Every month in Sex at Our Age, award-winning senior sexpert Joan Price answers your questions about everything from loss of desire to solo sex and partner issues. Nothing is out of bounds! To send your questions directly to Joan, email sexpert@seniorplanet.org.

I am 80 and in excellent health and physical condition. I take zero medications – except for Cialis when I want a full and long acting erection. Despite all that, I have lost sensitivity in the head of my penis to the extent that I neither ejaculate nor have an orgasm, whether with a partner or through masturbation. I know that ejaculation and orgasm are not the same, and I’m most concerned about the orgasm.

My wife died of cancer several years ago. Until her illness progressed, I experienced orgasms through penetration. It’s hard to pinpoint when my lack of sensitivity began, because our sex life ceased over time as I became her caregiver willingly and without remorse.

My wife and I underwent anticipatory grief before her death. We grieved together as well as separately. I understand the grief process and honestly do not believe that grief is related to my lack of penis sensitivity or orgasm.

I have had three monogamous relationships since her death, always without coming to orgasm despite fondling, penetration and oral sex. I now have a fully understanding and cooperative partner.

I last saw my doctor three years ago and plan to schedule an appointment soon. I’m an educated patient with a medical background and have Googled this issue extensively — can you point me in the direction of information I may have missed?

My lack of sensitivity and orgasm is not life ending – in fact, it seems rather trivial, because my partner and I have developed enjoyable sexual contact that is fully pleasurable to both of us. Orgasm would be icing on the cake.  — No Icing

First, I applaud you for understanding that sex can be extremely pleasurable even if you don’t reach orgasm. Your experience is very common. A study published in the New England Journal of Medicine found that about one in three men ages 75 to 85 were no longer able to reach orgasm.

With age, penis sensitivity lessens and orgasm becomes elusive or absent. It’s likely that you’ll need to adapt to this condition. But in case there’s a medical cause that can be treated, please make that doctor’s appointment. Check your testosterone level, which decreases with age and affects sensitivity along with erectile function, and your cardiovascular health. Some neurological conditions affect the nerves, such as diabetes. Since you haven’t had a medical exam in three years — and I don’t know if you told your doctor about your decreased sensitivity or problems with orgasm at that time — I suggest you get a check-up.

I checked in with clinical sexologist and sexuality education consultant Lawrence A. Siegel, MA, CSE. “In the absence of any vascular or neurological issues, this experience is quite normal,” he says. “Changes in how the blood vessels direct blood flow in and out of the penis, as well as changes in penile nerve function, truly are inevitable to varying degrees.” Siegel recommends avoiding overuse of lubricant (use just enough for your and your partner’s comfort) and experimenting with different positions and angles of penetration. “It might also help to practice mindfulness, focusing on erotic images and the pleasurable sensations, while also experiencing different kinds of sensations: harder, softer, lighter, lower, under, over, faster, slower,” he says.

You say that you’re in excellent health and take no medications other than Cialis. But other readers who have more health issues should know that many prescription and non-prescription drugs can affect arousal, erection and orgasm. A consultation with your pharmacist and doctor is always a good idea. Since many medical professionals assume that seniors aren’t having sex and don’t care about it, I always suggest starting with, “My sexuality is important to me, and here’s what’s interfering with it….”

You’re already doing so many things right; you’re enjoying oral and manual sex as well as penetration. As you know, the older penis needs a lot more direct stimulation than it used to. A performance-enhancing drug like Viagra or Cialis helps with erections, but not with sensation, desire or satisfaction. Many people think that if the penis is erect, its owner is ready for sex – but that’s not necessarily true, especially at our age. Erection or not, you may not be aroused yet. You already know this, but for other readers – take lots of time with sexual play before penetration.

Even if aging is the sole reason for the issue and there’s no medical explanation, these six lifestyle behaviors will help maximize your sexual response:

1. Exercise before sex to increase blood flow to the genitals
2. Don’t eat before sex, because that diverts the blood flow to the digestive system — save your hunger for afterward
3. If you smoke, quit
4. Use vibrators for extra stimulation of the penis. I especially recommend the Pulse
5. Have sex at the time of day that you’re most alert
6. Try not to stress about it, because stress will only make it worse

These resources will give you some more ideas:

• “Ejaculation and Orgasm Problems: Causes And Treatments of This Surprisingly Common Problem” by Michael Castleman, on greatsexguidance.com
• “Desperately Seeking Orgasm: Help For An Older Man” by Joan Price, on SeniorPlanet.com

I wish we all understood what you’ve discovered — that orgasm is “icing on the cake,” and the cake is pretty tasty even without icing. —Joan

Would you like to see more questions and answers? See all of Joan’s advice in Sex @ Our Age.

Send Joan your questions by emailing sexpert@seniorplanet.org. All information is confidential.

Joan Price is the author of the new “Ultimate Guide to Sex After 50: How to Maintain – or Regain! – a Spicy, Satisfying Sex Life”;  the award-winning self-help book “Naked at Our Age: Talking Out Loud about Senior Sex”; and the sexy memoir, “Better Than I Ever Expected: Straight Talk about Sex After Sixty.” Visit Joan’s  blog, “Naked at Our Age,” and her Facebook page.