Marvin was a very pleasant sixty-seven-year-old man who had undergone radiation treatment for prostate cancer ten years earlier. Since that time, his cancer had been in remission, but the radiation had caused his erections to worsen and then fail, and
206 ABRAHAM MORGENTALER
seven years ago he had opted for a penile implant. Marvin had an unusual demeanor. He spoke very slowly and deliberately. He had a bemused attitude toward life and a wisdom that was almost Talmudic.
When I saw him for a routine follow-up this past year, I asked, “How are things going with the implant? Are you having sex?”
“Doctor, you have just asked me two separate questions. Please allow me to answer each of them separately. I will begin with the second question. I am not having sex. My wife takes approximately 230 medications a day. She has no interest. By now, it is an old story. I suppose if I pleaded my case she might accommodate me. However, it is not enjoyable to have sex with a woman if she has no interest. I’m not delighted by my situation, but what can I do?
“For younger couples,” Marvin continued, “if there is no sex maybe they’re better off with someone else. But when a couple has been together as long as we have, there are other things that keep the relationship going besides sex. It would be nice to have that great feeling, that excitement, once in a while, but our relationship doesn’t depend on those experiences anymore.
“Now, as to your second question, or rather your first, which I’ve elected to answer second, the implant itself is fine. I take it out for a spin now and again, to check and see if the equipment is functioning, and that my own internal organs still do what they were designed to do. It’s a bit like a middle-aged divorced man driving a red convertible sports car with the top down. If there’s no one in the street to watch him drive by, it is a reasonably good experience, but empty. I was hoping that the implant would bring my penis back to its original size. It’s become smaller as I got older. But other than that, it works and I have no complaints.”
This was the first time Marvin had ever commented on the size of his penis.
“Marvin,” I explained, “the reason your penis isn’t as large as when you were younger is that the radiation treatments cause
scarring of the tissues. They become less elastic, so the erection can’t expand the penis to the same size.”
“It’s all right, Doctor. I’m not really complaining. You know, I had always been annoyed that I was short, at five foot six. However, I had an uncle who was five foot five. He told me that he also used to be very annoyed that he was short until he went into the army. One day he’s in battle, and the guy behind him, who was six feet tall, gets his head blown off. From that day forward, he told me, it didn’t bother him that he was five foot five. We have to make
peace with the way things are.”
*
Men are funny about the size of their penises. They compare, when they can. In the shower at the gym where men see each other naked, you can see each man putting on a show of not being interested in checking out the penises of other men, yet still trying to catch a glimpse if they think they won’t get caught doing it. It is a reckoning of sorts, trying to figure out where they stand with their own penis.
Thanks to my work I have probably seen as many penises as anyone else in the world, sometimes as many as fifty in a day. Not just glancing looks from afar but detailed looks under bright lights as part of an examination. And yet one evening in a restaurant bathroom, after a long day with patients, I caught myself glancing down at the guy at the adjacent urinal! I nearly burst out laughing at myself. If there is anyone alive who does not need to check out one more penis, it is me. It’s a male reflex.
The male obsession with size is related to the belief that a larger penis makes a man more desirable, more powerful. In my experience, men are anxious about being seen naked if they believe their penis is small, but if they believe they have something large hiding in their underpants, they are very quick, sometimes comically so, to drop their trousers. Confidence is paramount when it comes to sex, and a man’s assessment of his penis size has an outsized effect on that confidence.
A common problem for men is they think their penis is small even when it isn’t. In studies where men are asked whether they believe their penis is smaller than average, average, or larger than average, as many as 75 percent respond that their penis is smaller than average. Since it is statistically impossible for 75 percent of men to be below average, this means that either men have a skewed ability to assess themselves, or they have a misguided notion of what an “average” penis looks like.
One day, a longtime patient of mine asked me if I would see his twenty-five-year-old son, Charlie. “He had an undescended testicle removed when he was a child, and he’s very self-conscious about having only one testicle,” the father said. Charlie had finished college, was a smart kid, but he still lived at home in their basement. He worked occasional shifts at a comic book store. Although he used to be fairly social, his father said he never went out anymore, not even with his old friends. And, his father added, Charlie did not date, despite being a “good-looking kid.”
