Maintaining Masculinity With Aging

Andrew Siegel MD  7/21/17

“Time has a nasty way with human materials.”…Zadie Smith

“The reality of our bodies is that they are born and grow and in time suffer and decline.”  …Senator Ben Sasse

Bona Lane

No matter how old, most men wish to be able to travel down this road until their final breath.

Although the term masculinity may be better understood conceptually than described in words, it can be defined as possessing positive qualities traditionally associated with men: virility, drive, strength, vigor, resiliency, confidence, self-sufficiency, etc. Carried to an extreme, it can sometimes be associated with alpha behaviors including aggression, hyper-sexuality and supreme authority. Certainly, masculinity implies a certain “swagger” that clearly is unique from femininity. Sadly, aging and natural deterioration gradually rob men of many masculine attributes with the ultimate result–at some point in time–infirmity and frailty.

The Inevitable Loss of Horsepower

Our bodies-as-machines slowly lose their maximal horsepower and morph into less performative and functional machines.  The realities and challenges that accompany reaching senior years–the anatomical and functional deterioration that affect every organ system–are a direct blow to masculinity. A central premise of masculinity is having a strong and fit body; however, aging is at direct odds with masculinity because of the loss of bone and muscle mass, slower healing, accumulation of injuries and the occurrence of disease processes, resulting in declining strength and fitness.

All systems go to ground, as eventually we do. The senses–vision, hearing, taste, smell, touch–slowly rust away. Locomotion, nervous system, urinary system, bowel system, cognition and memory deteriorate. There is a good reason that athletes are considered “old” in their thirties. Rigidity of erections, the literal totem of masculinity, declines in proportion to age in years.

The silver lining is that although the degenerative process is inevitable and there will come a time when frailty will ensue, with the combination of strength training, cardiovascular conditioning, core and balance work, this process can be deferred substantially. Thinned bones, wasted muscles and hunched posture can be largely prevented by proactive and preemptive strikes against their onset.

I have an amazingly fit and cognitively intact 95-year-old patient who goes to the gym three times a week.  He lamented to me that because of an injury he was unable to work out for a few weeks and as a result he felt flabby and listless.

Retirement: Death with Benefits

At some point in the aging process, retirement from work becomes a reality for the vast majority of men.  Leaving work is one of the more challenging aspects of aging as our careers can often be considered “masculine” experiences from a primal perspective, since our roles as “hunter”—“warrior”—“gatherer” provide for our families.  Aside from financial resources, works provides benefits on so many levels—engendering a sense of usefulness and purpose, identity, dignity, self-worth, achievement, recognition, respect, (particularly self-respect), status and influence.  Furthermore, work also provides connection, collaboration and networking that are central to the human experience.  There is something special about having purpose and being productive, both of which give real meaning to one’s existence and help maintain vitality. This does not necessarily involve continuing to work full-time and compromising our fun and leisure activities, but rather achieving a healthy balance between work and play with part-time work, an encore career, volunteering, etc.

As a urologist with many years of clinical experience, I can attest to the fact that one of the shared attributes of my older patients who have aged well (Youthful Elderly Persons, a.k.a. Yeppies) is that they have NOT retired, often working well into their eighties and beyond.

Mitigate Risks

Typically associated with “masculinity” is risk-taking behavior.  Men are more likely than women to engage in activities such as smoking, heavy drinking, fast driving without seat belts, participating in sports with high injury rates, etc.  However, as we age, continued participation in such activities will not help the masculine cause, so at some point those who wish to maintain their masculinity will need to curtail unhealthy lifestyle activities and tailor sport participation in such a way as to maximize benefits, but minimize risks, for example, playing doubles tennis instead of singles.

Masculine to be Feminine

Masculinity often entails “alpha” behavior, which typically implies stoicism and self-reliance, in contrast to the female gender that is generally more emotive, communicative and willing to seek help from others. This translates to less preventive health care as men tend to be more reactive than proactive.  Furthermore, it generally leads to men having less meaningful and more superficial relationships than our female counterparts. This cool and independent alpha manner does not foster the skillset necessary to deal with many of the unpleasant circumstances that often accompany aging. It behooves men to seek preventive health care as well as nourish internal health by developing deeper and more meaningful relationships with our significant other, children, family and friends. We are a species who exists to coexist and connect and it is this social web that provides a safety net for us, valuable always, but particularly so when isolation, depression, fear, anxiety, etc., strike.

Bottom LineThe aging process gradually and insidiously erodes “masculinity.” Continuing to work in some capacity, working out regularity, working towards minimizing high-risk activities and maintaining a healthy lifestyle, and working “inwards”—fighting the culturally-based stoicism and self-reliance that runs counter to humans as highly social creatures–in concert can preserve “masculine capital” to an advanced age.  Although aging can be considered the “enemy” and will ultimately prevail, it is all about the possibilities as opposed to the limitations of the process.

Thank you to Rick Siegel–my brother–for suggesting an entry on this topic, based upon reading a Wall Street Journal article from 2/27/17: “Need To Redefine Masculinity As We Get Older” by Dana Wechsler Linden.

Wishing you the best of health,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health

Co-creator of the PelvicRx male pelvic floor muscle training DVD.




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One Response to “Maintaining Masculinity With Aging”

  1. Bill Stewart Says:

    Andy, extremely well stated. We all are fated to shrivel up to nothing (death), but there are better and worse roads to get there. Positive lifestyle measures will help us to proceed along a better road where we can better enjoy the delights of life; over reliance on drugs and surgery is likely to push us to a bumpier and ultimately a more painful road. We should learn more about (and from) your 95 year old patient!

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