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Erectile Dysfunction at Age 50: Causes & Treatment Options

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Nicholas Gibson

Published 03/17/2021

Updated 10/11/2023

Sitcoms associate midlife with men having an identity crisis: blowing their savings on a Corvette or illogically uprooting their life in some way. The reality is that, for most men, this pop culture perception of turning 50 isn’t very accurate.

Don’t get us wrong — entering midlife does come with various emotional and physical changes. Some are to be expected, like graying hair as you enter your silver fox era. But many 50-something men also encounter unanticipated sexual challenges. 

One of the most common is erectile dysfunction (ED), the inability to achieve or maintain an erection during sex. This condition can affect men of any age, but there’s a strong correlation between ED risk and getting older. 

As frustrating as it can be, most ED cases are treatable with medication and lifestyle adjustments.

Below, we’ll outline some of the most common causes of ED in your 50s, plus available treatment options. Let’s get your healthy sex life back!

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ED affects around 30 million American men. Data from the 2001-2002 National Health and Examination Survey (NHANES) showed that ED prevalence increased from eight percent among men 40 to 49 years old to nearly 78 percent among those 75 and older. 

While these stats sound defeating, having ED isn’t an inevitable part of getting older. It’s a multifactorial condition with physical and psychological influences. 

Like popping a tire when you’re cruising the highway, sudden ED can disrupt a joy ride in an instant.

Although the first time it happens can be jolting, ED could be a result of other health problems or medical conditions that have been building up for a while. 

Most Common Causes of ED for Men 50+

Let’s be clear: aging isn’t the actual cause of ED. So then, what are the causes of erectile dysfunction in your 50s?

Older men experience ED more often because the risk of other health conditions that can impact sexual function increases with age.

We may hate to admit it, but our bodies undergo changes with age that interfere with the ways we’re used to doing things.

And we’re not talking about no longer being able to do 50 push-ups or eat whatever you want without gaining a pound. We’re referring to underlying physical issues that start to derail activities that used to be easy — like sex.

For instance, the risk of high blood pressure, type 2 diabetes, atherosclerosis (build-up of plaque in the arteries from high cholesterol) and heart disease goes up as you age.

These conditions aren’t confined to the heart and blood vessels. They can be physical causes of ED, impairing blood flow to the penis and making sexual performance more challenging.

Research from 2005 estimated that atherosclerotic disease accounts for 40 percent of ED in men over fifty.

Obesity can further increase the risk of these health conditions. It’s prevalent among middle-aged adults, affecting nearly 42 percent in 2017, respectively.

Even if you don’t have the issues mentioned above, ED is a multifactorial condition. There are many potential causes of ED in midlife.

Lifestyle Factors

Everyday habits can impact your sexual health and performance. 

Being physically inactive, smoking, drinking alcohol excessively or using illicit drugs can increase your risk of ED (and other health issues).

That’s largely because these habits promote inflammation, which could result in blood vessel dysfunction and reduced blood flow to your tissues — including those in your penis.


Medication use, in general, increases with age. Unfortunately, ED can be a side effect of certain over-the-counter (OTC) and prescription drugs. 

Some of the most common culprits include antidepressants and blood pressure medications.

This doesn’t mean you should stop using the medications prescribed to you (please, don’t do that). Instead, speak with your healthcare provider about potentially switching medications or adjusting your dosage.

Psychological Factors

Not everyone with erectile dysfunction has an underlying physical ailment. In many cases, there are psychological causes of ED to consider.

After all, the mind is a powerful thing. Your thoughts and mental health may be interfering with your sexual performance more than you realize. 

Many men experience performance anxiety that can trigger ED or make existing symptoms worse. Depression, anxiety, low self-esteem, stress, pornography use and relationship problems can also contribute.

Neurological Issues

Another possibility is that you have neurological ED caused by a nervous system impairment.

Arousal and stimulation trigger your brain to release impulses to the tissues in your penis. These impulses are also necessary to sustain increased blood flow for an erection.