When Charlie came to see me in the office, I said, “Your father told me you were concerned about having just one testicle. Is that right?”
“That’s part of it,” he answered. “The thing I’m more worried about, though, is that my penis is too small.”
“Why do you say that?”
“I just think it is. Can you make it bigger?”
On examination the left testicle was absent, but the right one was fine. And Charlie’s penis wasn’t small at all. Flaccid, it was 4.5 inches, slightly larger than average (which is, according to some studies, around 3.5 inches—but more on that later in this chapter). “Charlie,” I began after he had dressed and was seated in front of me, “your examination is perfectly normal, apart from the fact that you’re missing one testicle. You’d be surprised how many men have just one. They go on to live perfectly normal lives, and I expect you to as well. The testicles make two things—testosterone and sperm—and one good testicle is all a man needs for those.”
WHY MEN FAKE IT 209
Charlie was listening intently.
“As for your penis, you’ve got a great penis. Many men I see would love to have a penis as big as yours.”
“That’s hard to believe,” he said. “I’ve seen guys in X-rated movies, and they all have penises that are way bigger than mine.”
“Charlie, you can’t compare yourself to the guys in porn movies. Most of those men are freaks of nature. They are selected for those movies exactly because they have an unusually large penis. It’s certainly not because of their acting skills!” I joked. “Listen,
no one compares well to those guys.”
*
Charlie nodded. “I know,” he said. “I go to the gym once in a while. You see other guys in the shower. I’ve never seen anyone as big as the guys in the movies. They really are freaks.”
“Charlie, have you had sex?” I asked.
“Yes, a couple of times.”
“I’m curious why you think your penis is small.”
Charlie was quiet for a moment, then spoke up. “I’ve only had sex with two girls. The last one, we just had sex once. I barely knew her. She said something as she was leaving that sounded like she was making fun of my penis. That was, like, five years ago. I haven’t had sex since then.”
“Did you think your penis was small before that day?”
“No.”
“Charlie, people say awful things. It doesn’t mean they’re true. I’m sorry that girl said something cruel to you, but you need to forget what she said. Listen, I see penises all day long, and I assure you that your penis is fine. In fact, it’s above average in size.”
Charlie didn’t have much of a reaction to what I said. I invited him to visit me again in a couple of months, but he never came back. About a year later I saw Charlie’s father for a routine appointment. When we were done, I asked about his son.
“Doctor, I don’t know what you said to Charlie last year, but you’re a magician. I meant to tell you about him. A few weeks after he saw you he found a good job, moved out of the house, and got
210 ABRAHAM MORGENTALER
his own apartment. He started going out again, and he’s got a girlfriend now. It’s been a complete transformation.”
All Charlie needed was reassurance that his penis was all right.
Making the Most of What You Have
How long should a penis be? Practically speaking, an erect penis needs to be long enough to reach inside a woman’s vagina. That may not sound like a very high bar to reach, but there are rare cases where even this is a problem.
Some men are born with a penis that is truly too small, called a micropenis, but this is extremely rare. It is defined by an erection that is less than two inches in length. Obesity can cause the penis to “hide” within the surrounding fat, but the penis itself is fine in those cases. A colleague presented data at a meeting that obese men gain an average of one inch of visible penis for every thirty-five pounds they lose. Now there’s a good reason to diet! A more serious problem is when there’s been a trauma or cancer that requires surgery to remove a portion of the penis. For the surgeon, the rule of thumb is to try to leave a minimum of two inches so that the penis can be “functional.” This length allows the man to direct his stream when he urinates, and to reach the vagina and move in and out a bit during sex.
