How to Get an Erection After 65

Written byErica Garza
Published 08/06/2025

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 than younger men.

Overview


How to Get Hard After 65

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 than younger men.

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 there’s a strong link between ED and aging, it doesn’t mean you have to live with sexual dysfunction if you’re 65 and older.

Although there’s no cure for ED, lifestyle changes and research-backed medications for ED can reverse symptoms and help you get 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.

The Basics

What Is Erectile Dysfunction?

Erectile dysfunction is the inability to get or maintain an erection long enough for sexual intercourse. It’s a common problem affecting approximately 30 - 50 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.

Losing an erection during sex can feel like a buzzkill, but know that it happens to almost all men at some point or another. 

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

Common Causes of ED

What Causes Erection Problems in Men 65+?

There could be multiple reasons you’ve lost your ability to get an erection.

Erectile dysfunction can result from medical conditions, medications, mental health conditions, and lifestyle choices.

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

Cardiovascular Issues

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

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 participants between 2005 and 2011. It 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.

Diabetes

There’s also a link between diabetes and erectile dysfunction. A review of multiple studies reveals that men with diabetes than non-diabetic men. 

Diabetes can also cause neurological ED. That’s because diabetes can cause nerve damage that can make it hard to get an erection.

Other Health Conditions

Other diseases and medical conditions that can cause erectile tissue damage in men over 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 penile skin, making erections curved and sexual intercourse difficult or painful.

  • Radical prostatectomy. This is a surgery for prostate cancer where the prostate glands are removed. Several studies suggest up to 85 percent of patients will be diagnosed with ED after this type of surgery. If you’re going under the knife, understand that ED after prostate surgery is possible.

ED can also be a risk factor for health problems like heart disease. Erectile dysfunction could be a warning sign that 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 — all of which can impact your erectile function.

Medications that may cause ED as a side effect 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. Studies on antipsychotics show a link between these mental health drugs and ED.

  • Benzodiazepines. Anti-anxiety medications like Xanax® are known to cause sexual dysfunction among users.

  • Beta-blockers. These are one of many antihypertensives linked to ED.

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

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 in men 65 and older.

These factors include:

  • Smoking. Is there a link between smoking and ED? Yes. Smoking can lead to cardiovascular problems, whether you opt for cigars or cigarettes. Cardiovascular issues related to smoking can contribute to ED.

  • Drinking lots of alcohol. Research on long-term alcohol users shows that drinkers, especially those with alcoholic liver disease, may be more susceptible to developing erectile dysfunction.

  • Being overweight or obese. Being overweight or obese is linked to erectile dysfunction.

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

  • Using illicit drugs or having a substance use disorder. Research on chronic drug use shows that street drugs can cause sexual dysfunction issues like ED, premature ejaculation and delayed ejaculation.

Psychological Causes

Erectile dysfunction isn’t just physical. In fact, in many cases, it can happen due to psychological or emotional issues. Understanding the link between mental health and 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, people with depression had a 39 percent increased risk of erectile dysfunction.

  • Anxiety disorders. A review of 12 studies revealed a higher prevalence of ED in men with anxiety disorders

  • 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, according to a 2016 study.

Treatment Options

Medical Treatments for ED

So, you want to know how to get a hard-on after 65?

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

Here are some ways you can improve ED symptoms.

ED Medications for Seniors

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

The U.S. Food and Drug Administration (FDA) has approved four medications for ED. These prescription drugs are known as phosphodiesterase-5 inhibitors or PDE5 inhibitors. 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 ED symptoms, allowing you to maintain a full erection.

Here are the best ED medications:

  • Sildenafil. Sildenafil is both the active ingredient and the 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 works quickly and is less likely to cause side effects common with other ED drugs.

If you’re not the biggest fan of oral medications, consider chewable ED hard mints containing the same active ingredients in Viagra or Cialis in personalized dosages.

Medical Treatments

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

  • Vacuum devices or penis pumps

  • Penile injections (like alprostadil)

  • 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 people 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 participants 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 essential to get treatment. Your healthcare provider may prescribe certain medicines, treatments, or devices to help reduce your diabetes and ED symptoms.

