Does ejaculation change as you get older?
Premature ejaculation does not become more common with age, according to a large US survey, while erectile dysfunction does. Difficulty reaching climax is more common later in life. In a US sample of men aged 57 to 85, 20% reported being unable to climax, and 73% of them were bothered by it. Most later changes have identifiable causes.
Does premature ejaculation change with age?
In a large US national survey, the prevalence of premature ejaculation was not affected by age, unlike erectile dysfunction, which becomes more common as men get older. The European guideline divides premature ejaculation into four subtypes.
Lifelong premature ejaculation is present from a man's first sexual experiences and is thought to involve the brain's serotonin system and other biological factors. Acquired premature ejaculation develops later and can be linked to performance anxiety, psychological or relationship problems, erectile dysfunction, prostatitis, an overactive thyroid and poor sleep. Variable premature ejaculation is considered a normal variation in sexual function, and subjective premature ejaculation describes a perception of ejaculating too fast when timing is in fact normal.
Why do erection and ejaculation problems often appear together?
A significant proportion of men with erectile dysfunction also have premature ejaculation. Performance anxiety about erections can make premature ejaculation worse, and this carries a risk of treating the ejaculation problem while the underlying erectile dysfunction is missed.
"Many patients with ED develop secondary PE caused by the anxiety associated with difficulty in attaining and maintaining an erection." Source 1, p. 60
Because erectile dysfunction rises with age, this combination becomes more common later in life, even though premature ejaculation on its own does not. The history therefore records whether the problem is lifelong or acquired and whether it happens with a specific partner or in all situations.
Does delayed ejaculation become more common with age?
Delayed ejaculation means a marked delay in ejaculation, or no ejaculation, on 75% to 100% of occasions for at least six months, causing personal distress. Its prevalence is around 3% among sexually active men, with lifelong and acquired forms estimated at around 1% and 4%.
Men with lifelong delayed ejaculation tend to be younger and are less likely to have a medical condition or medicine that explains it. Difficulty reaching climax is more common in older men. In a US sample of 1,455 men aged 57 to 85, 20% reported being unable to climax and 73% of those men were bothered by it.
What can change orgasm and ejaculation later in life?
Later changes in orgasm usually have identifiable causes. They include testosterone deficiency, an underactive thyroid, medicines such as antidepressants, antipsychotics and opioids, psychosexual causes and loss of penile sensation, and psychological factors are considered responsible for 90% of cases where orgasm is absent. Absent orgasm is usually linked with delayed ejaculation, and the two are believed to share the same risk factors.
Treatment for prostate cancer can also change orgasm and ejaculation, and men having it are told about these effects before treatment. Blood tests for testosterone, prolactin and thyroid hormone can help rule out physical causes.
How do ejaculation problems affect a relationship?
Premature ejaculation can harm self-confidence and the relationship with a partner, and it can cause distress, anxiety, embarrassment and depression. Despite these effects, few men seek treatment. It can also affect the partner's own sexual function, and the partner's satisfaction with the sexual relationship falls as the problem becomes more severe.
Men with premature ejaculation are more likely to report low satisfaction with their sexual relationship and with intercourse, difficulty relaxing during sex and less frequent intercourse. Psychological and behavioural therapy combined with medical treatment is recommended for acquired premature ejaculation.