Hal was thirty-six when he first came to see me. He was a muscular, exceedingly polite construction worker, “all man,” one would think, with a plaid lumberjack shirt with ragged sleeves cut short showing off huge biceps. Hal had been born with a devastating condition called exstrophy (pronounced “ex-trophy,” with the emphasis on the first syllable, as in “ecstasy”). Infants born with exstrophy have a developmental problem in which the abdominal muscles don’t develop properly, and the pubic bones are wide apart instead of having fused in the midline as they normally do. The most obvious and dramatic abnormality, however, is that the bladder sits open on the front of the abdomen, external to the
body. These babies undergo surgery to close their bladders and create space for them inside the pelvis. In some cases, however, the bladders are only rudimentary, and the best choice is to remove it entirely and create an alternative way for the urine to come out. In Hal’s infancy, his bladder was removed, and the ureters, the tubes that bring urine down from the kidneys, were rerouted to drain into his colon. This meant that every time Hal had a bowel movement, he urinated. And vice versa.
Exstrophy is particularly hard on males once they grow up, because they often have an additional problem with a deformed and unusually small penis. Since the two corpora cavernosa are anchored to the underside of the pubic bone, and because the two halves of the pubic bones are so far apart in these cases, much of the length of the corpora cavernosa is spent just reaching to the midline to join the other side. Length that would normally go to create the visible shaft of the penis is hidden inside and under the separated pubic bones.
Hal’s penis was very short, at about two inches, and he had extensive scar tissue along the upper portion that caused the penis to curve severely upward when it became erect. The tip of Hal’s erect penis tickled the lower part of his abdomen, like a miniature boomerang. Between the curve and the short penis, there was no way Hal could have intercourse.
Hal came to see me once a year for three years to discuss what could be done surgically to have a penis that would allow him to penetrate a vagina. After his third visit and a lot of hand-wringing, he decided to do it.
I wanted to accomplish two things with the surgery: One was to free up the two corpora cavernosa from the scar tissue that held them back and also to free them from the underside of each half of the pubic bones. This would give Hal more length. The second was to tighten up the underside of the corpora cavernosa so that the penis would be straighten At the end of the procedure Hal had just over three inches, and his erection pointed outward from his body for the first time in his life.
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“Doctor, my erection is so much better," Hal said, when I saw him for a follow-up one month after surgery. “But it still seems awfully short. Do you think I’ve got enough to be able to have sex?”
“Sure,” I replied. “Is there someone you’re planning on trying it out with?”
“Not really.”
“Well, you’ve healed up nicely. You’ve got the green light from me to go ahead and have sex.”
Hal returned three months later for another follow-up. All was going well, but he still hadn’t had sex.
I didn’t see Hal again for about two years. He was now fortyone. He seemed happy and less rewed up than I’d seen him before. Interestingly, he wasn’t wearing anything that showed off his muscles anymore.
“Have you had sex yet?” I asked, though I expected the same answer I’d heard in his last two visits. Even when a man goes through a major event, such as surgery, to fix something like this, the physical part is only a piece of the action. Socially, mentally, it can be difficult to switch gears, to go from feeling like a “freak,” as Hal had put it in an early conversation with me, to feeling comfortable enough to put himself out there with a woman.
“I have!” answered Hal enthusiastically. He seemed pleased with himself.
“Great,” I said. “How did it go?”
“Doctor, I hope there’s no ten-thousand-mile limit on the work you did, because the truth is I’ve been wearing my penis out. First , I took a chance with this girl I knew. I was nervous that she’d laugh at me because my dick was too short, but it worked out great. It was amazing to finally be able to have sex after all these years. We did it a couple of times. Then I saw another girl for a while. Right now I’m dating a woman I really like. We have sex four, maybe five times a week! I know I don’t have the longest dick in the world, but it seems to do the trick. I guess there’s something to that old line, ‘It’s not the meat, it’s the motion.’ ”
“When did you start having sex?” I asked.
“It. was soon after my last visit, with you, about two years ago. I was thirty-nine years old Can you believe it? There I was, a thirtynine-year-old man having sex for the first, time. I’m not complaining; 1 was convinced it. would never happen in my lifetime”
“Did you see the movie The 40-Year-Old Virgin?” I asked.
“I did! I laughed about that one a lot. 1 snuck in there just before he did!”
