At around forty, people enter a period of transition from their younger years to what has traditionally been called “middle age.” It is a time when the visions and energy of youth begin to give way to hard realities and when most people first confront their own mortality and sense that time is running out. Some feel alarmed because their physique has folded and their youth “has flown the coop,” never to be regained (despite attempts at fancy diets, jogging, hair dye, and face-lifts). For most people, life must be reappraised in terms of goals, accomplishments, and experiences. As a result, a midlife crisis sometimes begins to take shape. From a sexual perspective, the male seems to be particularly vulnerable to the midlife crisis. Since rumor has it that after age forty a man is “over the hill” sexually, many men begin to check their sexual performance for signs of wear and tear. This is well-described in the following:
He notes that it takes more time to become aroused. Where it used to be a matter of seconds and a mere glance at the orbs of flesh colliding beneath a pair of tennis shorts, he may take minutes or more to reach erection as he gets older. He also notices, correctly, that he is slower on the comeback. In the sweet agonies of teen age he may have walked about with an erection all day, seldom completely losing it even after he made love or masturbated — a virtual prisoner of his hormones and tight-fitting pants. But now each sexual act has a definite beginning and end, and it may be a matter of hours or all day before he can reach erection again. Comparisons, stinging comparisons … he is not the boy he once was.
Once a man begins to question his sexual capabilities, the odds are that he will experience difficulty getting or keeping an erection. This, of course, “proves” the correctness of the underlying concern, and a vicious cycle is set in motion.
Some men turn to younger sexual partners to heat up their passion4 and Others succeed, at least to a certain degree, in blaming the problem on their wives. But the middle-aged male is in a precarious position of sexual vulnerability. If he goes to a physician to discuss the problem, he may be told (as several of our patients have been), “At your age, you shouldn’t worry about it anymore.”
The woman’s midlife crisis is less apt to include concern about her sexual capacity. For women who have chiefly been mothers, it is a time for an emerging identity, a freeing of the inner self as children reach a relative stage of greater independence. It is a bittersweet time in which a woman who has not established a career or nonfamily interests may mourn the passing of her offspring into their own maturity and may simultaneously look at available options for redirecting her talents and energy. As children leave home, the “empty-nest syndrome” may strike, causing depression and listlessness as the woman tries to deal with too much unstructured time and few sources of rewarding or interesting activities. Since these vulnerable feelings may be followed by or coincide with the menopausal years, it may be a particularly trying period for such women. Interestingly, recent research suggests that it is not only women who may be affected by the empty-nest syndrome. Roberts and Lewis point out that men are also sometimes distressed by their children’s departure from home, “discovering that their marriages and friendships had become empty shells about the same time that loved children were leaving.” Of course, having children leave home can have positive effects on a marriage, too — for instance, it gives couples a chance to focus on their own interaction and can create opportunities for freer, more relaxed sex as well.
There are more and more variations on the midlife transition today. Career-oriented women who postponed motherhood (and time off from work) until their mid-thirties may be anxious to reconfirm their work identity, but may have trouble finding a job or getting back on the “fast track.” Other mothers who refused to restructure their lives around childrearing and continued to work outside the home — either by choice or by economic necessity — may feel considerable guilt or exhaustion. Still other women find their lives complicated by divorce and face child-rearing as a single parent; alternatively, if they remarry a man with children of his own, the family interactions may become particularly complex.
Another component of the midlife crisis for both sexes that has been generally overlooked is the phenomenon of sexual burnout, which may affect as many as 20 percent of people in this stage of the life cycle. Unlike occupational burnout, which occurs largely in reaction to a person’s intense investment of time and energy in his or her work coupled with chronic, unrelenting emotional pressure, sexual burnout stems from tedium and satiation with the same sexual-routines. More than simply boredom, which can certainly be one of its precursors, sexual burnout is typically marked by a sense of physical depletion, emotional emptiness, and a negative sexual self-concept. Caught in the throes of sexual burnout, the middle-aged adult develops a feeling of sexual helplessness and hopelessness, as though nothing can be done to rekindle erotic passion or pleasure. Sexual burnout occurs not only in married couples but also in singles who have previously been very active sexually.
Sexual burnout is not the same as the sexual lack of interest that often accompanies depression. Depression is typically marked by disturbances in sleep and appetite and by a general loss of pleasure in all or almost all usual activities or pastimes. People experiencing sexual burnout do not have these symptoms. While the prognosis for sexual burnout is generally good, since most people recover spontaneously from this syndrome over time, about 10 percent of those affected remain sexually inactive on a relatively permanent basis. Perhaps this indicates that they are happier with celibacy than with cultural stereotypes that prescribe sexual participation as obligatory for a “healthy” adulthood, or perhaps it shows their inability to overcome the negative effects of the sexual burnout syndrome.
Of course, not everyone experiences a full-blown midlife crisis, and for some, the forties and fifties are a time of happiness and sexual satisfaction. One woman told us, “I’d never want to be twenty-one again — being forty-five is more fun!”
Most men have “discovered” their sexuality in a joyous way by their twenties, but — at least in past generations — a sizable number of women did not awaken from their socially programmed sexual dormancy until their thirties or forties. Given the traditional limits set on female sexual behavior and feelings (“nice, girls don’t. . .”) and given the traditional division of marital responsibilities (domestic and childbearing duties are “female,” career orientation is “male”), this pattern should come as no surprise. As a result, many women undergo a process of sexual self-discovery in mid-adulthood, perhaps including being orgasmic for the first time. The woman in this phase of the life cycle is just as likely as her mate to seek out extramarital sexual opportunities, although this fact is not written about extensively.
The sexual problems of mid-adulthood are not restricted to heterosexuals, although little attention has been given to the middle-aged homosexual population in America. Here, too, a wide variety of patterns is seen. Gay men in their forties may find that it becomes more difficult to attract younger partners on physical grounds alone. As a result, some homosexual males turn to paid male prostitutes, others become relatively celibate, and still others form long-term relationships that provide companionship and emotional support as well as sexual opportunity Gay men who were previously in heterosexual marriages — including many who were fathers — often decide to divorce and change to an exclusively homosexual life.
It has been noted that some gay males who have put an emphasis on conquests, techniques, and the ideals of the youth culture develop much anxiety about aging. These men sometimes resort to face-lifts or hair transplants to retain the illusion of their youthfulness (as some heterosexual men do, too) and they often develop depression or become alcoholic as a reflection of the negative sense of self they experience as their aging becomes more apparent. However, most homosexual men do not encounter such difficulties; generally, they have the same types of problems as they grow older that heterosexuals have.
Lesbians are often able to make an easier transition into middle-adulthood because of the fact that more of them are in lasting, one-to-one relationships. Nevertheless, while concern over physical attractiveness may not be quite as strong an issue as it is for some gay males, there can be intense jealousy that arises in these relationships “whenever the relationship is threatened by other women who might intrude and attempt to disrupt the coupling”
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