Please discuss your ED concerns with a healthcare provider to determine the best treatment plan for your needs and regain your quality of life.

Check Your Testosterone Levels

Testosterone levels can play a significant role in erectile dysfunction.

Male hypogonadism (low testosterone) 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, the American Urological Association reports that 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 is effective, but it has potential drawbacks. Our guide to testosterone replacement therapy discusses the benefits, risks, and other details.

Tips and Strategies

Talk to a Therapist

ED is often psychological. Mental health issues can lead 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 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 for ED can be an effective non-pharmacological approach to treating sexual problems.

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?

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. Aim to fit in at least 40 minutes of aerobic exercise four times a week and follow a healthy diet.

  • Limit alcohol consumption. You don’t have to stop drinking altogether but don’t make it a daily habit. Drinking alcohol can affect your sexual health and potentially 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, which reduces blood flow to your penis. Consider quitting smoking to improve your ED symptoms.

What to Do Next

A Final Word on How to Get an Erection After 65

You don’t have to give up on your sex life because of erectile dysfunction. Once you know what’s causing your symptoms, you can treat ED and enjoy sex again after age 65.

Here’s what to remember:

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

  • ED has physical and mental causes. Physical and psychological problems — like certain medical conditions, medications, and lifestyle factors — can cause ED. Getting to the root of these causes is key to devising a treatment plan.

  • Treatments are available. Erectile dysfunction treatment options include PDE5 inhibitors, therapy, testosterone replacement therapy, and lifestyle changes.

For more ideas on how to keep your sex life healthy in your golden years, check out these sex tips for seniors.

And remember, it’s important to discuss any changes in sexual functioning with your healthcare provider to figure out the root cause(s) and learn about safe and effective treatment options.

Want to learn more about erectile dysfunction? Get medical advice from a healthcare professional today to see if you qualify for treatment.