The Lengths Men Go To
*
Mans obsession with penis size is nothing new. As an adolescent on family vacation at. the ruins of Pompeii, I remember my father paying the tour guide an extra fee to look at a special fresco behind a curtain. My mother and sister were not. invited. Painted on the wall w’as the picture of a nobleman (some accounts say the character is Priapus, the Greek god of fertility) with an enormous erect penis, the length and girth larger than a man’s leg, placed on an ancient, scale, with sacks of gold balanced on the other side. I rediscovered that image on the Internet and have occasionally used it in lectures, with the quip that men have always viewed a large penis as worth its weight in gold.
The male preoccupation with penis size causes some men to pursue advertised treatments to help them enlarge their penis. Dustin was a thirty-three-year-old married man who bought a traction device online arid used it for several months in the hope that it would make his penis longer. He came to see me because he was experiencing penile numbness, chronic discomfort, and a change in urination. The traction device attaches behind the head of the penis and the other end pushes against the pubic bone. Spacers are used to adjust the length, arid the device then stretches the penis away from the body. The sales pitch is that the traction device will stretch the penis over time as much as two to three inches, which would be incredible if it were true. A minor drawback is that the man needs to wear the traction device for a minimum of four hours daily. That means putting it. on as soon as one
returns home from work. Or wearing the device under one’s pants at work. That’s dedication.
If it weren’t a real product, the traction device would sound like a joke. Imagine a man’s genitals stretched for hours at a time with a deviously engineered device that resembles the medieval torture mechanism the rack? Can you imagine if word got out that a captured al-Qaeda terrorist was forced to wear one of these? There would be protest marches in the street at this violation of the Geneva Conventions. Yet men do this voluntarily in the neverending search for greater virility in the form of a longer penis.
There is no shortage of modern-day con men willing to take advantage of this obsession with penis size. Supplements and herbal concoctions are sold in stores and online with promises to increase a man’s size. “Be the man you’ve always wanted to be,” they say. Then there are the manipulation techniques that provide a more “organic” version of the penile rack. The most popular of these at the moment is called jelqing. Jelqing consists of massaging the penis outward while semierect to “push” more blood into the glans, thereby (according to jelqing proponents) causing the penis to expand. This makes no medical sense at all, but a brief Internet search leads to dozens of videos and instructional guides. One nineteen-year-old man, Louie, came to see me after a few episodes of jelqing, afraid that he had ir\jured himself by being too enthusiastic in his technique.
Then there are the pumps. These are similar to the vacuum erection devices used to treat ED. A plastic cylinder is placed over the penis and air is pumped out of the cylinder, causing blood to move into the penis and creating an artificial erection. The famed comedic movie ladies’ man Austin Powers used a Swedish penis pump to keep himself in tiptop shape. And back in the realitybased world, an Oklahoma judge, Donald Thompson, was convicted of indecency due to his habit of using a penis pump behind the bench while presiding over criminal cases.
It’s easy enough to understand why a man might want to have a larger penis. The question is what impels him to actually do
something about it when the solutions are so obviously fantasybased. For some men, it is a feeling of masculine inadequacy. Dustin, aka Mr. Traction Device, couldn’t answer my question directly when I asked why he had been using this device. However, it turned out that his wife had cheated on him. Louie, aka Mr. Jelqing, explained that he tried the technique because he “thought it would be cool to have a bigger penis.” At nineteen, his sexual experience was limited to two very brief “hookups,” none within the last year. He thought it was possible that a larger penis might
make him more appealing to women. Ironically, Louie’s penis was
*
already quite generous in size.
It is common for men to assume that difficulties in a relationship stem directly from their performance in bed. Some men may believe that by taking Viagra or enlarging their penis they can win back the hearts of their partner, even though nonsexual issues (e.g., alcoholism, abusiveness, lack of affection) are more likely causes for a partner to stray sexually or to break off a relationship.
Men may believe it would be great to have a huge penis, but it’s not necessarily so. Take Peter, for example, a fifty-two-yearold Web site developer in whom I placed a penile implant for ED. He was a serious, thoughtful man. And he had one of the largest penises I’ve seen: a full eight inches erect. At surgery he required the longest implant available, and I had to add several spacers to allow the implant to fit properly. At a follow-up visit I asked whether he was aware he was unusually large.
