Dear Bearded Confidant,

Love your answers!  Serious answers to serious questions! And I have one ... am a 50 yr old gay man ... and get very erotic with my boyfriend but can't seem to get a really hard erection ... same is true when I masturbate ... what gives?  Have played with a vacuum pump in the past and wonder if that's not the problem.  Any suggestions? 

Dear TX2001,

I don't recommend vacuum pumps for the reason that they can stretch the erectiile tissues of the penis and potentially cause dysfunction over time.  However, your problems may be also be a simple lack of optimal blood flow to the genitals.  At 50 you are by no means "old," but blood flow to the genitals can certainly decline as men age.  While there are various creams on the market designed to help men stay hard, I have not personally tested any of them and therefore cannot vouch for any one brand.  And while cock rings can effectively keep blood in your penis and maintain your erection, if you aren't fully hard in the first place then they won't help.  In any case, I recommend that you get to the root of the problem instead of relying on short-term fixes.  First, see a traditional (sometimes called "alternative") doctor, such as a doctor of Traditional Chinese medicine.  They specialize in virility issues and can usually bring relief with a combination of herbs and acupuncture.  I also recommend regular massage therapy to help keep everything in your body free of blockages.  If those courses of action don't have the desired results, then you can always pursue Western medicine.  The health of your penis is too important for you not to seek immediate help.