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Dear Betty,

I'm sure that this is a common problem as people age but seeking help to sexual problems when you are older can be quite disconcerting it seems.

In recent years, my wonderful wife who is 64, has lost almost all interest in sex. Sexual intercourse for us is a once or twice annually event and I happen to know that she rarely masturbates now either. I'm 65 and in recent years have noticed a decline in my libido too and in particular a decline in the strength of my erections.

While my wife seems to be completely accepting of her lack of desire, I have actively worked to maintain mine with a variety of measures including watching a bit of internet porn. While she knows I masturbate, I still do it privately. I really enjoy masturbation of course but I do miss the intimacy of sex with my wife. Occasionally (rarely) she will join me and we will masturbate together. While it's not perfect, I do really enjoy the intimacy.

I am on blood pressure medication and read on the Pfizer web site that caution should be used if using Viagra if a person is on hypertension medication. So, rather than try and get hold of Viagra on my own I went to my doctor to see what could be done to rejuvenate my sex drive and sex life using alternate means.

Now I'm guessing my doctor is about 40 years old and I've been with him now for about 2 years. Because I thought I would need something more than a little blue pill, I felt I should give him some background to my current concerns. The thought of discussing these issues openly with him did create a bit of anxiety but because I have always felt quite comfortable with him, I opened up and gave him a full and detailed history. I explained that, to my disappointment, my wife had lost interest in sex and that most of my sex these days was spent masturbating. I must have spent 15 minutes filling him in on some of my most intimate details thinking this would give him an insight into how to treat the problem.

There was nothing in what I told him that I thought he'd find too disconcerting. I guess the worst of it was that I told him I now resorted to watching porn to induce enough arousal to masturbate and even then I often had to do it without a full erection.

What I was amazed about, was that he seemed quite uncomfortable while I was discussing the details with him. He wasn't the only one because I was way out of my comfort zone too. What I expected was for him to recommend a remedy, perhaps hormonal therapy or counselling, that would address both my wife's and my libido issues. What I got was a short sharp "wait a second", before he disappeared from his surgery and returned a few minutes later with a couple of trial packs of Viagra. I questioned him about my hypertension medication and he said "That's fine." I was amazed and felt extremely embarrassed because he'd obviously felt quite awkward about what I was telling him. It wasn't a pleasant experience for me either.

It didn't do me any good knowing I could have just gone to him and said "I have ED." and I'd have been out of his surgery in 2 minutes with the same result. I was quite surprised too that he didn't touch on the deeper issues of lack of libido and maybe suggest that my wife and I should get some assistance to rectify that. I felt humiliated by his assessment that the total issue could be solved by issuing a little blue pill.

Now, when I go to him for a consultation, he seems slightly different. Perhaps it's just me but I get the distinct impression he feels I'm some sort of "weirdo." Who knows, maybe I am. Is it that unusual for a man of my age watching porn and masturbating to make up for a lack of sex with their partner?

Dear M,

You have perfectly described the lack of sex education in the case of most doctors. A few might bring themselves up to speed, but for the most part it's just as you said. . .a pill with no information because they really don't have anything else to offer. The weirdo is your doctor not you. Not all men can safely take Viagra. Shame on him.

If you've spent some time on D&R, I'm sure you'll come across some of my essays dealing with women and menopause. I haven't done much about older men but you guys also go through what we might call "manopause" as your testosterone levels drop just like women lose their estrogen. Masturbating with porn would be recommended by any decent health care provider unless he or she was a Christian and felt that images of sex were sinful and not in keeping with their faith. So their sex organs just shrival and dry up.

I recommend you get some sex toys and add some spice to your sessions with Mr. Happy. Be sure to use a nice clean massage oil that is without chemicals or perfumes. One thing we all can share and enjoy at any age is giving and receiving a massage. If you did this with your wife you could both include genital massage. Make it clear that neither one of you has to respond sexually. Just relax and enjoy the intimacy. Also consider hiring a professional for massage. I have gone for years with just masturbation and massage. I take care of my orgasms and my massage therapists provide professional over all touch that is very healing. We all need to be touched.

For your masturbation get a couple of vibrators. Either the electric Magic Wand or the smaller battery operated Mystic Wand. Men can get much benefit from using a vibrator on their penis just like a woman feels it on her clitoris. Next time you and your wife watch porn together, you could each be using a vibrator which offers far more stimulation than our hands alone. Go to our sex shop and consider getting a fleshlight for your masturbation. Men say it's very much like having sex inside a vagina. Also anal penetration would be beneficial for your prostate gland and it feels fabulous.

All of this information is available on our website. So my advice for all of us seniors is to take advantage of every and anything in order to squeeze out one more orgasm. They aren't as big or as strong or as passionate as when we were younger, but they continue to feel damn good.

Next time you see your doctor, tell him about all you've learned at www.dodsonandross.com. Maybe he'll pay us a visit too.

Dr. Betty