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Erectile Dysfunction at Age 40: Causes & Solutions

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Steph Coelho

Published 03/19/2021

Updated 10/11/2023

The big 4-0. Congrats on reaching this milestone! 

Getting older can come with many benefits: wisdom, a greater sense of self, feeling established in your life and career. And a little salt-and-pepper hair looks sexy on just about anyone.

On the flip side, aging comes with a few drawbacks. For instance, being more aware of your mortality than ever or not being able to do backflips off a dock like you used to without dislocating a limb.

It also means you’re more likely to develop erection problems at 40.

There’s a good reason most Viagra® ads feature older men. Erectile dysfunction (ED) is more common in older people. You can have erection issues when you’re younger, too. It’s just way more common the older you get.

But just because you’re getting older doesn’t mean your sex life has to take a hit. And by the way, 40 isn’t old! You have plenty of runway ahead, and you deserve to fill it with great sex.

In this article, we’ll dig into erectile dysfunction at age 40, including how common it is, what might be causing it and how to treat it with medications and lifestyle changes.

You feel young, vibrant and full of life. You’re in your 40s, not your 80s, after all!

Unfortunately, data suggests that when you reach your 40s, you have a 40 percent chance of developing ED symptoms. And that number goes up 10 percent with every decade — 50 in your 50s, 60 in your 60s, and so on and so forth.

A few things can make it harder to get and maintain erections as you enter your 40s. We’ll outline the most common causes of ED in your 40s below.

Bottom line, though: It’s important to talk with your healthcare provider if you’re experiencing ED symptoms to figure out the underlying cause — regardless of whether you have sudden ED or experience symptoms off and on.

Okay, you’re in your 40s and having erection troubles or sexual performance issues. What might be causing your ED symptoms?

Causes of erectile dysfunction can be physical or psychological.

Psychological causes (like stress, anxiety or depression) can impact sexual function and make it harder to, well…get hard.

Pair that with the fact that life in your 40s is likely filled with stressors (work stress, relationship stress and everyday stress). Plus, your risk for mental health conditions increases with age.

The physical causes of ED can be:

  • Vascular (the most common cause), relating to blood flow and blood vessels

  • Neurological, relating to the nervous system

  • Hormonal

Let’s break down what might lead to vascular, neurological and hormone-related ED.

Vascular Causes of ED

Cardiovascular issues are the main contributor when it comes to vascular-related ED. 

Some types of heart disease — like hardened arteries (aka atherosclerosis), high cholesterol and high blood pressure — can impact blood vessel health and restrict penile blood flow. Without proper blood flow to the penis, you can’t get or maintain an erection.

As you get older, you also have a higher risk for medical conditions that can cause ED, like diabetes.

Since high blood glucose levels can damage nerves and blood vessels (yes, even the ones in your penis!), diabetes can mess with your ability to get hard.

As noted, you’re more likely to develop diabetes the older you get. According to the Centers for Disease Control and Prevention (CDC), people most often develop type 2 diabetes after age 45.

Neurological Causes of ED

Neurological ED stems from conditions like Parkinson’s disease or multiple sclerosis (MS). Neurological disorders can impair the nervous system, meaning your brain may be unable to send the signals needed to start or keep an erection.

And guess what’s a major risk factor for neurodegenerative diseases like these? Aging.

Hormonal Causes of ED

People often associate age-related hormone changes with female menopause. But men also go through hormonal changes as they get older.

Yep, your ED may be the result of age-related hormonal changes like a dip in testosterone levels, which happens naturally as you get older. Low testosterone can hamper your ability to get and stay erect long enough for sexual activity.

The following causes may also lead to sexual dysfunction:

  • Medications. As you get older, you’re more likely to develop health problems that require you to take prescription drugs. A side effect of some medications — like antidepressants and high blood pressure (aka hypertension) meds — is *whomp, whomp* ED. Some common culprits include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which are both used to treat depression and anxiety, as well as beta-blockers, which help treat hypertension.

  • Lifestyle choices. Being inactive, smoking, drinking a lot and a bad diet can all increase your risk of ED. Why? These habits increase your chance of developing certain health conditions.

  • Prostate cancer. Prostate cancer treatments like chemotherapy and radiation may impact your ability to get and keep an erection. But also, cancer just sucks. It can take an emotional toll that trickles into your sex life, making it more difficult to get excited about sexual intercourse.

  • Physical trauma. We can feel you wincing after reading this. And we’re sorry for bringing it up, but yes, injury to your pelvic area can cause ED. Injury might happen from direct trauma, like having a blood vessel or nerve nicked during prostate surgery. Or it could be an accident that causes a spinal cord injury.

And FYI: It’s possible for several causes to contribute to ED at once.

