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ED Cures for Seniors: How to Get Hard at 65+

Kelly Brown MD, MBA

Reviewed by Kelly Brown, MD

Written by Nicholas Gibson

Published 08/25/2021

Updated 03/28/2024

Can an 80-year-old man get hard? The short answer is yes. But there are some reasons why it may be more difficult for older men to get aroused during sexual stimulation than younger men.

Let’s face it: It’s common for older men to deal with erectile dysfunction (ED). According to one study, men in their 40s have a 40 percent chance of experiencing ED, and the rate increases by 10 percent each decade.

While ED is commonly associated with aging, it doesn’t mean men 65 and older have to suffer from sexual dysfunction.

Although there’s no cure for ED, it’s crucial to make lifestyle changes and take science-based medications for ED to reverse symptoms and start getting hard again.

Let’s dive into why ED is a common men’s health issue and how you can treat it for better sex after 65.

Erectile dysfunction is the inability to get or maintain an erection long enough for sexual intercourse. It’s a common problem affecting approximately 30 million men in the U.S. alone.

Older age and ED go hand-in-hand. So the older you get, the more likely you are to develop this sexual dysfunction problem.

Losing an erection during sex can feel like a buzzkill, but know that it happens to all of us at some point or another. It often has multiple causes, and healthcare providers usually seek to pinpoint them before recommending a treatment.

Knowing the possible underlying causes of ED can guide ED treatment options. We’ll break these down below.

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Do you ever wonder what made you lose your erectile function? As noted, there’s not just one possible cause of ED — there could be multiple reasons you’ve lost your abilities.

Erectile dysfunction is linked to certain medical conditions, medications, mental health conditions and lifestyle choices.

Here’s a deeper look into the more common causes of ED after 65.

Health Conditions

Hypertension (high blood pressure) is often connected to ED. A review of multiple studies suggests that ED is commonly found in men with hypertension.

According to another review, about 30 percent of patients with hypertension complain about erectile dysfunction to their healthcare providers.

Another study looked at data from 108 patients between 2005 and 2011, prospectively. Researchers concluded that men with severe ED had a higher risk of developing hypertension and/or cardiovascular disease at 10 years than those with mild or moderate ED.

Overall, an estimated 15 percent of participants in the study had erectile dysfunction at a 10-year assessment. Whew — that’s quite a high rate for ED, right?

Diabetes has also been associated with erectile dysfunction. A review of multiple studies reveals that men with diabetes are three times more likely to develop ED than nondiabetic men. In addition to ED caused by hypertension, or vascular ED, another type of ED is neurological ED. For example, diabetes could be a cause of ED as it is a condition that can cause nerve damage and vascular issues.

Other diseases and medical conditions that can cause erectile tissue damage in men above the age of 65 include:

  • Chronic kidney disease

  • Multiple sclerosis

  • Atherosclerosis (clogged arteries)

  • Physical injuries affecting the penis, prostate, pelvis, bladder or spinal cord

  • Complications from surgical procedures, such as surgery for bladder or prostate cancer

Urogenital diseases and treatments that can cause ED include:

  • Peyronie’s disease. Also known as penile curvature, Peyronie’s disease can cause scar tissue to form underneath the penis’s skin, making erections curved and sexual intercourse difficult and/or painful.

  • Benign prostatic hyperplasia (BPH). A common condition among aging men, BPH, is the noncancerous growth of prostate tissue. One risk factor for developing erectile dysfunction is having BPH or undergoing its accompanying treatment.

  • Prostatitis. Prostatitis is a painful condition that causes inflammation in the prostate. For some men, having it may induce erectile dysfunction and cause ejaculation problems.

  • Radical prostatectomy. This is a surgery for prostate cancer where the prostate glands are removed. Several studies suggest up to an 85 percent increase in ED diagnoses after treatment. If you’re going under the knife, understand that ED after prostate surgery is possible.

On the contrary, ED can also be a risk factor for health problems like heart disease. Erectile dysfunction could be one of the biggest warning signs you may develop certain diseases and disorders in the future.

Medications

Now, let’s dive into the medications that can cause ED.

Some medications can affect your nervous system, your level of interest in sex or blood flow to your penis, potentially causing erectile dysfunction.

These medications include:

  • Antidepressants. Selective reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs) might cause ED, an occurrence known as antidepressant-associated sexual dysfunction. The likelihood of sexual dysfunction is higher with SSRIs and SNRIs compared to TCAs.

