Unlike women, men do not have a physiological (and cultural) event to mark reproductive changes, although there is a gradual decline in testosterone levels (Seidman, 2003). Men do not experience a complete loss of the ability to father children, as this varies widely from individual to individual, but men do experience a normative decline in the quantity of sperm (Knowles, 2006). However, even at age 80 a man is still half as fertile as he was at age 25 and is quite capable of fathering a child.

With increasing age the prostate gland enlarges, becomes stiffer, and may obstruct the urinary tract. Prostate cancer becomes a real threat during middle age; annual screenings are extremely important for men over age 50 (American Cancer Society, 2008a). Testosterone levels stay about the same or decrease only slightly in most men (Knowles, 2006). However, some men who experience an abnormally rapid decline in testosterone production during their late 60s report symptoms similar to those experienced by some menopausal women, such as hot flashes, chills, rapid heart rate, and nervousness (Ebersole et al., 2004).

Men experience some physiological changes in sexual performance. By old age, men report less perceived demand to ejaculate, a need for longer time and more stimulation to achieve erection and orgasm, and a much longer resolution phase dur­ing which erection is impossible (Saxon & Etten,

94 CHAPTER 3

1994) . Older men also report more frequent fail­ures to achieve orgasm and loss of erection during intercourse (AARP, 1999a; Jacoby, 2005). However, the advent of Viagra and other medications to treat erectile dysfunction has provided older men with easy-to-use medical treatments and the possibility of an active sex life well into later life.

As with women, as long as men enjoy sex and have a willing partner, sexual activity is a lifelong option. Also as with women, the most important ingredient of sexual intimacy for men is a strong rela­tionship with a partner (AARP, 1999a; Jacoby, 2005). For example, married men in early middle age tend to have intercourse four to eight times per month. The loss of an available partner is a significant reason frequency of intercourse drops on average by two and three times per month in men over age 50 and 60, respectively (Araujo, Mohr, & McKinlay, 2004).