The Truth About Men and Sex: Intimate Secrets from the Doctor’s Office

By Abraham Morgentaler, MD, BIDMC Department of Urology and the Director of Men’s Health Boston

1. Men fake orgasms. First time I across this, it was a 28 year old man who had difficulty having orgasm with intercourse. When he fell in love, he started faking his orgasm so that his girlfriend wouldn’t feel bad about herself. Turns out that 25 percent of men fake orgasms, according to a study from University of Kansas. Men do it for the same reasons women do: to make their partner feel they did a good job, and to put an end to the proceedings so everyone can get some sleep.

2. Sex drive is tied closely to a sense of vitality. Men who experience diminished or absent libido report they feel old, as if they were on the road to death. When they regain their desire for sex they routinely say they feel “younger,” or “like a teenager again.” Men may lose sex drive for a number of reasons, including side effects from medications (particularly the SSRI antidepressants), low levels of testosterone or depression. It’s important to note that most of the time these concerns are treatable.

3. Men care deeply about being good sexual partners. Once a man’s feelings are engaged, he will often care more about his partner’s pleasure than his own. I’ve had men who have received treatment for erectile function treatment and when they come back in they’re thrilled. They say things like, “I feel like a man again.” And it’s not just because they’re having sex again, it’s often more about what they’re able to do for their partners. Men value being sexual providers.

4. The modern version of the penile implant has been around since 1973, but is almost unknown. The device consists of two hollow plastic cylinders filled with saline that are inserted into the two erectile chambers of the penis during surgery. A pump inside the scrotum is used to control the device. These are used primarily for men who are unsuccessful with the erectile function pills, which includes a lot of men after prostate cancer treatments. Satisfaction rates for men and their partners exceeds 90%.

5. Men are hormonal too. Low levels of testosterone become common as men enter their 50s, and can cause symptoms of decreased sexual desire and performance, chronic unexplained fatigue, depression, irritability, and increased fat, especially around the midsection. Treatment to raise testosterone can cause remarkable improvements for some men, and solid benefits for many others. Recently I saw an 83 year old patient of mine for his annual visit. He had been on testosterone treatment for 12 years, and he was doing great, exercising daily and still having sex with his wife.

6. Sexual stereotypes about men are wrong. Men are not always ready to go. Especially once they’re out of the craziness we call young adulthood. It is not at all unusual for a perfectly normal, healthy man to have periods where he may not be in the mood for sex. Yet men often think there’s something wrong if they feel this way, that it’s not manly. Stress can be a common reason. One patient of mine, a middle-aged business owner, came to see me because he said he was unable to have sex with his wife during the week, but had no problem during weekends. “During the week I’m always thinking about work,” he said. Men are human too, and need the right circumstances to feel sexual, despite what the movies may tell us.