  • Antipsychotics. Medications typically prescribed for mental health disorders may induce ED.

  • Benzodiazepines. Commonly sold as Xanax®, these medications are known to cause sexual dysfunction among users.

  • Beta-blockers. These are one of many antihypertensive drugs associated with erectile dysfunction.

  • Estrogen-containing medications. These medications may lower libido in men.

  • Finasteride. Long-term use of finasteride, which is used to treat BPH and male pattern hair loss, can worsen erectile dysfunction symptoms.

  • Opioids. Opioids, such as morphine and oxycodone, are strong pain medicines that can decrease a man’s sex drive.

If you’re taking any of the above medications, speak with your healthcare provider to see if there’s an alternative that doesn’t have ED as a side effect.

Daily Habits and Lifestyle Factors

Certain habits, behaviors and lifestyle factors can increase the risk of developing erectile dysfunction for men 65 and older.

These factors include:

  • Smoking. Is there a link between smoking and ED? Yes. Smoking cigarettes and cigars can lead to cardiovascular problems. Cardiovascular issues can be a cause of ED as well as an independent risk factor for this sexual dysfunction problem.

  • Drinking lots of alcohol. Long-term alcohol users and those with alcohol liver disease may be more susceptible to developing erectile dysfunction.

  • Being overweight or obese. Yes, that hot dad bod you’ve been working on (or that beer belly) may lead to ED. Being overweight or obese is commonly associated with the development of erectile dysfunction.

  • Living a sedentary lifestyle with limited physical activity. Sedentary behaviors — like prolonged sitting and low levels of physical activity — can contribute to cardiovascular diseases. They’re also independent factors for ED.

  • Using illicit drugs or having a substance use disorder. Chronic use of illegal drugs can cause sexual dysfunction issues like ED, premature ejaculation, delayed ejaculation and hypoactive sexual desire disorder.

Psychological Causes

Erectile dysfunction isn’t just physical. In fact, in many cases, it’s linked to psychological or emotional issues. Understanding how mental health is linked to sexual function can help you better navigate treatment and get back to your old self.

Here are some psychological ED conditions men 65 and up should be aware of:

  • Depression. In a meta-analysis of nearly 170,000 men across 48 studies, patients with depression had a 39 percent increased risk of erectile dysfunction.

  • Anxiety disorders. A review of 12 studies revealed a higher prevalence of ED among men with anxiety disorders. But more research is needed to confirm these mental health conditions as an independent factor for ED.

  • Chronic or severe stress. Dealing with chronic stress can worsen ED symptoms for some men.

  • Low self-esteem, fear of sexual failure or sexual performance anxiety. According to a review of multiple studies, sexual performance anxiety can contribute to premature ejaculation and erectile dysfunction.

  • Guilt about having sex or engaging in certain types of sexual activity. Feeling guilty about letting down your partner, feeling like a failure or dealing with blame are all associated with ED.

Choose your chew

So how do you get hard as a member of the 65+ club?

Though you can’t entirely get rid of erectile dysfunction, you can work to treat your symptoms. Since this sexual dysfunction problem can be multifactorial, multiple treatment methods might be necessary for managing it.

That said, here are some ways you can improve ED symptoms.

ED Medications for Seniors

In addition to addressing the root cause(s) of your sexual dysfunction, your healthcare provider might recommend other solutions for ED.

One of the most effective ways to treat erectile dysfunction and maintain good sexual function is medication.

The U.S. Food and Drug Administration (FDA) has approved four medications for ED. These prescription drugs are known as PDE5 inhibitors, and they work by increasing the level of blood that flows to your penis when you feel sexually aroused.

PDE5 inhibitors are first-line drugs for treating erectile dysfunction symptoms so you can maintain a full erection.

Here are the best ED drugs for seniors:

  • Sildenafil. Sildenafil is both the active ingredient and generic form of Viagra®. It provides relief from ED for roughly four hours per dose. These ED pills are an effective treatment option for men 65 and older.

  • Tadalafil. Tadalafil is the active ingredient and generic version of Cialis®. It’s a longer-lasting ED medication that can work for up to 36 hours per dose.

  • Vardenafil. Vardenafil is the active ingredient in Levitra®. It typically provides relief from erectile dysfunction for four to six hours per dose.

  • Avanafil. Sold as Stendra®, avanafil is a second-generation ED medication that’s fast to work and less likely to cause certain side effects associated with other ED drugs.

