Erections and age: when do they weaken, and what is behind it?
The studies and sources we used are listed at the end. Not reviewed by a doctor. Editorial policy
"It wasn't like this in my 20s." Even so, age is rarely the only cause. Let's look at the research to see whether blood vessels, muscles or habits might be involved.
Large surveys show that ED becomes more common with age. But the cause is usually less about age itself and more about a mix of blood vessel health, too little exercise, weight, the pelvic floor muscles, smoking and sleep, and some of these you can work on yourself.
Contents
Age and ED
In the Massachusetts Male Aging Study of 1,290 men aged 40 to 70, 52% reported some degree of ED, and complete ED rose from about 5% at 40 to about 15% at 70. Younger men get ED too, though. You cannot say "it's just my age", and you cannot say "I'm too young for this" either.
The main causes
1. Blood vessels work less well
Erections depend on blood flowing into the penis, so they are affected by aging arteries and by high blood pressure, diabetes and high cholesterol. This is why ED can be a sign of heart or blood vessel disease.
2. Pelvic floor muscles weaken
The muscles around the base of the penis are thought to help hold blood in during an erection. Like other muscles, they slowly weaken if you don't use them. In a randomized trial of 55 men with ED (Dorey et al., 2004), 40% of the group that trained these muscles for 3 months had erectile function scores back in the normal range.
3. Too little exercise and weight gain
A review of exercise and ED studies (Gerbild et al., 2018) suggested aerobic exercise for 40 minutes, 4 times a week. In a study of men with obesity (Esposito et al., 2004), 31% of the group that changed their lifestyle to lose weight for 2 years had erectile function scores in the normal range, against 5% of the comparison group.
4. Smoking, alcohol, sleep and stress
Smoking strains blood vessels and is a known cause of ED. Heavy drinking, poor sleep, work stress and anxiety can all affect erections too.
What you can do yourself
- Pelvic floor (Kegel) training every day: try the 1-minute Kegel timer
- Brisk walking or jogging, around 150 minutes a week
- Strength training such as squats 2 to 3 times a week, plus a look at your diet
These were all studied over several months; nothing changes overnight. And exercise is not a substitute for medical treatment.
When to see a doctor
See a urologist, men's health clinic or your doctor if it has bothered you for several months, started suddenly, if you have a long-term condition, or if you have chest pain or shortness of breath. Doctors commonly prescribe tablets that help erections (PDE5 inhibitors), and some clinics offer online consultations.
FAQ
At what age do erections start to weaken?
Large surveys such as the Massachusetts Male Aging Study found that ED becomes more common with each decade, but it also affects younger men, so age alone does not decide it. Blood vessel health, activity, weight, smoking, sleep, stress and the pelvic floor muscles all play a part.
Can exercise or lifestyle changes help with ED?
Aerobic exercise (around 160 minutes a week), pelvic floor training, and diet plus exercise to lose weight have all been studied. In a randomized trial of 110 men with obesity (Esposito et al., 2004), about a third of the lifestyle group had erectile function scores in the normal range after 2 years. ED can also be an early sign of heart or blood vessel disease, so have a doctor check the cause first.
How long do I need to keep training before I can judge it?
In the studies, pelvic floor training was assessed after 3 months, aerobic exercise after about 6 months and lifestyle change to lose weight after 2 years. Nothing changes in a few days, so treat 12 weeks as your first checkpoint.
References
- Feldman HA, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151(1):54-61. pubmed.ncbi.nlm.nih.gov/8254833/
- Gerbild H, et al. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sex Med. 2018;6(2):75-89. doaj.org/article/91eb296258654277ba5cb0268ced6754
- Dorey G, et al. Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. Br J Gen Pract. 2004;54(508):819-825. pmc.ncbi.nlm.nih.gov/articles/PMC1324914/
- Esposito K, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978-2984. search.pedro.org.au/search-results/record-detail/11354