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You’re 40, struggling to get it up and worrying this might be the end of a satisfying sex life. You might even be asking yourself, Can ED be reversed?

We’ve got good news: ED is treatable!

Just because you’re in your 40s and experiencing symptoms doesn’t mean you have to live with them forever.

There’s no one-size-fits-all solution for ED, but seeking out a healthcare professional who specializes in urology is a great first step in finding medical treatment that works for you.

Let’s break down the different ED treatments your healthcare provider might recommend.

ED Medications

ED meds can make it easier to get back into the swing of things in the bedroom. They can help you get and stay hard while you work with a healthcare provider to address underlying issues.

Here’s an overview of current FDA-approved ED medications known as PDE5 inhibitors:

Another option is our chewable hard mints, which contain sildenafil or tadalafil, the active ingredients in other FDA-approved erectile dysfunction meds.

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Healthy Habits and Lifestyle Changes for ED

Day-to-day choices have a big impact on overall health — including erectile function.

Healthy lifestyle habits can help improve your overall well-being and make you less likely to develop medical conditions that can impact your D and make it tough to maintain an erection.

The following good habits may help prevent ED and improve existing erectile dysfunction symptoms:

  • Eat a healthy diet. Good nutrition can help manage conditions that can lead to ED, like cardiovascular disease, high blood pressure and diabetes. Our blog has tips for maintaining an erection naturally, including ways to adjust your diet to improve sexual health.

  • Quit smoking. You probably already know it’s bad for you, but did you know smoking increases your risk of developing ED? Smoking can damage the blood vessels necessary for getting and maintaining an erection. So while you might think smoking looks cool, it definitely won’t make you feel cool — especially in bed.

  • Limit alcohol intake and drug use. Both can be fun, but overdoing it can seriously mess with you down there, making it almost impossible to get your penis to stand at attention.

  • Get moving. You don’t have to run a marathon tomorrow, but getting your heart rate up often is good for your cardiovascular health and can help improve conditions like high blood pressure.

  • Try stress-reduction strategies. Since stress can cause and exacerbate ED symptoms, finding ways to better cope with daily stressors — like yoga, meditation or listening to soothing music — may help.

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We’re way past a time when most people didn’t live until their 40s. Life is longer now! This means way more time to enjoy the things that make you feel good — sex included.

Your risk of developing ED increases as you get older. But know that if you start experiencing ED symptoms, you’re not doomed to live with them.

This men’s health condition is highly treatable. With so many erectile dysfunction treatment options available, you’re bound to find one that works for your needs. Still, it’s a good idea to talk with a healthcare professional to discover the underlying cause. 

Ready to get help for your ED symptoms? Get a prescription online.

In addition to prescribing meds, our telehealth providers can recommend testing and physical exams to help diagnose any underlying conditions that may be contributing to your sexual function issues.

18 Sources

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  7. Hou, Y., Dan, X., Babbar, M. et al. Ageing as a risk factor for neurodegenerative disease. Nat Rev Neurol 15, 565–581 (2019). Retrieved from https://www.nature.com/articles/s41582-019-0244-7
  8. Golan, R., Scovell, J. M., & Ramasamy, R. (2015). Age-related testosterone decline is due to waning of both testicular and hypothalamic-pituitary function. The aging male : the official journal of the International Society for the Study of the Aging Male, 18(3), 201–204. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816459/
  9. Kaplan-Marans, E., Sandozi, A., Martinez, M., Lee, J., Schulman, A., & Khurgin, J. (2022). Medications most commonly associated with erectile dysfunction: Evaluation of the Food and Drug Administration National Pharmacovigilance Database. Sexual medicine, 10(5), 100543. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537247/
  10. Higgins, A., Nash, M., & Lynch, A. M. (2010). Antidepressant-associated sexual dysfunction: Impact, effects, and treatment. Drug, healthcare and patient safety, 2, 141–150. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/
  11. How cancer can affect erections. (2020, February 5). Retrieved from https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer/erections-and-treatment.html
  12. Definition & facts for erectile dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  13. Treatment for erectile dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
  14. Preventing erectile dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/prevention
  15. Kovac, J. R., Labbate, C., Ramasamy, R., Tang, D., & Lipshultz, L. I. (2015). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087–1092. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
  16. Mark S. Allen, Emma E. Walter, Erectile Dysfunction: An umbrella review of meta-analyses of risk-factors, treatment, and prevalence outcomes, The Journal of Sexual Medicine, Volume 16, Issue 4, April 2019, Pages 531–541. Retrieved from https://academic.oup.com/jsm/article-abstract/16/4/531/6966810?redirectedFrom=fulltext&login=false
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Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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