Dear Dr. Milrod:

I’m in my upper 40s and I have never had any trouble getting an erection.  I have, however, found that it’s harder to ejaculate. Back in college, three times a night was no problem, but now I’m a one hit wonder.  Also, unless it’s been a few days since my last orgasm, I sometimes struggle having an orgasm in a condom with a temporary partner. I do find that foreplay helps a lot.  For example, if I am with someone and we massage each other and go in the whirlpool before sex – I never have trouble in that situation (feeling all clean and pampered gets me ready without fail).

So my question is whether this seems normal…  Apparantly there’s a big market for drugs to improve male performance, but I’m not sure if it applies to me.  Should I take the phrase “erectile dysfunction” literally?  In other words, since I have no trouble with erection am I not a candidate for these meds?

I’ve read in men’s magazines that a guy (presumably somewhat younger) should basically be able to ejaculate when desired, but have the “control” to decide when that should be, and thereby create a nicely synchronized experience with his partner. Now, could come a lot of times back in college, but it was the situation where I’d “reach the point of no return” and that was that.

So can you share some perspectives on whether this evolution seems normal, and if you’d expect that I could improve my situation (e.g., get back to being able to have multiple orgasms)?

One Hit Wonder

Dear One Hit Wonder:

Back in college…if you are in your upper 40s, there’s simply no point in comparing anything with what happened back in college.
Yes, you are as normal as can be. No, you don’t have ED (erectile dysfunction), although the pharmaceutical companies would probably love for you to think so and throw some free samples of PDE-5 inhibitors at you left and right. Yes, your sexuality is changing – now it’s more about the journey rather than the destination. It’s going to take longer for you to climax, your refractory period may be longer and you may not always be able to come on command. So what? That’s life. I bet you can’t run as fast as you could when you were in college, or play an equally rough game of football without feeling it the next day. Is that “normal?” You bet it is. It’s called “aging” and it catches up with all of us.

If you want to have “multiple orgasms,” I suggest you put yourself in the hands of a very skilled tantrika or an erotic body worker who specializes in prolonging pleasure, eliciting dry orgasms, etc. You will learn a whole different level of control that resembles very little to what went on for you in days of yore (or shall we say youth?) Repeat after me – it’s the journey, not the destination.

Christine Milrod, PhD