What Age Does A Man Stop Getting Hard?

Erectile dysfunction (ED), also known as impotence, is a common sexual condition that affects approximately 12 million men¹ in the U.S. It can be a short- or long-term condition, with symptom severity varying between individuals. 

Although symptoms are physical, the effects of ED can affect one’s sexual well-being, mental health, and self-confidence. 

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What is erectile dysfunction?

ED is a condition that occurs when you can’t get or maintain an erection. Although it’s common for men to experience difficulties having erections occasionally, frequent occurrences or persistent episodes may affect your ability to have sexual intercourse. 

Normally, the penis is flaccid.² When you become sexually aroused, the brain uses hormones to send messages to arteries in the spongy penile muscles (known as corpora cavernosa), telling them to relax. 

When the arteries and corpora cavernosa muscles relax, there is increased blood flow into the blood vessels, filling the open spaces in the muscles. As a result of the increased blood flow, the penis becomes erect, and an erection is maintained. ED can result when problems at any stage of getting an erection to occur. 

ED can also result in the inability to have or keep an erection long enough for sexual intercourse.

Symptoms of erectile dysfunction

The main symptom of ED is persistent trouble in getting or keeping an erection. However, other symptoms may occur, such as: 

  • Being able to get an erection, but not in sexual situations

  • Being able to get an erection but unable to make it last

  • Persistent lack of desire for sex

  • Premature or delayed ejaculation

Causes of erectile dysfunction

While ED is a physical characteristic, it’s often a sign of other conditions. ED can be caused by various physical conditions alone or in combination with mental or emotional disorders. 

Medical causes

Any condition that can affect your nervous system, vascular system, or endocrine system can result in ED. Common medical causes of ED include: 

  • Cardiovascular disease

  • Type 2 diabetes

  • High blood pressure

  • Thyroid disorder

  • Chronic kidney disease

  • Reproductive organ disorders

  • Brain or spinal cord injuries

  • Multiple sclerosis

  • Stroke

  • Peyronie’s disease³ (a condition in which scar tissue forms in the penis and causes it to curve when erect) 

Other causes

Although most causes of ED are physical, it can also develop as a result of psychological issues or lifestyle factors, such as:

  • Depression

  • Anxiety

  • Chronic stress

  • Previous trauma

  • Obesity 

  • Smoking

Other risk factors for erectile dysfunction

In addition to the medical, psychological, and emotional reasons, ED can be caused or worsened by other risk factors, which may include: 

  • Taking certain medications or substances

  • Relationship conflicts

  • Financial stress

  • Inactive lifestyle

  • Excessive alcohol consumption

  • Previous injuries from medical treatments

Relationship between aging and erectile dysfunction

ED is a common condition that’s associated with increasing age. Approximately 52%¹ of men aged 40 to 70 years suffer from mild to moderate ED. 

Although ED tends to be more prevalent in older men, research⁴ has shown that ED can also affect younger men, with 30% of cases occurring in men under 40. 

The risk of ED⁵ increases by 1.2% per year in men who are 40 to 49 years old and by 4.6% in men who are 60 to 69 years old. This risk is further increased when existing health conditions,⁶ such as diabetes, hypertension, obesity, or urinary tract⁷ conditions, are present. 

Experts believe that age is a strong risk factor for ED because of its close association with other health conditions. 

As a man ages, the body experiences several changes⁸ to its vascular system, increasing the prevalence of diabetes, hypertension, and vascular disease. The level of testosterone, a sex hormone that helps regulates sex drive and erections, may also naturally decline, resulting in testosterone deficiency. 

These age-related changes may require treatment, which could potentially alter sexual function. 

As a man gets older, staying aware of these medical conditions and the associated risks they may have for sexual and overall health is important. While age may increase the chances of ED, it is not the only contributing factor. 

Likewise, for men who have ED, treatment options are available to help them maintain good sexual health. 

Treatment of erectile dysfunction

Treatments are available for ED, regardless of age or how long ED has been present. Depending on the underlying cause of ED, a combination of treatments may be needed, including medication, lifestyle changes, talk therapy, and surgical procedures. 

