A point of departure from the exploration of the sexuality of aging males is an overview of the evidence of age-related changes in sexual behavior. This review incorporates a range of approaches: quantitative analysis of the frequency of sexual acts; phenomenological descriptions derived from nonrepresentative surveys based on nationally distributed questionnaires; systematic assessments of representative samples from the community at large; and objective measurement of sexual responses in the laboratory. The most relevant methodological aspects of these studies are summarized elsewhere (Schiavi and Rehman, 1995). This overview concludes with a brief discussion of the main findings on male aging and sexual behavior.

Aging and sexual behavior

Sexual activity in nonrandom subject samples

In the USA, the scientific approach to research into human sexual behavior started with Kinsey's pioneering studies in the 1940s. Kinsey, Pomeroy and Martin (1948) included over 14 000 men in their cross-sectional survey of male sexual behavior, but only 106 were over 60 years old. A progressive decline in sexual activity beginning at adolescence was noted, with nearly 30% of men completely inactive by the age of 70. The weekly frequency of total ‘sexual outlets’ (intercourse, masturbation, nocturnal emissions) in the active population decreased from a mean of 3 at ages 26–30 to 1 at ages 61–65, and to 0.3 in those aged 71–75 years. There was considerable variability in the frequency and range of sexual behaviors within every age group. Some of the men continued to report masturbation and nocturnal emissions well into the 76–80 age group. The percentage of erectile impotence remained less than 7% until the age of 60, when 18% of white males reported erectile failure.