The expert helping midlife men to satisfy their partners

Having rediscovered his own missing libido, sex therapist Ian Kerner is helping other men overcome their anxieties in the bedroom. By Boudicca Fox-Leonard

Ian Kerner sees a lot of middle-aged men unhappy with their sex lives come to his Manhattan office. They are often overweight. Overworked. Stressed. And it is all affecting their libido.

While Kerner’s job is to be objective and not just relate everything back to his own experience (“Because we are all unique and different”) he can definitely relate to many of his male midlife patients’ anxieties. “Because I was one.”

As a young man in 2004, Kerner scored an international hit with his bestselling book, She Comes First. It rewrote the script onsssss sex, putting women’s pleasure at the centre of the sexual experience, redefining it as not just foreplay, but coreplay.

His own sex life had always been, he says modestly, “good enough”. His wife was certainly happy. But then things changed, for Kerner in particular.

His metabolism started to slow. He put on weight. As a result, he started experiencing back pain and snoring, the latter being a big issue for his wife.

At the same time, he was busier than ever, running his central Manhattan

‘It’s not just about having sex, but being proactive in creating a sexy space between us’

therapy office, raising their kids. There was less time for sex, and even if there had been more, he wasn’t in the mood anyway.

He didn’t feel good about his body, didn’t want to be seen in the shower, or undressing at night. His libido was down and he was “a little depressed”.

Niggling in the back of his mind, he knew that he needed to lose weight. As a typical New Yorker, he could easily walk five miles a day.

In the end, it wasn’t his sex life that made him go on a diet, it was pure vanity, he admits. He switched to a mainly plant-based diet because he needed to have an author photo taken for his new book, So Tell Me About the Last Time You Had Sex.

Eight months on, he has lost 3st, and his libido is raging. “I feel so much better in my body and I’m much more proactive. It’s not just about having sex with my wife, but being proactive in creating a sexy space between us,” says Kerner on the phone from Manhattan.

In his therapist’s office, he has witnessed first hand what happens when midlife men like him start to realise their bodies are not responding like they used to. Often, testosterone levels are falling and metabolisms are slowing. Clients come to him with their first experiences of physiological erectile dysfunction, which adds to an anxiety that makes it psychological.

Men as they age are also having to acknowledge that their needs have changed. Where once they may have wanted a lot of adventure, now they crave intimacy. Sometimes, of course, the reverse is true. On top of that, many live complex lives: with kids, work, and busy households to manage, it can be hard for men to make time for their erotic selves.

Self-esteem is a huge issue for men, which Kerner feels does not get talked about a lot. That extends to their sexual performance. “I hear from a lot of men that they feel their partners are expecting sex to still look a certain way.”

Their partners may have no such expectation, but it still makes these men anxious. Take two of his clients, a couple in their early 60s. The man feels pressure to still have the same sexual performance he had when he was younger. That anxiety has led him to a low desire mode and erectile dysfunction.

“She’s willing to change the way she thinks about sex. She just wants to be touched and feel desired, and she’s open to being desired in a different way, but he’s not getting the message. He’s sticking to the idea that he has to be a certain kind of man and have sex in the way he used to,” says Kerner.

It is the kind of negative internal dialogue that Kerner himself fell into. Having been a therapist for so long, he says he doesn’t so much think his own advice but live it.

His wife has even said that he has become nicer, more thoughtful and more communicative in a positive way as they have got older. But nobody is perfect. And not even a renowned sex therapist has the perfect sex life. “Sometimes when I behave poorly I feel like a hypocrite based on how I advise patients and that gives me some perspective,” he says.

At his heaviest and his lowest libido, although his wife didn’t care what he looked like (“That’s what she used to tell me at least!”), he couldn’t accept that.

“I would say, ‘I feel really dumpy today’ and I would never have my picture taken,” he says. “And she would say ‘That’s ridiculous. Come on!’ And even so, I held on to my negative internal picture of myself. It’s very hard to get that out of your head.”

The good news, though, is that it didn’t take long for him to feel a change. “The results were pretty immediate.”

His back pain is gone and as a result he is sleeping better and has more energy during the day. And that unsexy midlife manifestation, snoring? Also gone. “My wife’s really grateful for that!”

Now aged 55, he says his sex life is better than ever. “I would compare it to when we first met in our late 20s. And that has a lot to do with me feeling good about myself.”

He can see now that what was leading to his midlife sex rut was that he was burnt out. That turned into a vicious cycle of not feeling sexy, so he pulled away from sex. “And the more you pull away from sex, the more you get used to not having sex and you start to prioritise things like doing the laundry. It’s a slippery downward slope of negative feedback cycles.”

There’s no doubt in his mind that getting healthy was the key to rediscovering his self-esteem and recovering his sex life. “Because so much of sexuality is tied into lifestyle and health and how you eat and exercise. And how you take care of yourself.”

In his new book, Kerner talks about one of the ways back from low desire is having a willingness to take part in sex, even when you don’t feel like it, because a lot of arousal is psychological. “Just by having the willingness to show up, the desire can emerge from that.”

And making that willingness a ritual, can transform your relationship. Studies show that couples who have sex once a week have higher levels of relationship positivity than couples who don’t. “And that doesn’t necessarily increase if you have sex more than once a week,” says Kerner.

Finding space, mentally and physically can be a huge barrier for men and women. In busy households, our bedrooms are often the least sexy, especially if you are in the grip of a newly acquired snoring habit. Kerner instead recommends threading eroticism into the day. “I want my sexual self to hang out with my wife a little bit. I try to look for those little opportunities. It doesn’t have to lead to sex,” he says. “Even if it’s to say a quick ‘Hi’, or squeeze or grab, sext or what have you.”

Part of the problem, he says, is that we simply don’t have the language to communicate with our partners about sex. We have language to talk about buying a house or talking about the kids, but most people don’t have that vocabulary when it comes to sex, because it is a taboo topic. Kerner finds it ironic, given we grow up in this world of sexy images but we have never had to talk to our partners about sex.

He has helped couples who, despite having talked about everything else under the sun, “when they get in bed at night and lie next to each other thinking

‘When you pull away from sex, you get used to not having it and start to prioritise other things’

about sex, they might as well be separated by an ocean”.

Often, midlife men are hiding their anxieties. “If he’s suffering from erectile dysfunction, early ejaculation or even delayed ejaculation, it is easier to pretend you are not interested in sex that night. It’s easier to say, ‘I’m so busy and working so hard’, than to tell the truth, which is that they are hiding some change in sexual function that they are embarrassed about.”

With men who are feeling anxious about their performance, he works with them on sexual mindfulness in the moment. Helping them to recognise when that anxiety wells up, and to see it and instead focus on something more arousing, like kissing, or their partner’s shoulder or neck.

“Finding something you can be curious and present with. That involves changing the sex script. Be willing to deconstruct the narrative as it’s happening. Don’t roll over and give up. Stay in pleasure and manage that anxiety.”

His job is to start a conversation between his clients. To be honest with each other about why they are not feeling desired; not blaming it on external factors when it is usually something to do with the relationship or their body.

“In the end, with everyone, whether male or female, the thing I hear most is, ‘I just want to be desired.’”

So Tell Me About the Last Time You Had Sex: Laying bare and learning to repair our love lives by Ian Kerner is published by Scribe (£16.99)