A doctor may recommend optimizing existing treatments, treatments based on your current health, medical history, the extent of ED, and personal preferences. Possible treatments for ED include:

Lifestyle changes

Lifestyle modifications are the initial treatment option for ED. Improving other aspects of general health may alleviate its symptoms. 

Exercise

Being physically active isn’t just beneficial for your overall health; it may also help reduce the risks of ED. 

Men who participate in moderate physical activity are less likely to develop ED, with the risk further lowered for those who have high physical activity. 

Regular exercise is believed to reduce symptoms of ED through a range of mechanisms, such as:

  • Increasing nitric oxide production;⁹ it is an important molecule that increases blood flow to the penis

  • Improving endothelial cell¹⁰ function; endothelial cells release substances to control blood vessel constriction and relaxation 

Exercise was proven to be a helpful treatment for ED in a study¹¹ that examined the effect of various exercises in 138 men with ED and ischemic heart disease. 

Researchers found that a six-month exercise program consisting of interval endurance training, resistance training, and general fitness exercises five times a week was associated with improved erection quality¹¹ and exercise tolerance. 

The increase in exercise tolerance may help endurance and reduce periods of exhaustion, which are key to improving erectile function. 

A range of exercises is available; however, you should consult a doctor before starting any exercise plan. This is particularly important if you have heart disease or any other condition that may be easily aggravated by strenuous exercise. 

Therapies

It may be beneficial for you to seek behavioral therapy or counseling if psychological or emotional issues are causing your ED. 

Cognitive behavioral therapy¹² (CBT) is a common form of talk therapy that treats psychological conditions (e.g., anxiety, stress, and depression) by helping you change the way you think and behave. 

It can be beneficial if you are suffering from underlying psychological causes of ED, such as low self-esteem, reduced sexual arousal, or performance anxiety. 

CBT can also be completed as a form of couples therapy if relationship problems are a factor.

Medications

Phosphodiesterase 5 inhibitors

Oral phosphodiesterase 5 (PDE5) inhibitors¹³ are a type of drug that helps men get and maintain an erection by relaxing penile muscles and enhancing blood flow to the penis. Currently, four FDA-approved drugs can be used to treat ED: 

  • Sildenafil (Viagra)

  • Tadalafil (Cialis)

  • Vardenafil (Levitra or Staxyn)

  • Avanafil (Stendra)

The drug of choice should be taken approximately one hour before sexual intercourse for peak effectiveness. 

Experts recommend only taking PDE5 inhibitors as needed, and it should be done before eating as fatty foods may delay or reduce the drug’s effectiveness. 

Discussing options with a doctor is important, especially if you are taking nitroglycerin, nitrate drugs, or alpha-blockers,¹⁴ as the combination of those treatments and a PDE5 inhibitor can cause severe hypotension (extreme low blood pressure). 

Alprostadil

Alprostadil¹⁵ (also known as Caverject or synthetic Prostaglandin E1) is an alternative treatment used for men who can’t tolerate or who respond poorly to PDE5 inhibitors. It works identically to PDE5 inhibitors and can be delivered in several ways: 

  • Intracavernous (direct injection into the corpus cavernosum at the base of the penis)

  • As a cream that can be applied to the head of the penis

  • Intraurethral (insertion of a dissolvable pellet into the urethra to be absorbed by the corpus cavernosum)

Alprostadil is a prescription drug, so a doctor must first be consulted. Depending on the doctor’s assessment, they may prescribe alprostadil or Trimix, a medication that combines phentolamine, papaverine, and alprostadil to treat ED. 

For men with blood disorders such as sickle cell disease, multiple myeloma, or leukemia, taking alprostadil may increase the risk of priapism,¹⁶ a prolonged, painful erection that lasts more than four hours and may cause permanent damage to the penis.

Testosterone therapy

ED is also a sign of low testosterone. Testosterone replacement therapy is a potential treatment for ED if a doctor observes low testosterone levels. 

However, this treatment is usually reserved for men with hypogonadism¹⁷ (reduced or absent testosterone production) and ED who also have low libido or can’t tolerate PDE5 inhibitors. 

