While age doesn't have to be a barrier to a fulfilling sex life, however, biological changes can have a significant impact on libido and performance. So, what really happens to sex drive as we age and, more importantly, once it's lost what can be done to get it back? But heartening research on 25, middle-aged men published last week in The American Journal of Clinical Nutrition found that consuming three or more portions of food and drink such as red wine, blueberries, cherries, citrus fruits and radishes could reduce a man's risk of developing ED by 14 per cent.
Men who exercised regularly reduced their risk by 21 per cent. Declining sex hormones play a big part in both desire and sexual functioning as we age. In men, for every year after 40, the sex hormone testosterone drops by about one per cent, with one in five men tested showing low levels, says Vivek Wadhwa, consultant urological surgeon at Spire Parkway Hospital and Heart of England NHS Foundation Trust.
Your GP can refer you to a urologist who can measure testosterone levels and, if needed, prescribe replacement through gel, patches or injections. However, he advises that men see a specialist urologist "as testosterone supplementation in men with an undiagnosed prostate cancer can feed its growth". If testosterone doesn't work, however, drugs such as Viagra or the newer Cialis can be taken. While the former takes about 40 minutes to work and can be taken up to twice a week in mg dosages, the latter can be taken in a 5mg once-a-day dosage.
This means "levels in the blood stay stable, so the sex needn't be planned", says Wadhwa. If you have erectile dysfunction, ensure you have a screening for cardiovascular disease risk before taking drugs. Sex and the menopause Sex researchers Masters and Johnson found that in middle age, women tended to take less time to reach orgasm than men, but hormones could still have an impact.
Locally applied oestrogen cream, which can be prescribed by your family doctor, in small doses "is like using a very expensive night moisturiser", she says. Applied twice a week for three months, it moisturises the cells and restores natural secretions.
While many women fear hormone replacement therapy HRT because of the highly publicised debates over its increased risk of breast cancer, this is a tiny dose - 10mg compared with 1, in a typical HRT pill - and "too low a dose to enter the blood circulation".
Lifestyle measures can help both men and women, says Ian Kerner. Brief periods of cardiovascular exercise can also help. A study published in the Journal of Sexual Medicine found that minute bursts of exercise performed five-to minutes before sex, with the heart rate at 70?
The myth of desire in middle age Don't fancy it tonight? Get started anyway, say experts. This is a boom area, with products such as "female Viagra" becoming a holy grail for companies seeking solutions for what is dubbed the middle-age "sex problem".
Thinning skin around the genital area can increase the risk of sexually transmitted infections, which peaked in the over-fifties last year, along with thrush and urinary tract infections. It can increase your ability to orgasm. For women, the Pericoach is a new medical device and app that has been shown to strengthen the pelvic floor. Studies have shown its effectiveness, but you might need to sign up to a six-week sex ban to break bad habits, says Relate's Cate Campbell.