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Other medical treatments for erectile dysfunction at age 65+ include:

  • Vacuum devices or penis pumps

  • Penile injections

  • Surgery

There’s also the inflatable penile prosthesis, an implantation device healthcare providers may offer if other treatments are unsuccessful.

According to one study involving 56 patients aged 71 to 86 who got an inflatable penile prosthesis, 91 percent found the device easy to use and said they’d get the procedure again. Only about 4 percent of patients had complications with this erectile dysfunction treatment.

Treat Any Underlying Health Conditions

If an underlying condition is causing erectile dysfunction, such as diabetes, it’s important to get treatment. Your healthcare provider may prescribe certain medicines, treatments or devices to help reduce your diabetes and ED symptoms.

Discuss your ED concerns with a healthcare provider to determine the best treatment plan for your needs and get back your quality of life.

Talk to a Therapist

ED is often psychological. Mental health issues — such as depression, anxiety and even guilt about having sex — may contribute to weak erections or poor sexual performance.

If you’ve experienced depression symptoms or other signs of a mental health issue at the same time as ED, you may want to get in touch with a psychiatrist, psychotherapist or another mental health provider for guidance.

Unfortunately, dealing with sexual dysfunction may put a damper on your romantic and sexual relationships. Seeking marital or couples therapy can be an effective non-pharmacological (no medicine) approach to treating erectile dysfunction problems.

With our online therapy services, you can connect with an online psychiatrist or take part in online counseling from the comfort and privacy of your home.

Check Your Testosterone Levels

Testosterone levels can play a significant role in erectile dysfunction.

Male hypogonadism (low testosterone production) is a common age-related issue that can affect sex drive, physical strength and even sperm count.

Although the link between testosterone and ED is complicated, some research suggests low testosterone levels may cause or contribute to ED.

If your testosterone levels are lower than the expected range for your age, your healthcare provider might recommend testosterone replacement therapy (TRT). TRT treats hypogonadism, a condition that causes sexual dysfunction.

TRT is effective, but there are potential drawbacks. We’ve discussed the benefits, risks and other details in our guide to testosterone replacement therapy.

Focus on a Healthy Lifestyle

Medication and therapy can be effective for treating ED — but what lifestyle changes can you make to have the best sex at 65?

According to a review of studies, positive lifestyle changes can significantly improve men’s sexual health. In other words, you can reduce your ED symptoms to improve your sexual performance by adopting healthy habits and lifestyle.

Here are some ways you can limit the effects of erectile dysfunction:

  • Maintain a healthy weight. Make sure you’re sustaining a healthy weight, as ED is connected to physical inactivity, cardiovascular diseases and obesity. It’s recommended that you do 40 minutes of aerobic exercises four times a week.

  • Get enough sleep. A review of studies revealed that irregular sleep, disrupted sleep and sleep disorders can affect sexual function. The CDC (Centers for Disease Control and Prevention) recommends adults 65 and older get seven to eight hours of sleep every night.

  • Limit alcohol consumption. You don’t have to stop drinking completely, but don’t make it a daily habit. Regular alcohol consumption can not only affect your sexual health but also lead to alcohol-induced erectile dysfunction.

  • Quit smoking. Smoking can negatively impact your sexual performance, which can worsen ED symptoms. The main culprit behind the negative effects of smoking on your sexual health is nicotine, as it reduces blood flow to your penis, making it more difficult to maintain an erection. So consider quitting smoking to improve your ED symptoms.

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You don’t have to give up on your sex life because of erectile dysfunction. Once you know the causes of your ED, you can seek treatment and enjoy sex again after age 65.

Here’s what to remember:

  • As you age, erectile dysfunction is more likely to occur — and it may or may not be a sign of something else going on.

  • Physical and psychological problems — like certain medical conditions, medications and lifestyle factors — can cause ED.

  • Erectile dysfunction treatment options include PDE5i medications, psychotherapy, testosterone replacement therapy and behavioral modifications.

  • It’s important to discuss any changes in sexual functioning with your healthcare provider to figure out the root cause(s) and see what treatment options are available.

Want to learn more about erectile dysfunction? Check out the pros and cons of the best ED drugs for seniors, and learn how stress can cause sexual dysfunction.

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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.

Kelly Brown MD, MBA
Kelly Brown, MD

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown is a founding member of Posterity Health where she is Medical Director and leads strategy and design of their Digital Health Platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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