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Difficulty In Sustaining Erection. Is It Age Related?

Posted on Tue, 6 Dec 2022

Question: I am age 73 healthy have no ED have Peyronies but was treated early on so intercourse is not a problem. I cannot experience orgasm during normal intercourse my wife is 66 and we try to have sex once a week. She is not overweight and is healthy and attractive but is sensitive during penetration so I let her handle the process once it is achieved I cannot really feel anything. It takes so long that I am desensitized. After she experiences orgasm she accommodates me manually. This has been a problem for about the last 6 times we have had sex.

Answered by Dr. Lekshmi Rita Venugopal (1 hour later)

Brief Answer:
Use lubricants during intercourse. Your wife can use vaginal estrogen gel.

Detailed Answer:
Hello,
Thank you for trusting HCM

The issue you are facing seems to be difficult penetration leading to prolongation and inability to achieve orgasm. I believe that you are able to have an erection. So, if penetration becomes easier, you will likely achieve orgasm.
You can use lubricants like k-y gel for easier penetration. Also, vaginal dryness in postmenopausal women is the reason for sensitivity during penetration which can be effectively treated by vaginal estrogen gels. She can follow up with her obgyn to get a prescription for estrogen gel.

Hope this answers your question
Please let me know if you need further clarification
Regards
Dr.Lekshmi

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Lekshmi Rita Venugopal (1 hour later)

Yes we always use lubricants but even with the lubricants and foreplay it still takes her considerable time to get me inserted. During that time she is kind of manhandling me because it seems as if the orifice does not want to open and must be painful for her. She will not use any estrogen medication because she is a breast cancer survivor and wants nothing to do with using estrogen on the vaginal epithelium. I just find that I have difficulty achieving orgasm during intercourse I begin to sweat while trying. As far as I know my prostate is normal as of 2 months ago and PSA is acceptable. When she manipulates me manually I don't seem to have a problem. Maybe at my age that is all I can hope for. I also find my libido I very low. I am sure that free testosterone is marginally low and at one time I took clomed (LH) to subtly raise the levels and it worked. I was seeing a prominent Urologist to the Peyronie's and he suggested it rather than Androgen gel.

Answered by Dr. Lekshmi Rita Venugopal (17 hours later)

Brief Answer:
You can try Clomid or testosterone

Detailed Answer:
Hi again,

Since you are complaining of decreased libido and recurrent episodes of inability to orgasm, it is best to get your testosterone levels checked. If low, Clomid (clomiphene) taken once daily can help boost testosterone levels.
Another option would be testosterone replacement therapy.
Please discuss with your urologist regarding this.
If you are noticing excessive sweating during intercourse, it is also important to get an EKG done to rule out cardiovascular disease.

Bests
Dr.Lekshmi

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Above answer was peer-reviewed by : Dr. Prasad