Free O by Jonathan Margolis Page B

as ever about the implications this may hold for earlier eras – epidemiological surveys of male sexual functioning suggest that 13-17 per cent of men ofan age to be sexually active suffer from decreased or non-existent libido; 7-18 per cent are unable to get an erection; 28-31 per cent of those who can suffer from premature ejaculation as they themselves see it; 7-9 per cent of those with fine, long-lasting erections find themselves nevertheless prey to anorgasmia, the inability to orgasm at all; and 15 per cent are anxious either from their own or their partners’ perspective about their sexual performance. The incidence of erectile dysfunction in men increases with age; at 40, about 5 per cent suffer the condition; at 65 and older, the incidence is 15-25 per cent. But although sexual vigour in men declines with age, a man who is healthy, physically and emotionally, should be able to sustain erection, and enjoy sex regardless of age; impotence is not an inevitable part of ageing.
    The male sexual performance is clearly a rather more delicate flower than is generally acknowledged. Ageing aside, any of the above symptoms can be brought on by problems in any of the following areas: ill health, psychological wellbeing, medical treatments, smoking, family, societal and religious beliefs, and neurological, vascular or endocrine systems. Ejaculatory disorders come in three varieties: premature ejaculation, retarded ejaculation and retrograde ejaculation – the propulsion of semen through the urethra back into the bladder rather than out through the tip of the penis, aka ‘injaculation’.
    Sexual dysfunction in men can additionally be quite paradoxical because the mind exercises such a huge influence on sexual function. It is commonplace, for example, for a man to be unable to get an erection because a woman is unattractive to him. But with such a partner, he may easily be able to achieve and maintain a fine erection – only to have his underlying lack of true sexual attraction betrayed by anorgasmia. And just as easily as he is able to put in what appears (until he fails to ejaculate) to be a championship performance when he does not actually find a woman very attractive, he may equally suffer a disastrous premature ejaculation precisely because he finds his partner extremely beautiful. Su-nii-ching Fang Nei Chi,the seventh-century author of a book called
Secrets of the Bedchamber
, recognised the potential for men to use to their advantage this ability to maintain an erection with an unattractive partner. He advised: ‘Every man who has obtained a beautiful crucible will naturally love her with all his heart. But every time he copulates with her he should force himself to think of her as ugly and hateful.’
    Masturbation also confuses the picture of male sexual dysfunction a little. Many men can easily orgasm through masturbation but have difficulty in heterosexual intercourse. This may be because they use far heavier pressure in masturbating than is normal in vaginal intercourse. Until they learn to orgasm with lighter pressure, they may well have problems in ejaculating during coitus. Equally, masturbation may be an easier way than intercourse for an anorgasmic man to ejaculate because he suffers an emotional dysfunction over intimacy.
    Then there is the fraught question of whether a lot of sexual dysfunction
seen
as the woman’s predicament is actually a male failure. What has been called ‘the dissatisfaction theory’ holds that a great deal of female sexual dysfunction – ‘frigidity’ as it was charmingly called until recent times – is not caused by psychological factors, hormone deficiency, diminished pelvic blood flow or any one of the usual suspects; it results from nothing more than inadequate genital stimulation, by men.
    A host of factors, from religious observance to shyness to simple lack of communication, can result in men not knowing how to stimulate a