The Sex Issue That Plagues Most Men of a Certain Age Haunts Me. I’m Ready to Do Something Drastic.
How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!
Dear How to Do It,
I’m a gay man in my late 50s, and I’ve dealt with erectile dysfunction for years. I am versatile, but I’ve been bottom more than top, especially over the last few years due to the ED. I’m on multiple medications (ADHD, blood pressure, antidepressant) that can impact erections, and have tried different medications to reduce this problem with little success. My testosterone levels are fine on supplementation.
I’ve taken Viagra and Cialis for years with diminishing effectiveness, so I saw a urologist, and he proposed an inflatable penile prosthesis. This was a shock to me because I did not think I would qualify or that my insurance would cover it, but he assured me that it did. Insurance initially rejected it, but I did try a vacuum pump and injections in the interim, both of which work, but neither is conducive to spontaneous sex. I can still get an erection 90 percent of the time by myself, and a fair amount of time with a partner; however, most of the erections are not strong enough for anal, or if they are, they soften up after a few minutes, and it ends up not being something that will take me all the way to climax.
I’m currently scheduled for surgery in a couple of months, but I keep wondering if I am rushing things and should wait until it is the only alternative. I also don’t want to spend the next 10 years sticking myself in the dick with a needle every time I want to have sex, when I could be having awesome “on demand” sex. It is an irreversible procedure, so I’m, of course, having natural hesitancy, but I also feel like I’m going to do it unless you wise people tell me that it would be a big mistake.
Dear Future Bionic Top,
At this point, it’s reasonable to consider an implant. You have tried many options and haven’t yet been satisfied with any. There’s probably some room for you to experiment (a cock ring in combination with medications/injections could help, for example), but not very much. Regarding your mindset, I generally caution against prioritizing spontaneous sex because it upholds an unrealistic ideal in the face of actual, practical help. But look, you’ve found a solution for someone who, in fact, prioritizes spontaneous sex while experiencing erectile dysfunction. In that respect, you seem to be a prime candidate for the procedure.
A few years ago, I interviewed a doctor who frequently performs implant surgeries (to the tune of 80 a year, at least at the time of the interview in 2021). You should read that column. One of the facts I’d like to highlight from it is just how irreversible the procedure is. “You can’t say, ‘I’ll try a prosthesis, if I don’t like it, in two years from now, I’ll just try some Viagra,’” Dr. Arthur Burnett told me. “Your penis structure will have changed, so medications or other, more minimal options are likely to be unsuccessful.” He also said that the surgery comes with the risk of infection (like virtually all surgeries), but in this case, it happens in around one of every 100 implants. Burnett described implants as “something that can restore a man’s sense of wholeness, not to mention his function,” which is to say that the psychological benefits are very clear. As someone who is pro-medicine and trusting of doctors, I think you’ve been put on a good path. Definitely be sure that this is exactly what you want before you go through with the procedure, but I am all for it.
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Dear How to Do It,
I’m a woman planning to have a threesome with two guys. This will be my first time being with two men at once. Do you have any advice or pointers?
—Hoping Three Is Kind of a Crowd
Dear Hoping Three Is Kind of a Crowd,
It always helps to go in with a semblance of a plan. If you can verbalize to them what you’d like to do ahead of time, go for it. Also include hard nos and plans for contraception and precautions against STIs. If you absolutely don’t want any form of double penetration, state that clearly before you get started, and they won’t be surprised. (If they attempt to do so anyway, you have every right to shut it down then and there—and you’ll know you’re with inconsiderate partners who don’t deserve a second round.) It’d also be useful to ask the guys (preferably together, but individually could work, too) what they would like to happen during this encounter. Will they want to play together? Are there preferred positions? Do they favor oral over penis-in-vagina or vice versa?
Once you have a good sense of boundaries and preferences, approach what is on the table with abandon. This is supposed to be fun. Connection means different things to different people, and in a casual situation like this, it can seem appealing or off-putting, depending on taste. But if connection is something that you’re looking for, know that it’s possible to achieve even in a group setting (via things as simple as eye contact or encouraging language).
If you want things to go smoothly, and especially if you want a repeat of this group, stay mindful and attempt to give the guys equal attention. It’s not always easy or even possible (sometimes you may find yourself gravitating to one dick over the other or just realize that you vibe with one of the guys more once you’re all naked), but it’s worth striving for. Going in with a good attitude and resolve to ensure that everyone comes out feeling great will set you up for success.
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Dear How to Do It,
My wife and I turned 50 this past year. We have been together since we were 18 and got married at 23. In most aspects, our lives are great. We have two wonderful teenagers and stable jobs, we’re upper middle class, and are surrounded by many family and friends. Our sex lives are lacking.
We have only been with each other, except for me, who had a brief relationship before we met at 18. We seem to have great, but vanilla sex on vacation. Years ago, we experimented with tantric massages. When we’re at home, we don’t have sex, which I attribute mostly to the daily stresses of life and busy schedules. But I also want more. I want to be able to explore together, learning new things about sex and pushing our boundaries. I have tried to engage a little bit about our fantasies, but that hasn’t really gone anywhere. We’ve bought toys, but usually those are used once and then stored away. I know I watch porn and masturbate too much, and this has jaded my expectations of what sex is supposed to be. But I know we can do better. How do we get out of this rut, reignite our sex lives, and explore together?
Dear Long-Term Relationship Rut,
What you are experiencing is extremely common, and there are a lot of great tips in Esther Perel’s Mating in Captivity that may inspire you (that book is the Bible of long-term bed death for a reason). One of her suggestions that leaps out as a potential helper here is to get a hotel room with some regularity, specifically for sex sessions. Try this. You have the funds, and you’ve seen that your sex life thrives outside of your typical environment. Of course, getting a hotel room nearby where you live isn’t quite the same thing as going on vacation, but perhaps the change of scenery will be all you need to mutually turn on. If you find yourself still saddled by the stressors of life despite the venue change, consider working on relaxing—introducing meditation, a fitness regimen, or even some spa time might do the trick.
The theme of this guidance is effort. You can’t sit around expecting your sex life to magically improve. Why are you treating sex toys like single-use plastics? Bring them out again! What does it mean that you “tried to engage a little bit about our fantasies, but that hasn’t really gone anywhere?” Don’t let that conversation fall to the wayside so easily. Don’t be annoying or badger your wife, but be persistent enough to gain an understanding of where her mind is regarding the topic of your sex life and fantasies that could yet be realized. You’ll need her participation and effort, too, so if she’s not willing to do that, you can at least probe as to why.
More Advice From Slate
I am a woman who’s begun dating a man who it turns out is a virgin. He went to Catholic school his entire life. He’s focused on reading up on how to please a partner while he’s spent his time alone, and I’ve gotten the benefit of that, but he also didn’t know that you don’t need to be literally inside of a woman to get her pregnant when you ejaculate or otherwise get semen around her vagina.