+Equipment
+Physical bodies
+Libido
+Approach to passion and sex
+Positions
Equipment: ( All equipment eventually needs maintenance

I suffered with ED starting in my mid 50's We made it work going from pills to trimix injections. I needed testosterone injections as well. When I eventually became impotent I had the implant. I was 68 yo. We both are very happy with the AMS 700. It has changed my life. see my post viewtopic.php?f=6&t=15678
My wife had her issues with equipment. She found a wonderful female urologist specializing in womens issues Dr Laura Foot in Utah. She recommended some prescriptions and the "Mona Lisa Touch" Vaginal laser treatment. This has made a world of difference. The point of this is that as a couple trying to keep passion alive we both needed medical assist
Physical bodies. As our bodies age we just can't do what we once were capable of. The combination of aging and increased weight and decreasing exercise has taken a toll. I dug out our copy of the Kama Sutra that we bought after we were married. Holy Moley Cow if we were to try the vast majority of positions it would be an ambulance ride to the hospital for one or both of us. Pounding flesh is currently unthinkable/undoable.
Desire and libido:
Looking back on our lives: sex, passion and lovemaking came so easily. Desire was high, time was lacking. The biggest issue was having the time while living a very hectic life, work, bills, children, obligations. We were young so if we had 15 minutes we could both reach satisfaction. The goal was mutual climax and satisfaction.
Fundamental change in Approach: At our current stage in life " the spirit is only sometimes willing but the flesh is always weak"
This situation was causing some issues in our marriage, I came across a book and a website that totally changed how my wife and I approach passion, sex, romance. The fundamental change in our approach was this: No longer was climax and orgasms the sole goal for our couple time. We now look at our couple time to pleasure each other. Erotic time to enjoy the many gifts of the flesh. We have favorite ways of pleasing each other that may or may not lead to sex or to orgasm. We use this time to experiment to explore to ask each other what can I do to please you today. One, both or none of us may have a climax. We have more time for each other than we ever had. Que sera sera. It is freeing for the both of us. PIV is not the only way to pleasure and climax
The book I referred to is "Naked at our age" By Joan Price. Her website is joanprice.com. I don't subscribe to everything in the book. We did have some great take aways
I am including some positions that have had some potential for my wife and I