“Yes,” he said. “My wife and I go to a nude beach every summer, and I’ve never seen anyone with a longer penis than me. I’ve known since middle school that I was bigger than most guys. The other boys made a lot of comments about my penis.”
“Did that make you proud? Make you feel like you had some kind of male advantage over them?” I asked.
“Not at all,” Peter answered quietly. “I was terribly embarrassed by it. The boys would say, ‘If you ever have sex with a girl, you’re going to come out the other side.’ I felt like a freak.”
“What about when you were older and more experienced? Was your penis a source of pride then?”
“No. I was as awkward with girls as anyone else. I don’t understand the obsession with penis size.”
I’ve always been impressed by the number of men I’ve seen with serious medical challenges who are accompanied by attractive women. In some of these cases the men are unable to function sexually, yet their partners are devoted to them. One lesson women have been trying to tell men for a long time is, “It’s not about the penis; it’s about the man the penis is attached to.”
As obvious as this message may sound, it may not get through to a young man just learning the complex rules of sexual engagement. And when there has been a blow to a man’s ego, for example, when a man finds a girlfriend has cheated or simply moved on to another man, it is commonplace for the man to blame it on his penis or his inadequacies as a lover. No wonder, then, that men frequently succumb to the seductive charms of the Sirens of the Internet, promising incredible virility, instant sex appeal, and eternal happiness ($49.99/month, credit card required).
Okay, But How Do I Stack Up?
So, what is a normal penis size? In a study performed at the University of California in San Francisco, doctors measured penis size in eighty volunteers. They measured penises flaccid (soft), as soon as the subjects dropped their trousers, and they measured them erect. The erections were achieved pharmacologically, by penile iryection of the same medications used to treat ED. The average flaccid length, measured from the point where the skin of the penis meets the body to the tip of the penis, averaged 8.9 centimeters, or 3.5 inches, with a range of 2 to 6 inches. Erect penises averaged 12.9 centimeters, or just over 5 inches. The shortest penis in this group of men was 3 inches, and the longest was 7.6 inches. The average increase in length from flaccid to erect was 4.0 centimeters, or a bit more than 1.5 inches. Some men had a
substantial increase in length, as much as 3.5 inches, whereas others had almost none.
Men with smaller penises had on average the same amount of growth with erections as men with larger penises, contrary to lore that smaller penises lengthen more. However, there is some truth to the concept if one considers proportional growth. For example, a man with a 3-inch penis when flaccid who gains the average amount of 1.5 inches will have increased his length by 50 percent, whereas a man with a flaccid length of 6 inches who gains the same 1.5 inches will have added only 25 percent to his flaccid length. So perhaps it is still all right to say that “some men are grow-ers, and some men are show-ers.” And of course, all men experience shrinkage when cold or nervous, which would make their subsequent erection when aroused appear to be even more substantial.
Can I Make It Last All Night, Every Night?
Gary was a fifty-six-year-old sales director who wanted to discuss his symptoms of low testosterone with me. His wife of thirty-four years, Anna, accompanied him. She was one year younger than he was. Gary told me that his energy was way down, and he felt constantly fatigued. “Recently, I’ve taken to sleeping a minimum of nine hours a day just to be able to make it through the day,” he said. “And my sex drive is way down. My erections aren’t that great either. We only have sex now about once a week.”
“When did you notice a change in your sex drive?” I asked.
“I’d say about nine months ago,” Gary replied.
Anna looked at Gary, then at me. “Doctor, may I say something?” she said. “Gary has always had a low sex drive. On our honeymoon, if you can believe it, he sent me home with a couple of his coworkers! That’s not normal!”
“I don’t understand,” I said to Anna. “What were coworkers doing on your honeymoon?”
“We were at a resort on a lake about two hours from where we lived. A couple of guys from Gary’s work were traveling nearby,
so he arranged for them to stop by for dinner, and then they drove me back home to stay with my folks.”