47 Sources

  1. Erectile Dysfunction. (n.d.). https://diabetes.org/healthy-living/sexual-health/erectile-disfunction
  2. Benowitz N, et al. (2016). Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958544/
  3. Cavayero C. (2022). Penile prosthesis implantation. https://www.ncbi.nlm.nih.gov/books/NBK563292/
  4. Cho J, et al. (2019). Sleep, sleep disorders, and sexual dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704301/
  5. Dauffenbach H. (2014). What medications might lower a person’s libido? https://www.issm.info/sexual-health-qa/what-medications-might-lower-a-person-s-libido?highlight=WyJtZWRpY2F0aW9uIl0=
  6. Definition & facts for erectile dysfunction. (2024). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  7. Dhaliwal A. (2023). PDE5 inhibitors. https://www.ncbi.nlm.nih.gov/books/NBK549843/
  8. Diabetic neuropathy. (2018). https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies
  9. Emanu J, et al. (2016). Erectile dysfunction after radical prostatectomy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005072/
  10. Ferrini M, et al. (2017). Aging related erectile dysfunction—potential mechanism to halt or delay its onset. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313305/
  11. Gerbild H, et al. (2018). Physical activity to improve Erectile function: A systematic review of intervention studies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960035/
  12. Ghadigaonkar D, et al. (2019). Sexual dysfunction in persons with substance use disorders. https://journals.sagepub.com/doi/10.1177/2631831819849365
  13. Hehemann M, et al. (2016). Can lifestyle modification affect men’s erectile function? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837314/
  14. Higgins A, et al. (2010). Antidepressant-associated sexual dysfunction: Impact, effects, and treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/
  15. How smoking affects heart health. (2021). https://www.fda.gov/tobacco-products/health-effects-tobacco-use/how-smoking-affects-heart-health
  16. Huri H, et al. (2016). Association of psychological factors, patients, knowledge, and management among patients with erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874731/
  17. Javaroni V, et al. (2012). Erectile dysfunction and hypertension: Impact on cardiovascular risk and treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357516/
  18. Jiann B. (2010). Effect of alcohol consumption on the risk of erectile dysfunction. https://www.sciencedirect.com/science/article/pii/S1879522610600371
  19. Liu Q, et al. (2018). Erectile dysfunction and depression: A systematic review and meta-analysis. https://www.sciencedirect.com/science/article/pii/S1743609518310075?via%3Dihub
  20. Kalaitzidou I, et al. (2013). Stress management and erectile dysfunction: A pilot comparative study. https://pubmed.ncbi.nlm.nih.gov/23822751/
  21. Kim S. (2011). Prostatic disease and sexual dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123811/
  22. Kovac J, et al. (2014). Effects of cigarette smoking on erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
  23. Maiorino M, et al. (2014). Diabetes and sexual dysfunction: Current perspectives. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949699/
  24. Mollaioli D, et al. (2020). Lifestyles and sexuality in men and women: The gender perspective in sexual medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025405/
  25. Montejo A, et al. (2021). Management strategies for antipsychotic-related sexual dysfunction: A clinical approach. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829881/
  26. Moon K, et al. (2019). Obesity and erectile dysfunction: From bench to clinical implication. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479091/
  27. Ng M. (2022). Benign prostatic hyperplasia. https://www.ncbi.nlm.nih.gov/books/NBK558920/
  28. Nunes K, et al. (2012). New insights into hypertension-associated erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004343/
  29. Osterberg E, et al. (2014). Risks of testosterone replacement therapy in men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/
  30. Ostfeld R, et al. (2020).Vasculogenic erectile Dysfunction: The impact of diet and lifestyle. https://pubmed.ncbi.nlm.nih.gov/33227246/
  31. Penile curvature (Peyronie’s disease). (2022). https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease
  32. Pozzi E, et al. (2020). Longitudinal risk of developing cardiovascular diseases in patients with erectile dysfunction—Which patients deserve more attention? https://www.researchgate.net/publication/340910154_Longitudinal_Risk_of_Developing_Cardiovascular_Diseases_in_Patients_With_Erectile_Dysfunction-Which_Patients_Deserve_More_Attention
  33. Preventing erectile dysfunction. (2022). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/prevention
  34. Prostate enlargement (Benign prostatic hyperplasia). (2022). https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia
  35. Prostatitis: Inflammation of the prostate. (2022). https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate
  36. Rowland D, et al. (2019). Anxiety and performance in sex, sport, and stage: Identifying common ground. Front. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01615/full
  37. Sharp R, et al. (2017). Nebivolol versus other beta blockers in patients with hypertension and erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298412/
  38. Shin Y, et al. (2019). Finasteride and erectile dysfunction in patients with benign prostatic hyperplasia or male androgenetic alopecia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479090/
  39. Sooriyamoorthy T. (2023). Erectile dysfunction. https://www.ncbi.nlm.nih.gov/books/NBK562253/
  40. Symptoms & causes of erectile dysfunction. (2024). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  41. Treatment for erectile dysfunction. (2024). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
  42. Vaishnav M, et al. (2020). Principles of marital therapies and behavior therapy of sexual dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001355/
  43. Velurajah R, et al. (2022). Erectile dysfunction in patients with anxiety disorders: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964411/
  44. Villarreal H, et al. (2012). Outcomes of and satisfaction with the inflatable penile prosthesis in the elderly male. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368302/
  45. Wagner G, et al. (2001). Sildenafil citrate (VIAGRA(R)) improves erectile function in elderly patients with erectile dysfunction: A subgroup analysis. https://academic.oup.com/biomedgerontology/article-abstract/56/2/M113/563357
  46. What Is low testosterone?. (n.d.). https://www.urologyhealth.org/urology-a-z/l/low-testosterone
  47. Zoroufchi B, et al. (2021). Benzodiazepines related sexual dysfunctions: A critical review on pharmacology and mechanism of action. https://www.sciencedirect.com/science/article/abs/pii/S1698031X19300834
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]!

*All images feature a model portrayal

(unless otherwise noted).