I agree with Mr. Fisher, and I think this is a normal part of the maturing process. Things that are consistent for most are:
1) decreasing sensitivity (which is good because you can actually slow down and enjoy what you are doing for a change, not just the penile part of it. Surprise! You are a whole body not a set of genitals on life support!)
2) decreased ejaculatory volume (which is typically only of concern to men as they view themselves and gay men as they view the ejaculate. Most women could, honestly, care less about the mess. It does nothing for us and if we say it does, it is to feed your ego).
3) delayed response times (see upsides to decreasing sensitivity)
4) decreased urgency/fullness/stupidity (the lessening of "omygod-IgottafuckNOW" urgency makes you much less selfish in bed, a lot less stupid or offensive in conversation and generally a better human being to deal with all around. what you see as a decline, we experience as a bonus where we get more of the parts of you that we LIKE dealing with)
So, with all that said (like you wanted to hear any of that) - there is a point where our sexuality has to evolve as our maturing progresses. When younger, pretty much anything warm and wet would work. When slightly mature, it had to have a personality or the ability to stay quiet so you could just focus on what you were seeing instead of having to deal with the whole person and when older - well, this is where you have to check in with yourself because the other two previous approaches aren't going to work so well anymore. Maybe the problem isn't in the plumbing but in how you perceive how you should participate/engage in sexuality still.. in spite of the evolution of the rest of you?
Also, if you have previously spent a lot of time masturbating yourself/training yourself into a more desensitized state so that you can have more "stamina", you are going to have problems getting off without masturbating to completion ESPECIALLY as you get older and naturally become less sensitive. There is no remedy for it. You just have to start looking a different approach to how you enjoy sexuality and find a new approach to what your expectations are.
EOM.
SIDEBAR: And BTW - THIS... "3. Check your meds carefully. I have gone over my meds and to the great consternation of my physicians I stop taking my antidepressant and my hypertension medication 36 hours before the session. THIS IS DANGEROUS SO CONSIDER IT CAREFULLY. Immediately after the session I take my normal dosages of those skipped medications."
DO NOT EVER PLAY GAMES LIKE THIS WITH THESE KINDS OF MEDICATIONS. The consternation of the docs isn't because they are worried about you being a dumbass but because (a) playing around with serotonin levels in the brain by "skipping" med doses is like playing Russian Roulette with the suicide/homicide gun. Brain chemicals have a very narrow range that they can be in (high OR low) before you go completely cuckoo for cocoa puffs temporarily and either you get committed or arrested for hurting yourself/other people. Its the hurting other people that everyone worries about. Skipping your meds deliberately and checking yourself out of here? That's Darwin's law.
High blood pressure medications? Taking yourself off your meds temporarily MAY appear to have the ability to give you back an erection but what it is doing is completely screwing up your kidneys and your future ability to ever have an erection again (sooner not later in life). Constantly mucking around with fluid pressure in pressure sensitive valves (Hi, blood pressure = fluid pressure) results in permanent damage to the valves, pipes and controls that regulate the whole system. And there's also that nasty bit about HAVING A STROKE. So, sure if you think you can find someone to sleep with you after you have had a stroke AND can't get it up anymore? You go right ahead and play games with your meds and prove Darwin's law
No, seriously can I see it