "What
would you like me to do?" In a surprising number
of cases making the effort to develop the relationship,
improve communication, and explore ways of pleasing each
other leads to satisfying sex.
Striving
for sensual satisfaction is a good place to start. The
right music, the right perfume, the right lighting and
all of the other pleasurable smells, touches and visual
sensation helps a lot. If sometimes this whole thing
sounds like a big production, well it is. Unfortunately,
if sexual interest has declined over a period of time
then it takes as lot of effort and time to get things
back in gear.
It is
easy to forget the rituals of courtship. One or both
members of pair can start with little presents from time
to time and remembering what the partner likes for
entertainment and enjoyment. Find the right foods to
prepare or the right restaurant to make a reservation. All
of these little things help to create a climate for
intimacy.
Many
couples report that living out fantasies is very
sexually exciting. For example, a man goes to a bar and
soon a woman comes in. He goes through all of the
motions of "picking up" an unattached woman,
who is in fact his wife. Both people can really enjoy
this. It takes a little work to recall sexual fantasies
Or invent new ones that are sexually stimulating and
then figure out how to put them in action.
Unfortunately,
if a relationship has deteriorated to the point where
there is very little affection or caring between the
partners, there is need for some more general
discussion. The conversation can build around "What
can I do to be a better person for you?" If nothing
of value comes out of such a discussion both people have
to question why they stay in the relationship.
Many
partners in relationships are quite comfortable without
sex. The couple know each other well, enjoy being
together, and one or both of them know that they don't
want to live alone, or face the family, children and
community after a separation. Also, there is always
someone there to call on in time of trouble or illness.
Also, neither of them wants to be on the open market and
go through the process of learning again how to act as a
single person with other seniors. Separation would lead,
to religious, financial, and estate problems, and so on.
Relationships like this can continue indefinitely, until
something happens that causes a reevaluation.
Some
couples arrive at the notion that each partner should be
free to pursue sexual activity outside of the
relationship. This kind of decision relieves a lot of
pressure. Both men and women seek out younger partners
and often same-sex partners. Actually, second marriages
tend to be better than first marriages except they are
shorter.
There
are a host of other issues that contribute to sexual
dysfunction. Age differences between partners become
more important as a couple ages. Religious and long
established ethical constraints prevent people from
speaking easily, or considering options in their
relationship.
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As
many as 30 million American men suffer some form of
sexual dysfunction, according to estimates of the Nation
Institute of Health. The majority of these 
