Psychosexual and Psychosocial Aspects of Male Aging and Sexual Health
Metz, Michael E., Miner, Michael H., The Canadian Journal of Human Sexuality
ABSTRACT: This paper examines the male aging process in the context of the biological and psychosocial dimensions of male sexual health. The scientific literature concerning the physiological and psychosocial aspects of male aging, and the impact of aging on male sexual function and sexuality is summarized and discussed. A biopsychosocial model for conceptualizing the interaction between the various aspects of the aging process is proposed as a means of assisting men in adapting to their changing sexuality in a positive way. The importance of distinguishing between the normal changes in sexual function and response associated with aging and those changes associated with specific health problems is emphasized.
Key words: Male sexual health Aging Psychosexual issues
There is considerable discussion about the effect of aging upon men's physical, psychological, and sexual health. In both the medical and popular literature, there are comparisons to women's aging, and some have proposed that there is a male "menopause" similar to women's (Heller & Myers, 1944; Werner, 1939) which "strikes at the core of what it is to be a man [...] his youthful sexual drive and performance" (Sheehy, 1993) and purportedly includes such symptoms as hot flashes, depression, insomnia, mood swings, irritability, impotence, decreased libido, weakness, lethargy and lose of bone mass. Also, it has been observed that men, on average, have shorter lives than women (Nathanson, 1990; Niven & Carroll, 1993). In the United States, for example, the average life expectancy of men is about seven years shorter than that of women. Yet women also report experiencing more illness, being more incapacitated by their illnesses, and making greater use of medical care than men do (Verbrugge, 1985).
This paper offers a summary of the professional literature examining aging and sexuality among men. In spite of claims to the contrary, a review of the premium medical literature regarding male aging suggests that normal physiological and sexual changes as men grow older are gradual and modest (Metz & Miner, 1995). In addition, the psychosocial literature suggests that there are few consistent emotional or cognitive changes associated with age, and some appear to be beneficial rather than disabling. Subsequently, we advocate a biopsychosocial model that acknowledges an ongoing interaction between physical and psychological health, and recognizes that there is a variety of physical and psychological scenarios within which aging men experience their sexuality. On the one hand, for men who adapt to the inevitable physical changes of aging that occur even with good health, and experience high success in those areas of life that are important to them (such as career, financial well-being, relationship with spouse, relationship with children/extended family, avocations, friendships, social status), well-being will be very high. On the other hand, men who experience either poor physical health (e.g., serious, chronic illness that impairs lifestyle) or who feel that they have had lower success in those areas of life important to them, will experience lower well-being. Table 1 presents our expanded biopsychosocial schema to conceptualize the ways in which various levels of physical health and psychosocial health might interact to affect overall sense of well-being as men age (Metz & Miner, 1995). The numbers in this model show how high scores in both areas might yield high levels of well-being (1), low scores in both would yield low sense of well-being (9), and scores in between would derive from various combinations of these two dimensions of health status. The model is meant to emphasize integration of the different areas of life and promote a systemic notion of health or well-being. It is such an integration of physical and psychosocial dimensions in mid-life which offers men a developmental opportunity -- and in some cases a demanding challenge -- to integrate the compartments of their lives more humanely, compassionately, and inclusively. …