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Changes in Erectile Function

Home » Ask Yvonne » Answers » Changes in Erectile Function
I am a 65-year-old man. My wife and I have been married for 35 plus years. I am unable to get a natural erection any more due to health/medication issues, so I pleasure myself or my wife masturbates me. Though I still desire sex and intimacy, lately it just seems like too much trouble. When I do orgasm nothing comes out. Is this a normal or common disorder and can it be fixed. Thanks so much.

David and Diane

Dear David & Dianne,

It is perfectly normal – and quite common – for a man to experience changes to his erectile functioning with age, especially if he’s grappling with any health issues (like diabetes or hypertension). Also if he is taking certain medications (e.g., antidepressants). Other factors that can impact his ability to have an erection include smoking, alcohol, stress, performance anxiety, relationship difficulties… Some of these may be temporary issues, while others can be long-term.

If you’re finding yourself dealing with erectile dysfunction (ED) on a regular basis, your best starting point is to talk to your doctor about your health and the medications you’re on. Your physician should also screen you for any other health or lifestyle issues that may be affecting your ability to get hard. The two of you will then want to strategize on the best and most appropriate treatment, whether that would involve a drug for ED: like Viagra, a vacuum device, penile prosthetic implants, or other modes of therapy.

Changes in your ability to ejaculate may or may not be due to erectile disfunction. That is something that your doctor will have to determine. You may also need to be screened for retrograde ejaculation, which is where the semen enters the bladder instead of being released through the penis for a “dry” orgasm.

Dealing with the issues at hand can then be made even easier in working with a certified sex therapist or counselor (you can find one in your area at:, especially since erectile dysfunction can take a toll on one’s emotional health or relationship. This professional can also guide you and your wife around matters of sexual satisfaction and aging. Our sexual pleasuring and responses do evolve as we get older, but that doesn’t necessarily have to mean for the worse.

Challenges to sexual functioning and response can give couples the opportunity to re-think sexual activity and gratification, to experiment, and to redefine what can be pleasurable. Who says that ejaculate is required for an orgasm to be pleasurable? Who says that you need to have an erection in order to experience sexual pleasure?

In changing their sexual repertoire, in expanding their definitions of what it means to have sex, be pleasured, and experience satisfaction, and in maintaining a positive attitude, many lovers have continued to enjoy being intimate. Instead of letting your sex life go to the wayside because of bumps in the road, see the situation as your chance to get active, explore your sexuality and realize optimal sex on your terms and not just on what you’ve been taught or have experienced as so.

Best of luck in your efforts!

Dr. Yvonne

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