As adolescents and young adults, the great majority of males learn that a spontaneous erection signifies desire and that intercourse and orgasm are easy and autonomous (he needs nothing from his partner). Males mistakenly assume that totally predictable erections leading to intercourse are the measure of real male sexuality.

This assumption is a major cause of male sexual problems with aging, starting as early as age 40. The demand for spontaneous and easy erections leads to performance anxiety, erectile dysfunction, embarrassment, frustration, and sexual avoidance. He cannot live up to unrealistic demands to prove he is a real man. The truth is the way males have learned to be sexual does not promote healthy male sexuality with aging. Although spontaneous desire and predictable erections are welcome, the demand that a real man be measured by those performance criteria is self-defeating.

The challenge for a wise man is to accept “responsive male sexual desire.” This is optimal for the man and couple. Receiving a back rub as a cue to desire is more acceptable for women than men, although it is valuable for aging men. Enjoy spontaneous desire and erection when they occur, but be aware that responsive desire is more common, genuine, and satisfying for him and his partner.
This new understanding of male sexuality is just as important regarding erections. He enjoys easy erections when they occur, but values intimate, interactive touch and pleasure that promotes sexual responsivity and erections. With aging, this is more common than spontaneous erection. Erections involving intimate, interactive sexuality are more genuine.

The new model of male sexuality with aging is based on two core concepts--responsive sexual desire and good enough sex. This is more satisfying than the autonomous sex performance approach.

Responsive sexual desire is a relatively new concept for men. When the concept of responsive desire for women was introduced 20 years ago, it was accepted as a way to acknowledge healthy female sexuality, separating it from the male-dominant model of sexual desire. Male responsive desire is motivating and validating. However, it is difficult to convince men that responsive desire is normal and healthy. Male peers maintain that spontaneous erections and feeling horny are the right way to experience desire.

The breakthrough clinical intervention is developing “bridges to desire.” This involves creating scenarios that build sexual anticipation and promote a sense of deserving sexual pleasure. Giving and receiving pleasure-oriented touch facilitates desire. It is normal and healthy for the man to begin an encounter at neutral. He experiences sexual responsivity first and then experiences desire. He learns to piggyback his desire and pleasure on his partner’s. Rather than leading with desire, this involves acceptance and openness to pleasure. It is optimal to have “his,” “hers,” and “our” bridges to desire. This promotes strong, resilient couple sexuality. An involved, responsive sexual partner is a major aphrodisiac. Each partner experiencing pleasure promotes desire for both partners. In the new couple mantra of desire, pleasure, eroticism, and satisfaction, desire is the core factor. Openness to both spontaneous and responsive desire is reinforcing, while realizing responsive desire is more common.

The second component, especially for erectile comfort and confidence, is that both partners embrace the good enough sex model. Creating erectile self-efficacy is much superior to hoping for a return to easy, spontaneous erections. Rather than depending on totally reliable erections, he learns to enhance comfort and confidence based on responsive desire, relaxation, and pleasure. He moves from anticipatory and performance anxiety to developing comfort with a natural flow from pleasure to arousal to eroticism to intercourse. Rather than perform for his partner, he shares pleasure.

Anxiety is replaced by giving and receiving pleasure that promotes sexual responsivity and erection. The major reason men have disappointing results with medical interventions, especially Viagra, is as soon as he gets an erection he rushes to intercourse because he fears he will lose his erection. In good enough sex, he focuses on relaxation and pleasure, establishing erotic flow before transitioning to intercourse. He engages in the pleasure-eroticism experience. He does not transition to intercourse until subjective arousal is at least 8 (on a 10-point scale of subjective arousal).

Good enough sex celebrates erection and intercourse, but sexual satisfaction is not contingent on intercourse. Good enough sex accepts and celebrates great sex, good sex, okay sex, and even dissatisfying or dysfunctional sex. It accepts both synchronous and asynchronous (good, but better for one partner than the other) experiences. Good enough sex is a couple concept based on sharing pleasure, not an individual sex performance test. Accepting responsive desire and what's good enough is a solid foundation for male sexuality and aging.