Men, Sex, and Aging

Guys, it’s a fact of life that as you get older, certain physical changes can impact your performance in the bedroom. You may find yourself thinking about sex less often, your erections may not be as robust, and you may not get turned on as easily as you did when you were younger.

The good news is that there are solutions to your sexual health worries. Here’s a look at common concerns and ways to restore your sex life.

Low Testosterone

Testosterone is the hormone that fuels a man’s sex drive. After age 40, men’s testosterone levels begin to decline. In many men, T levels gradually go down, along with libido.

If you lose your desire for sex or have erection problems, you could have low testosterone, a more serious health problem.

Lots of things can make low T more likely, including type 2 diabetes, cirrhosis of the liver, kidney failure, hormone disorders, damage to the testicles, and certain genetic conditions. Some medications can also affect your testosterone levels. T levels can also fall if you pack on too many pounds or drink too much alcohol.

A blood test will tell you if your T levels are low. If they are, and you have many of the symptoms linked to low T, testosterone replacement therapy (TRT) can help boost your T levels and bring your sex drive back to normal. TRT comes in patch and gel form, and as long-lasting implants.

Testosterone therapy, however, should be used for medical reasons rather than the natural aging process. The FDA in March 2015 issued a safety announcement that prescription testosterone products are approved only for men who have low testosterone levels caused by certain medical conditions. "The benefit and safety of these medications have not been established for the treatment of low testosterone levels due to aging, even if a man’s symptoms seem related to low testosterone...” The FDA is requiring that manufacturers clarify the approved uses on medication labels and add that there is increased risk of heart attack and stroke in patients taking testosterone.

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Erectile Dysfunction

ED becomes more common as men get older. Blood flow to the penis -- needed for an erection -- slows with age, and you’ll probably have to work harder to get aroused. The ability to maintain an erection also wanes.

But don’t be too quick to blame erection problems on your age. Diabetes, heart disease, obesity, and high blood pressure boost your chances of getting ED, which may be a symptom of these and other serious health conditions.

Avoiding ED is another good reason to get and stay fit. If you exercise, eat well, and steer clear of tobacco, you’ll likely do better between the sheets.

Stress, depression, injuries to the penis, and hormone disorders can also play a role in ED, as can some medications and surgical procedures, including some forms of prostate cancer surgery.

There are many treatments for ED. Most often prescribed are drugs known as PDE-5 inhibitors (Cialis, Levitra, Staxyn, and Viagra), which help erections by improving blood flow to the penis. Surgery, vacuum devices, penile injections, and implants are also among the options for ED.

Enlarged Prostate (BPH)

Prostate growth is a normal part of aging for most men. Benign prostatic hyperplasia (BPH) is an enlarged prostate. BPH isn't cancer, and it doesn't make cancer more likely. But it does cause its own set of problems, which often impact a man’s sex life, particularly after age 50.

BPH often makes it tough to urinate. It also sends a man to bathroom much more often and urgently than in his younger days. These symptoms, known as lower urinary tract symptoms (LUTS), make it tough to get and maintain an erection. They also increase the chances of premature ejaculation. They can chill a man’s interest in sex or make sex much less satisfying. The worse the LUTS get, the worse the associated sex problems become.

Medications can help control LUTS for many men. These include:

Severe cases, however, may need surgery.

WebMD Medical Reference Reviewed by William Blahd, MD on July 11, 2017

Sources

SOURCES:

Harvard Medical School: "How Aging Affects Male Sexuality."

Hormone Foundation: "Low Testosterone and Men's Health."

Pantalone, K. Cleveland Clinic Journal of Medicine, October 2012.

Esposito, K. Diabetes Care, May 2005.

Urology Care Foundation: "ED: Non-surgical management."

Bruskewitz, R. Reviews in Urology, 2003.

Medline Plus: "Enlarged Prostate, Treatment."

FDA: "FDA Approves Cialis to treat BPH."

FDA: FDA Drug Safety Communication, March 3, 2015.

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