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Many great things come with age—like wisdom, experience, and discounts at the movie theater. But most people associate age with the not-so-good stuff, like wrinkles, health problems, and the end of one’s sex life. That last one is a common mistake, though. Erectile dysfunction may happen more often as men get older, but it’s not just a natural part of aging.
The answer to the question, “what age does a man stop getting hard?” is simple: it doesn’t exist.
Some men in their 90s can still get erections without any trouble, while many men in their 20s struggle with erectile dysfunction. There’s no age limit for having a healthy and enjoyable sex life, so if you have ED, know there are options to help.
Erectile dysfunction by age
ED, or erectile dysfunction, happens when you can’t get an erection sufficient for satisfying sex. This can mean being unable to get an erection at all or having erections that aren’t as firm or don’t last as long as you might like. Experts estimate 30 million American men have experienced ED at one time or another (Nunes, 2012). Having ED can also affect your sex drive.
ED can happen at any age, but it’s more common in older men. By the time a man is in his 40s, he has about a 40% chance of having experienced ED. That risk increases by about 10% for each decade of life—a 50% chance in his 50s, a 60% chance in his 60s, and so on (Ferrini, 2017).
So age is a risk factor for ED. But ED is not a natural part of aging that older men just have to accept and learn to live with, and ED can happen at any age. It’s always worth addressing with a healthcare provider, as ED can be a sign that something larger is going on with your health.
Multiple health conditions may also increase your risk of ED, including:
- Heart disease—The most common cause of ED in men over 50 is atherosclerosis, or hardening of the arteries, resulting in heart disease (Cleveland Clinic, n.d.). As men age, the linings of arteries become less flexible. That means they don’t expand as easily to let blood flow to where it needs to go (like to the penis to produce an erection). Plaque, caused by high cholesterol, can also build up in the arteries, restricting blood flow to the penis (Nunes, 2012).
- Hypertension—Also known as high blood pressure, hypertension means that blood pumps through blood vessels more forcefully than it should, potentially damaging and narrowing the blood vessel walls. This condition can lead to heart disease and stroke (AHA, n.d.).
- Diabetes—High blood sugar associated with diabetes can also damage the walls of blood vessels, impeding blood flow (ADA, n.d.).
- Stroke—A stroke can create neurological damage that can contribute to ED (Koehn, 2019).
- Cancer—A variety of physical and psychological issues related to cancer symptoms, surgery, and treatment can contribute to ED (ACS, n.d.).
- Anxiety and depression: ED certainly isn’t “all in your head” (and neither are mental health conditions), but depression, anxiety disorders, and issues like relationship problems and performance anxiety can all contribute to ED (Rajkumar, 2015).
Other lifestyle risk factors for ED
ED can also occur as a side effect of certain medications, including antidepressants. If you’re experiencing ED, be sure to tell a healthcare provider about all the medications you’re taking. They might be able to adjust your dose or substitute another medication.
Other lifestyle factors that can contribute to ED include: Having excess weight or obesity, not getting enough exercise, smoking or using tobacco products, drinking excessively (having more than two alcoholic drinks a day), and using recreational drugs.
ED can also result from physical conditions in which the body’s nerves are damaged or don’t function properly, such as nerve and spinal cord injuries and multiple sclerosis.
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How to treat ED
The good news is that there are many options for treating ED.
- Oral medications—Oral medications for ED are highly effective at improving sexual function. Several are available, including sildenafil (brand name Viagra; see Important Safety Information), tadalafil (brand name Cialis; see Important Safety Information), and vardenafil (brand names Levitra and Staxyn).
- Injectable medications—Non-oral medications have been helpful for some men, including alprostadil, papaverine plus phentolamine (brand name BiMix), and a mix of papaverine, phentolamine, and alprostadil (brand name TriMix). These are medications that can be injected directly into the penis, causing an erection.
- Natural remedies—Some men have found natural remedies for ED to be effective at improving their erections, and some research backs that up. Studies have shown that certain supplements (such as DHEA, ginseng, L-arginine, L-carnitine, and yohimbe) may be helpful for relieving ED. Be sure to speak with your healthcare provider before starting any supplements.
- Testosterone replacement therapy—If low testosterone is responsible for your ED, testosterone replacement therapy (TRT) can boost your testosterone levels via injection, a wearable patch, or a gel applied to the skin.
- Devices—For some men with ED, using a device such as a penis pump, cock ring, or—in severe cases—a surgically placed penis implant has been effective in restoring sexual function.
- Lifestyle changes—Your erections will be best when you’re healthy. Making simple lifestyle changes such as getting more exercise, eating a healthy diet, quitting smoking and recreational drugs, and limiting your alcohol consumption might be enough to improve ED and your sexual health.
No matter what your age, if you’re experiencing ED, it’s a good idea to talk with a healthcare provider to identify any underlying health conditions and find a treatment plan that is right for you.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
- American Cancer Society (ACS). (n.d.). How cancer can affect erections. Retrieved Aug. 23, 2020 from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer/erections-and-treatment.html
- American Diabetes Association (ADA). (n.d.). Erectile dysfunction. Retrieved Aug. 23, 2020 from https://diabetes.org/healthy-living/sexual-health/erectile-disfunction
- American Heart Association (AHA). (n.d.). How high blood pressure can affect your sex life. Retrieved Aug. 23, 2020 from https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-affect-your-sex-life
- Cleveland Clinic. (n.d.). Erectile dysfunction & heart disease. Retrieved on Aug. 23, 2020 from https://my.clevelandclinic.org/health/diseases/15029-heart-disease–erectile-dysfunction
- Ferrini, M. G., Gonzalez-Cadavid, N. F., & Rajfer, J. (2017). Aging related erectile dysfunction-potential mechanism to halt or delay its onset. Translational Andrology and Urology, 6(1), 20–27. doi: 10.21037/tau.2016.11.18. Retrieved from https://tau.amegroups.com/article/view/13319/13808
- Koehn, J., Crodel, C., Deutsch, M., Kolominsky-Rabas, P. L., Hösl, K. M., Köhrmann, M., et al. (2015). Erectile dysfunction (ED) after ischemic stroke: association between prevalence and site of lesion. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society, 25(6), 357–365. doi: 10.1007/s10286-015-0313-y. Retrieved from https://link.springer.com/article/10.1007/s10286-015-0313-y
- Nunes, K. P., Labazi, H., & Webb, R. C. (2012). New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension, 21(2), 163–170. doi: 10.1097/mnh.0b013e32835021bd. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22240443/
- Rajkumar, R. P., & Kumaran, A. K. (2015). Depression and anxiety in men with sexual dysfunction: a retrospective study. Comprehensive Psychiatry, 60, 114–118. doi: 10.1016/j.comppsych.2015.03.001. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0010440X15000346?via%3Dihub
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.