Men's Secret Sex Problem

What can you do?

First, consult your doctor. Your physician should investigate possible infections, drug issues, or pain or neurological problems. For antidepressant-induced problems, ask about switching to one that is less likely to impair sexual performance.

Practice Kegel exercises. These simple, discreet exercises tone the pelvic floor muscles, intensifying orgasm and strengthening ejaculation. Ask your doctor for instructions or look online for tutorials.

Value your erotic context. Young men can function sexually under almost any circumstance. But after 50, the context becomes increasingly important. Identify the optimal sexual situation for you, and work with your partner to find it.

Value your own pleasure. You're more than a delivery boy. You, too, deserve erotic satisfaction and have every right to ask for the stimulation that produces it. If you still have vaginal intercourse, it may not provide enough stimulation for ejaculation. "You may need vigorous manual or oral stimulation," Klein says. "If so, ask for it."

Coach your partner. Show your partner exactly what works for you, and coach your partner to provide it. You may feel bashful about demonstrating something that's usually private. But doing so not only teaches your lover what you need, it also involves self-revelation, which deepens the intimacy in your relationship.

Breathe deeply. It relaxes the nervous system so that erotic stimulation can trigger orgasm and ejaculation.

Focus on fantasies. Recall the sexual fantasies that have turned you on in the past. Elaborate on them. They need not include your lover. They just need to excite you. Or try X-rated videos.

Use lubricant. Sexual lubricants make the genitals more sensitive to touch, and often help men with performance problems.

Consult a sex therapist. If self-help doesn't provide sufficient relief, sex therapists can usually help men resolve any issues. To find a sex therapist near you, visit the American Association of Sexuality Educators, Counselors and Therapists, the Society for Sex Therapy and Research or the American Board of Sexology.

 Journalist Michael Castleman has written about sexuality for 37 years and currently publishes GreatSexAfter40.com.