The word on the street is that male sexual desire is automatic, erections are spontaneous, and intercourse frequent. Another assumption is that men are easily frustrated by women's inhibited desire and their difficulty to reach . And, with the introduction of pro-erection medications (Viagra, Cialis, Levitra) has been cured and the man returns to the easy, predictable, and autonomous erections of youth.

How true are these assumptions? The majority of men learn to be sexual with spontaneous erections, a sense of sexual lust and control, and highly predictable sexual intercourse. For most men under 30, sexual response is autonomous-he can experience desire, arousal, and orgasm and need nothing from his partner. The traditional model of total predictability and control with intercourse as a pass-fail test ultimately subverts male . With the aging of the man and his commitment to a relationship, sexuality needs to transition to an intimate, interactive couple process. Many men do not make that transition. Instead they become sexual performers or prefer (with or without Internet ) because of a greater sense of control and predictability.

And, here's the shocking truth. When couples totally stop being sexual, in over 90% of cases, it is the man's decision, made unilaterally and conveyed non-verbally. He has lost with erections, intercourse, and orgasm. Sex becomes increasingly frustrating, embarrassing, and eventually avoided. He tells himself "I don't want to start something I can't finish." Not only does he avoid intercourse, he stops all kinds of sensual and sexual touching. This is a loss for him, her, and the relationship.

There are two particularly high risk times for male desire problems to occur. The first is when the couple has settled into their relationship, whether married or cohabitating. Sometimes, the problem is a sexual secret-he has a variant arousal pattern, is more comfortable with masturbatory sex than couple sex, a history of sexual which has not been processed with the partner or anyone else, or conflicts about . The more common problem is he never makes the transition from /passionate sex to developing a couple sexual styles (the subject of my latest book Discovering Your Couple Sexual Style) which integrates intimacy and eroticism into their ongoing relationship.

The second high risk time is the man stops being sexual in his 50's, 60's, or 70's. It is usually in reaction to experiencing sexual dysfunction, either not maintaining an erection for intercourse or developing ejaculatory inhibition. Rather than turning to the woman as his intimate, erotic partner with whom he shares pleasure, he obsesses on trying to perform for her. He goes to his internist for a prescription for Viagra or Cialis with the hope of a return to the autonomous erections of his youth. Although these are very good drugs in enhancing vascular efficacy and serving as a to reduce performance anxiety, they cannot live up to the hype. In truth, the medical intervention needs to be integrated into their couple style of intimacy, pleasure, and eroticism and the couple need to adopt the variable, flexible "Good Enough Sex" approach to sexual satisfaction rather than cling to the perfect intercourse criterion.

The keys for enjoying intercourse and orgasm are to transition to intercourse at high levels of sexual satisfaction (not immediately go to intercourse because you losing your erection), use multiple stimulation during intercourse (rather than depending on thrusting alone), and freedom to use "orgasm triggers" to go from erotic flow to ejaculation (rather than working to force orgasm). If the man and couple can accept the challenge of being intimate, erotic partners and focus on sharing pleasure and eroticism rather than perfect intercourse performance, they can enjoy desire and sexuality into their 60's, 70's, and 80's.

Barry W. McCarthy, Ph.D., is a professor of psychology at American University, a certified marital and sex therapist, and recipient of the 2009 Smart Marriages Impact Award. McCarthy and his wife Emily have collaborated on 11 books which have sold more than a million copies, including Rekindling Desire, Getting it Right the First Time, Getting It Right This Time and Men's Sexual Health. Their most recent book is Discovering Your Couple Sexual Style.