In other words, proper erectile function is interrupted when there’s a neurological impairment. This could be a spinal cord injury, nerve damage from prostate or bladder surgery, Parkinson’s disease, multiple sclerosis, diabetic neuropathy (nerve damage from diabetes) or epilepsy.

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Now that you have a better understanding of what may be causing your ED, you probably have one question: Can ED be reversed?

Remember, ED is very common, meaning medical professionals have had many years to find solutions. As a result, most cases of erectile dysfunction are treatable. 

The first step in the quest of how to fix erectile dysfunction in your 50s is to talk to your healthcare provider.

We get it — discussing your sex life with someone you hardly know is totally awkward. But trust us, you won’t be disclosing anything your provider hasn’t heard before. The more honest you can be, the more they can help.

A combination of medication and lifestyle changes is often prescribed to help support both physical and mental health.

ED Medications

ED medications are commonly prescribed — but not to treat the underlying condition. Instead, they help alleviate symptoms of sexual dysfunction while you focus on addressing the cause(s).

Still, ED medications are very effective for symptom management. PDE5 inhibitors are considered the gold standard in treating ED. 

When you have an erection, an enzyme called PDE5 is released to slow blood flow and relax your penis. PDE5 inhibitors prevent this from happening, increasing blood flow to help you maintain an erection.

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Healthy Habits and Lifestyle Changes for ED

Addressing ED requires taking a good look at your whole lifestyle and identifying areas where positive changes could be made.

For example, being overweight can interfere with your ability to maintain an erection. Research shows that men with obesity are three times more likely to experience sexual dysfunction than men who fall within a healthy weight range. 

Obesity is a significant risk factor for other health conditions that can affect sexual function, like type 2 diabetes, high blood pressure and clogged arteries. Maintaining a healthy weight may reduce your risk of ED, improve erection problems you currently have and boost your overall health.

Consider making some intentional lifestyle changes, like: 

  • Being active. Moving your body helps promote a healthy weight and supports cardiovascular health. Exercising can also boost self-confidence. Aim for 30 to 60 minutes of physical activity most days. This could be a combination of activities like swimming, biking, playing tennis, walking or strength training.

  • Eating a nutritious diet. Good nutrition is a crucial aspect of overall wellness. A healthy diet for ED emphasizes foods like fruits, vegetables, whole grains, legumes, nuts, seeds and lean protein. Keep ultra-processed foods and sugary beverages to a minimum, as they’re considered empty calories with little nutritional value. 

  • Not smoking. Research shows that men who smoke cigarettes have a higher risk of developing ED than non-smokers. Why? Smoking narrows blood vessels, restricting blood flow to your penis. Men who quit smoking often see improvements in ED.

  • Not drinking excessively. Chronic and persistent drinking can induce sexual dysfunction. The Centers for Disease Control and Prevention (CDC) recommends men have no more than two alcoholic drinks a day.

The things listed above to treat ED are the same things that can help prevent ED. Whether you have erectile dysfunction or think you’re at risk for developing it, striving for a healthy lifestyle is a good place to start.

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Struggling with sexual arousal or sexual activity performance is a real let-down (literally) for everyone involved.

If you’re facing ED in your 50s, know it’s not simply a part of aging. And there are actions you can take to help realign your performance with your sex drive.

As you navigate the next steps, remember:

  • Erectile dysfunction is multifactorial. ED at 50 can be caused by many things, including obesity, high blood pressure, hardening of arteries, smoking, alcohol use, low testosterone, antidepressants (among other medications), stress, anxiety, depression and even physical deformities.

  • It’s treatable. Having ED isn’t exactly the midlife change you were anticipating, but it’s very common, and treatment options are available. Medication and lifestyle changes can be very successful. Erectile dysfunction treatments might include weight loss, smoking cessation, counseling and medications like PDE5 inhibitors. 

  • It requires medical support. Any “I can do it myself” energy you have is better used to fix the lawnmower. Have your healthcare provider do a comprehensive assessment for ED. Once the cause is identified, you can personalize your plan to address the issue.

Not everything has to slow down in your 50s (or at any age, for that matter). Take the first step toward improving your sex life with our free ED quiz.

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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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