<< Old Age and Impotence >>

We have the histories of 87 white males (and 39 Negro males) past 60 years of age. The number is too small to allow statistical analyses of the sort employed for the other age groups. Nevertheless, there is such interest in the sexual fate of the older male that it seems valuable to summarize the data even for these few cases.

The most important generalization to be drawn from the older groups is that they carry on directly the pattern of gradually diminishing activity which started with 16-year olds. Even in the most advanced ages, there is no sudden elimination of any large group of individuals from the picture. Each male may reach the point where he is, physically, no longer capable of sexual performance, and where he loses all interest in further activity; but the rate at which males slow up in these last decades does not exceed the rate at which they have been slowing up and dropping out in the previous age groups. This seems astounding, for it is quite contrary to general conceptions of aging processes in sex. The mean frequencies of these older white males who are still active range from 1.0 per week in the 65-year old group to 0.3 in the 75-year olds, and less than 0.1 in the 80-year old group (Table 44).

At 60 years of age, 5 per cent of these males were completely inactive sexually. By 70, nearly 30 per cent of them were inactive. From there on, the incidence curve (as far as our few cases allow us to judge) continues to drop. There is, of course, tremendous individual variation. 'There is the history of one 70-year old white male whose ejaculations were still averaging more than 7 per week. Among the Negro males, there was one aged ' 88 who was still having intercourse with his 90-year old wife, with frequencies varying from one per month to one per week. In the latter case, both of the spouses were still definitely responsive.

Heterosexual intercourse continues longer than any other outlet, but masturbation still occurs in some of the histories of men between 71 and 86 years of age, and nocturnal dreams with emission persist into the 76-80 year period. Among these cases, there is no male over 75 who has more than a single source of outlet. Erotic response at age 75 has a rating which is one-quarter of the mean rating for age 65.

Among these particular males, the mean frequency of morning erections had been 4.9 per week in the earlier years of their lives. In the 65-year period, it had dropped to 1.8, and at 75 years of age it had dropped to 0.9 per week. Morning erections usually persist for several years, even as long as five or ten years, after a male has become completely impotent in other situations.

The data on impotence will command especial interest. True ejaculatory impotence (incapacity to ejaculate even when aroused and in erection) is a very rare phenomenon (in 6 out of 4108 cases). Erectal impotence, on the other hand, is not uncommon. It appears occasionally in younger cases and is, of course, the ultimate outcome of the sexual picture in a portion of the older histories. Early erectal impotence occurs in only a few cases (0.4 per cent of the males under 25, and less than 1 per cent of the males under 35 years of age). In only a small portion of these is it a lifelong and complete incapacity. Sometimes the situation is complicated by a normal development of erotic responsiveness without an ability to perform. In some of these males, ejaculation may occur without erection as a result of the utilization of special techniques in intercourse. In many older persons, erectile impotence is, fortunately, accompanied by a decline in and usually complete cessation of erotic response.

Out of 4108 adult males on whom adequate data are available, there are 66 cases which have reached more or less permanent erectile impotence. Ruling out instances of temporary incapacity in younger individuals, the ages involved in onset of permanent impotence and the incidence data for each of the subsequent age groups are shown in Table 50 and Figure 37.

Table 50. Age and erectile impotence
Age Total
Population		 Cases
Impotent		 %
Impotent
Increment
%
10 4108 0 0  
15 3948 2 0.05 0.05
20 3017 3 0.1 0.05
25 1627 6 0.4 0.3
30 1025 8 0.8 0.4
35 741 10 1.3 0.5
40 513 10 1.9 0.6
45 347 9 2.6 0.7
50 236 16 6.7 4.1
55 134 9 6.7 0.0
60 87 16 18.4 11.7
65 44 11 25.0 6.6
70 26 7 27.0 2.0
75 11 5 55.0 28.0
80 4 3 75.0 20.0

An accumulative incidence curve; based on cases which are more or less totally and,
to all appearances, permanently impotent.
Figure 37. Age of onset of impotence

Percent of total population which is impotent is shown for each age.

It will be seen that there are stray cases of impotence between adolescence and 35 years of age. Between 45 and 50, more males become incapacitated, and after 55 the number of cases increases rapidly. By 70 years of age, about one-quarter (27.0%) of the white males have become impotent; by 75 more than one-half (55.0%) are so; and 3 out of the 4 white males in the 80-year group are impotent. Two Negro males were still potent at 80. We have three histories of Negroes 88 years of age, and one aged 90. One of these males had been impotent for fifteen years. Two had not tried to have intercourse for some years, but morning erections made them believe they would still be potent if aroused; they were, however, no longer responding to erotic stimulation. The oldest potent male in our histories was the 88-year old Negro, who was still having regular intercourse with his 90-year old wife. Only a portion of the population ever becomes impotent before death, although most males, but not all of them, would become so if they all lived into their eighties.

A problem which deserves noting is that of the old men who are apprehended and sentenced to penal institutions as sex offenders. These men are usually charged with contributing to delinquency by fondling minor girls or boys; often they are charged with attempted rape. Among the older sex offenders who have given histories for the present study, a considerable number insist that they are impotent, and many of them give a history of long-standing impotence. A few of these men may have falsified the record, and many courts incline to the belief that all of them perjure themselves. We find, however, definite evidence in the histories that many of these men are in actuality incapable of erection. The usual professional interpretation describes these offenders as sexually thwarted, incapable of winning attention from older females, and reduced to vain attempts with children who are unable to defend themselves. An interpretation which would more nearly fit our understanding of old age would recognize the decline in erotic reaction, the loss of capacity to perform, and the reduction of the emotional life of the individual to such affectionate fondling as parents and especially grandparents are wont to bestow upon their own (and other) children. Many small girls reflect the public hysteria over the prospect of “being touched” by a strange person; and many a child, who has no idea at all of the mechanics of intercourse, interprets affection and simple caressing, from anyone except her own parents, as attempts at rape. In consequence, not a few older men serve time in penal institutions for attempting to engage in a sexual act which at their age would not interest most of them, and of which many of them are undoubtedly incapable.

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