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How does age affect a man’s sexual health?
Everyone will experience sexual changes at some point in their lives. If you’re male, you’re likely to see changes in your erections and libido as you get older. But with the right support, you can still have a satisfying sex life. Here, I explain what happens to your sexual health as you get older, what can help, and when to see a GP.
How does sexual health change as you get older?
Your sexual desire as well as your erections are likely to change throughout your life.
It may feel as though your sexual responses become slower and less intense as you get older. You might also have less sexual desire. Changes like these may be nothing to worry about if they happen rarely.
Your erections may occur less often. Older men are also less likely to have repeated ejaculations, compared to when they were younger. This is all part of the natural aging process.
If you’re repeatedly unable to get an erection, or you can’t maintain one long enough to have sex, you may have erectile dysfunction (ED).
ED is very common and affects around 1 in 2 men in some way during their lives. Your risk of developing erection problems increases with each passing decade.
It affects around 1 in 10 men in their 40s and over a third in their 50s. By the time they’re in their 60s, almost half of men experience ED regularly.
Why do sexual problems increase with age?
Hormonal, physical and psychological changes occur in your body as you get older. Some of these may impact sexual health.
Testosterone levels
Testosterone is the male sex hormone. It’s key for things like facial hair and muscle growth. It also enhances libido and sexual function. Testosterone levels peak in a man’s 20s and 30s, and then very slowly decline from age 40 onwards.
Sexual health changes can be related to declining testosterone levels in older men. One of these is low sex drive for example, which is found more often in older men. It affects around 2 in 100 men aged between 40 and 79.
Low testosterone can also cause problems with getting or keeping an erection, as well as changes in your ejaculation.
Cardiovascular disease and diabetes
Older men are more likely to have heart disease, high blood pressure or diabetes. All these illnesses affect blood flow to the penis. In fact, heart disease and high blood pressure are the most common causes of erection problems.
Sometimes, ED can be an early sign of heart problems or Type 2 diabetes. It can happen before any other symptoms occur. That’s why it’s important to discuss this with a GP.
Medications
Some drugs affect sexual function and libido. These include several medicines prescribed for high blood pressure as well as anti-depressants, anabolic steroids, and recreational drugs like alcohol, cocaine, and cannabis.
Stress, anxiety, and other psychological factors
Anxiety, stress or conflicts in your relationship can cause sexual problems. This might be short-lived or, it could get worse over time. Depression and unhappiness, as well as past trauma, can also affect your erections and sexual desire.
How can I improve my erections and libido?
There are many options such as those listed below, that can help you.
Lifestyle changes
Making changes to your lifestyle can make a big difference to your desire and your erections. These include:
- losing weight if you need to
- regular physical activity (150 minutes of moderate physical activity or 75 minutes intense exercise a week)
- stopping smoking
- reducing how much alcohol you drink
- if you cycle, making sure your seat is in a comfortable position and/or keeping it under three hours a week (only for ED).
Counselling or therapy
If you think relationship problems or your mental health are affecting your sex life, it’s a good idea to talk to a doctor.
They can refer you for relationship counselling or psychosexual therapy. This can help with the psychological reasons behind your sexual difficulties.
Medication
There are several medications you can take for erectile dysfunction. First, your doctor will check for underlying causes of your ED, like diabetes or heart disease. This is important to make sure you’re not at risk from an underlying condition.
Once that’s clear, they can prescribe drugs known as PDE-5 inhibitors. You can take these daily (Cialis daily) or around an hour before you have sex (Cialis, Viagra and Levitra). If these drugs don’t suit you, vacuum pumps, injections, and implants are also options to speak to your doctor about.
Testosterone Replacement Therapy
If you’ve tested for low testosterone then testosterone replacement therapy (TRT) can be used to balance your testosterone levels. People generally take TRT as gels or patches applied to the skin but it can sometimes be taken as a tablet.
TRT might not be suitable for everyone. You can discuss with a doctor whether it might be the right option for you and speak to a specialist if necessary.
Opening up about sexual problems can feel embarrassing. But by talking things through with a doctor, you can find the best solution for you.
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Sources Sources
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- Erectile dysfunction (Health topics A-Z). NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2024
- Diabetes: asking about erectile dysfunction. NICE Indicator. nice.org.uk, last updated 29 June, 2022
- Erectile dysfunction: history and exam, key diagnostic factors. BMJ Best Practice. bestpractice.bmj.com, last revised 24 May 2024
- Yafi FA, Jenkins L, Albersen M, et al. Erectile dysfunction. Nat Rev Dis Primers 2016;2:16003. doi: 10.1038/nrdp.2016.3
- Testosterone. NICE British National Formulary (BNF). Indications and dose. bnf.nice.org.uk, accessed June 2024
- Shalender B, Juan P, Glenn RC, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018;103(5):1715-1744. doi: 10.1210/jc.2018-00229
- Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab 2002;87(2): 589–598. doi.org/10.1210/jcem.87.2.8201
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