Testosterone, which is secreted primarily from the testicles and secondarily from the adrenal glands, is an important hormone in male development. It is know that testosterone levels are secreted in the male according to a circadian rhythm, with maximal levels occurring in the morning and minimal levels at night. It is also known that serum testosterone levels do decline with advancing age, beginning in the mid-forties. This is most likely a result of a decreased rate of production in the testicles due to aging. In addition, the size and weight of the testicles decrease with age. Seventy-year-old males may be expected to have approximately 50 percent of the testosterone concentrations found in men half their age.

However, almost all older men still have serum testosterone levels that are in a range considered to be normal, and testosterone levels in men who demonstrate varying levels of erectile ability usually fall within the normal range, indicating that testosterone itself is usually not a cause of impotence. But while low testosterone is generally not responsible for impotence, it may cause a loss of interest in sex.

As a man enters middle age, there are obvious changes in his emotional makeup. A man may realize for the first time that many of his early aspirations, either personal or occupational, will not be met. Other men feel that they have gone as far as they are going to go professionally and financially, and that there is really nothing to look forward to in life. These anxieties common to middle age may result in psychological impotence.

Some men today believe they should be able to perform sexually like a machine. They expect that foreplay, erections, vaginal penetration, ejaculation and orgasm will follow in an automatic sequence. Since most bodily functions, including sexual drive, vary from day to day, the chances of not living up to a predetermined standard are significant; therefore there is a great tendency for men, especially those of middle age, to believe that they are sexual underachievers. It is imperative that they and their female partners realize that sexual performance will vary from time to time and that there are no set standards that must be met on every occasion.

A sympathetic and considerate female partner is one of the most important factors in continuing potency in the male. Men and their partners should take heart in the knowledge that sex, like a fine wine, may improve with aging.