Sex and Aging for Men: Main Changes

Primarily due to a drop in testosterone, men will experience changes in their sexual function as they age. These changes include (see sex tips for the older man for tips on dealing with these changes):
  • Fewer sperm are produced
  • Erections take longer to occur
  • Erections may not be as hard
  • The ‘recovery time’ (time between erections) increases to 12 to 24 hours
  • The force of ejaculation decreases
  • Sexual desire decreases are due to emotional reasons or health problems

Decreased Testosterone

As a man ages, his testosterone levels decrease. Typically this decrease in testosterone stabilizes around age 60. Testosterone decrease is the primary reason for many of the conditions listed above. Testosterone replacement therapy is becoming popular for addressing concerns of aging men. This type of hormone treatment is controversial and should be approached with caution. Increasing muscle mass through exercise and proper nutrition can help maintain a healthy testosterone level.

Cardiovascular Disease, High Blood Pressure and Male Sexual Health

These health conditions alter how the blood flows in the body. When the arteries become narrower and harder, blood does not flow as freely. This can be troublesome for men trying to achieve an erection, as erections depend on the ability of blood to fill the penis. Controlling high blood pressure and other cardiovascular diseases through lifestyle change and medication can improve sexual performance.

Diabetes and Male Sexual Health

Many men with diabetes have normal sexual lives. However, diabetes can cause impotence, the inability to have sex. Men with diabetes are approximately three times more likely to experience erectile dysfunction than men without diabetes. They also experience this condition approximately 15 years earlier than men without diabetes. If you have diabetes and are having trouble maintaining an erection, talk to your doctor. Many medications can help.

Pain and Male Sexual Health

Many health conditions such as arthritis, back pain and shingles can interfere with sex by causing pain that may make sex uncomfortable. These conditions also can alter your mood, sleep habits and attitudes. Experimenting with different sexual positions and techniques can help. You can also talk with your doctor about managing pain.

Incontinence and Male Sexual Health

Incontinence is the loss of bladder control which can cause urine leakage. This condition becomes more common as people age. Often leakage occurs during exercise, laughing or coughing. During sex, extra pressure is placed on your bladder. Men with an incontinence condition may be afraid to have sex. By controlling incontinence through medical or behavioral approaches, the chance of leakage during sex can be greatly reduced.

Medications and Male Sexual Health

Some of the medications prescribed to treat common age-related health conditions can interfere with sex. Some blood pressure medicines, antidepressants and diabetes drugs can make it more difficult for men to maintain an erection. These medications can also reduce sexual desire. You may be able to use alternative medications if you experience these side effects. Talk to your doctor.

Prostatectomy: Prostate Surgery

A prostatectomy is a surgical procedure that removes some or all of a man’s prostate. This is often done to treat prostate cancer or an enlarged prostate. A consequence of this surgery can be incontinence or impotence. Before undergoing a prostatectomy, be sure to talk to your doctor about any concerns you have about your sex life.

The Bottom Line

If you are not satisfied with your sexual ability, talk to doctor. Changes in your medication, managing your health conditions and treatment of sexual problems may help.


National Institute on Aging. Bound For Your Good Health: Sexuality in Later Life. NIH Publication Number 05-7185.

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