“In my defense,” said Gary, “it wasn’t a traditional honeymoon. It was more of a working trip that we took right after we got married. We stayed at a nice resort near where I had to do some work with clients. We would have sex in the morning before I left for the field, again when I came back for lunch, and then again when I came back at the end of the day. Anna would come to bed at the end of the night as late as midnight, and even though I had to go to work in the morning, we would do it again. After two or three days of that, I thought it was perfectly reasonable to send her home for a few days to stay with her family so I could get some rest!”
This topic was a bit delicate. I explained that one of the challenges within a relationship arises when one person enjoys sex on a more frequent schedule than the other. Until recently it was assumed that it was always the man who wanted sex more than the woman, but in my practice I’ve seen plenty of couples in which the woman is the driver. It can be a problem for both partners. One feels that he or she is being deprived, and the other feels put upon.
I told Gary and Anna about a scene in the movie Annie Hall (1977), where the Woody Allen character and his girlfriend, played by Diane Keaton, are both seeing their respective psychiatrists at the same time. Allen laments, “We never have sex,” to his therapist, while Keaton complains, “We’re constantly having sex,” to her therapist. Both shrinks ask, “How often do you have sex?” And both Allen and Keaton answer, “Three times a week.”
Neither Gary nor Anna betrayed any emotion as I told this story. Maybe they didn’t find the story as amusing as I did.
Gary’s blood tests later showed low levels of testosterone, and I treated him. I was curious whether the treatments would affect his libido. After a few months, Gary and Anna came back to see me.
“I feel better in general, I’d say,” reported Gary. “Energy, mood. I’m sleeping better too and don’t need to sleep as long to feel rested.”
“What about sex?” I asked.
“Oh that!” said Gary, with a chuckle. “Yup, that’s better too. I’d forgotten that was the original reason I came to see you.”
“In what way is it better?”
“All of it, I would say. Desire, drive, libido—whatever you want to call it. Erections are easier to get and easier to maintain too. I’d say we’re doing okay in that department, wouldn’t you?” he asked, turning to Anna, seated beside him.
“He’s better,” Anna responded, addressing herself to me. “I’m not going to say it’s where I think it should be, but we’re back to having sex about as often as we used to a couple of years ago.”
“How often is that?” I asked.
“Three times a week,” they both answered in unison.
There’s no right answer to the question “How often should I be having sex?” There is so much variation in what feels right from person to person.
The frequency with which we have sex is influenced by a number of factors. Younger men tend to have sex more than older men, but not by as much as one would think. A recent online survey of 522 men between the ages of twenty-one and fifty-nine published in Esquire magazine reported that 32 percent of respondents claimed to have sex one to three times per week, and another 33 percent had it less than once a week. And in a study of men and women older than fifty-seven years published in the New England Journal of Medicine, of those who were partnered and sexually active, roughly 60 percent of the men reported having sex at least two to three times per month. The figures were similar for women. In a study of sexual patterns in 27,500 men and women ages forty to eighty years from twenty-nine countries, Alfred Nicolosi and his colleagues reported that 44 percent of men and 38 percent of women engaged in intercourse more than once a week. A bigger issue as we age is that a substantial number of men and women stop having sex altogether. In men the most common reason is erectile dysfunction. In women the most common reason given is
220 ABRAHAM MORGENTALER
lack of sexual interest, which becomes much more prevalent after menopause.
Sex is far more frequent when a relationship is new than when it is three to five years old. The big surprise for many readers is that men with long-term partners, married or not, have more sex than single men. In one survey, single men were twice as likely as married men to go one to three months without sex. The married man (or woman) may complain that he (or she) doesn’t get enough sex, but in the vast majority of cases there is already an existing sexual relationship in which sex does occur with some frequency. In contrast, the single man who wants to have sex has to first find a partner.
Zachary is an example of a married man who had stopped having sex. When he came into my office for a routine visit, he was ninety-one, still mentally sharp, and still married to his first wife, who was eighty-six. He was dressed in jogging pants and sported a two- to three-day-old beard.
“I haven’t had sex in twenty years,” he told me.
“What about an orgasm? Can you still come?”
“No. I haven’t had one of those in about fifteen years.”