Procedures

Vacuum devices

A vacuum erection device is used to help draw blood into the penis and maintain an erection for approximately 30 minutes. The device is made of three components: 

  • Cylinder tube — this is placed over the penis

  • Vacuum pump— this draws air out of the tube and pulls blood in

  • Elastic ring — this is applied over the base of the penis to maintain the erection 

Penile implants

Penile implants¹⁸ are an invasive surgical procedure only considered when all other treatments are ineffective. The procedure involves inserting a prosthetic device into the corpora cavernosa to restore erectile function artificially. 

There are two kinds of implants: inflatable and malleable.

Inflatable implants consist of two tubes that replace the corpora cavernosa and a pump in the scrotum. The pump inflates the tubes with fluid from a reservoir in the lower abdomen, resulting in an erection.

Malleable implants, on the other hand, consist of a semi-rigid cylinder that can be physically altered for sexual intercourse. 

Penile revascularization

Penile revascularization¹⁹ is another surgical procedure that intends to restore erectile function without the need for medications or implants. This procedure involves joining the inferior epigastric artery to the dorsal artery (on top of the penis) or the corpora cavernosa. 

The outcome of this surgery aims to help improve blood flow into the penis. Currently, this procedure is only recommended for men who are younger than 55 and whose ED originated from pelvic trauma or a vascular injury. 

Can age-related erectile dysfunction be prevented?

Though ED is a medical condition, it’s also a symptom of many health conditions. Taking steps to improve your overall health and managing current health conditions is a good prevention measure to maintain sexual performance as you grow older. 

A doctor may suggest lifestyle adjustments to prevent ED. These can also be lifestyle modifications used to treat ED after onset. Some suggestions include: 

  • Quitting smoking

  • Limiting or stopping alcohol consumption

  • Losing weight for men who are overweight or obese

  • Increasing regular physical activity

  • Improving management of current health conditions 

When to see a doctor

If you think you may have ED or notice a considerable change in erectile function/sexual health, you should consult a doctor. The doctor may take a general health assessment and request blood tests to determine possible underlying causes of ED, such as diabetes or heart disease. 

Depending on the doctor’s examination, they will help determine the best treatment option based on your medical history and preferences.

They may also discuss treatment options or refer you to a mental health professional (if ED is psychologically caused) or a urologist (if you’re considering surgical treatments). 

The lowdown

Erectile dysfunction is a common sexual condition that’s strongly associated with age. Despite the condition being more common in older men, age is not the only factor that can lead to ED. 

While it’s not certain at what time age-related ED starts, one thing that’s certain is that regardless of age, ED may be treated with medication, lifestyle changes, and by treating underlying medical conditions.​​ 

ED can have a negative impact on your self-esteem, mental health, and intimate relationships, so seeking medical help as soon as possible can help address these concerns earlier so a healthy lifestyle can be achieved and maintained.

  1. Erectile dysfunction (2016)

  2. Physiology, erection | StatPearls

  3. Peyronie disease | StatPearls

  4. Erectile dysfunction in young men—A review of the prevalence and risk factors | ReaserchGate

  5. Erectile dysfunction in the elderly male (2017)

  6. The implications of increasing age on erectile dysfunction (2012)

  7. Lower urinary tract symptoms and erectile dysfunction (2011)

  8. Aging and sexual health: Getting to the problem (2017)

  9. Effects of exercise training on nitric oxide, blood pressure and antioxidant enzymes (2017)

  10. Physical exercise protects against endothelial dysfunction in cardiovascular and metabolic diseases (2021)

  11. Association between physical exercise and quality of erection in men with ischaemic heart disease and erection dysfunction subjected to physical training (2013)

  12. Cognitive behavior therapy | StatPearls

  13. PDE5 inhibitors | StatPearls

  14. Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension (2010)

  15. Alprostadil | StatPearls

  16. Clinical management of priapism: A review (2016)

  17. Erectile dysfunction | StatPearls

  18. Penile prostheses (2010)

  19. Surgical niche for the treatment of erectile dysfunction (2019)

Other sources:

Have you considered clinical trials for Erectile dysfunction?

We make it easy for you to participate in a clinical trial for Erectile dysfunction, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Joining community groups and exercise programs for my condition made me feel empowered – but I want to be part of finding a cure.
Peter, 64

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