“Do you miss it?”
“Sure, but I’m not twenty-one anymore. Let me tell you something. When I was seventeen I used to go get my hair cut at the barber shop by this Italian guy. He was probably about twentyone. One day he tells me about his wedding night. He had sex seven times that night, he says. You know, I still have dreams of not satisfying a woman sexually, and I think it came from listening to that barber. It made a big impression on me. I hadn’t even had sex yet, but I held that guy’s experience up as a standard. When I was in my twenties I could usually do it twice. Maybe once in my life I did it three times.”
He looked pensive for a minute and then said, “You know sometimes you hear guys talk about ‘screwing their brains out’? I never screwed my brains out. All in all, though, I think I did okay by my wife. She seemed satisfied.”
22 I
“Could your wife have an orgasm?”
“Oh, yeah. Most of the time. Not always.
“I still look at girls,” he continued. “That’s never stopped. And then I tell myself, ‘Who am I kidding?’ It’s like a dog chasing a car. What’s he going to do with it when he catches it? Anyway, no more sex for me. I still play tennis, though. I’m not great, but guys at the club still ask me to play. I only play doubles. Life is strange. Nearly everyone I know has died, and here I am playing tennis. Go figure.”
Zachary’s story is poignant in many ways. It’s fascinating to me that even at ninety-one he was still bothered by an experience that happened to him at seventeen, in which his idea of what was normal was created by a slightly older man who had had an evening of incredible sex that Zachary could never replicate. As a result, he saw himself as sexually deficient his entire life, despite having what sounded like a thoroughly satisfactory, even enviable, sexual relationship with his wife over several decades.
The need to constantly measure oneself against some impossibly high standard of masculinity leaves too many men feeling deficient. Men care enormously about their sexual proficiency, yet in the absence of real information it is easy for them to feel that they don’t quite match up.
The number of orgasms a man can have in one night or within twenty-four hours is highly variable. Men require a certain amount of time to reload and recharge. When they are young, it can be a few minutes. In their thirties and forties, it usually takes much longer, often hours, and some completely healthy young men find it impossible to have more than one orgasm until the next day. In the older years, it may take up to a week to recharge.
Relationships Without Sex
Some couples who are decades younger than Zachary and his wife don’t have sex at all. Scott was fifty-two and had been on testosterone for years under my care. His girlfriend of ten years, Jill, was
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forty-four. When I asked Scott whether he was having sex these days, he told me no.
“Why not?” I asked.
“Jill is kinda religious,” he answered.
“That’s a reason to not have sex?”
“I don’t know. I think she’s bothered by the fact that I never married her, after all these years.”
“Is she angry about it?”
“7 think so. She doesn’t say that, though, and she doesn’t really show it.”
“Are you okay with not having sex?”
“It’s all right. It’s just the way it is. Jill is a great person. Salt of the earth. Everyone likes her. I don’t think it’s right that we don’t have sex. Every time I’ve thought of moving on, though, it was me who came back to her. We stay together on the weekends and live in our own places during the week. Before we got together she raised her children on her own as a single mother. She had a female roommate when I met her. Even when we did have sex at the beginning, it was only once or twice a week.”
“Did you want to have sex more then?”
“Sure! Jill was never that interested, though. It seemed like she was doing it mainly for me.”
I never met Jill, so I can’t say why she was reluctant to have sex with Scott. Maybe Jill just didn’t enjoy sex. Maybe her religious training soured her on sex or made her feel uncomfortable with it outside of a marriage, as Scott had suggested initially. Maybe she had withheld sex from Scott out of anger. Perhaps she had been sexually abused as a child. Maybe she was gay. There could be any number of reasons.
What is important to note, though, is that Scott’s situation is not particularly unusual. There are many couples who don’t have sex or have sex only rarely. For every Anna, with a lifelong highfrequency desire, there are other women who don’t care for sex with their partner. So when men ask me, “How often should I be having sex?” there is no ready answer. Statistics show that the
WHY MEN FAKE IT 223
average married couple has sex approximately once per week, with rates higher among younger couples and more recent marriages, and declining with age and years of marriage.