Erectile dysfunction becomes more common after 50, but it is not a part of ageing you have to accept. In the Massachusetts Male Aging Study, about 52% of men aged 40 to 70 had some degree of erectile dysfunction. At this age there is usually a treatable cause, and it can be an early sign of heart disease.
Medically reviewed by Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Last reviewed:
Why does erectile dysfunction increase after 50?
- Artery disease: diabetes, high blood pressure, high cholesterol and smoking affect the arteries more over the years.
- Low testosterone: becomes more common with age and causes low desire and weaker erections. Read about low testosterone.
- Medicines: some blood pressure, antidepressant and prostate medicines can affect erections, ejaculation or desire.
- Prostate disease and its treatment, such as surgery for prostate cancer.
- Psychological and relationship factors such as anxiety, depression and stress.
Can it be a sign of another disease?
The European Association of Urology (EAU) 2025 guidelines regard erectile dysfunction as a possible warning sign of coronary and peripheral artery disease, so your doctor checks blood pressure, blood sugar and lipids and estimates your heart risk. Read about erectile dysfunction and heart disease.
Which tests are needed?
- A history of symptoms, illnesses and medicines, and an examination.
- Blood sugar and lipid tests.
- Morning fasting total testosterone, repeated if low.
- Specialist tests only in specific cases.
Details are in erectile dysfunction tests.
How is it treated after 50?
- Lifestyle change and risk factor control: exercise, weight loss, stopping smoking, and controlling sugar and blood pressure.
- A medicine review with your doctor, without stopping anything yourself.
- Tablets are the first treatment for most men, respecting their contraindications.
- Testosterone only when a deficiency is confirmed; it is the first treatment when erectile dysfunction is mild.
- Injections, shockwave therapy for selected cases, and a penile prosthesis when tablets do not work.
Desire and the relationship
Sexual desire can fall with age in either partner. Guidelines suggest addressing the sexual health of the couple together, so an open conversation with your doctor and your partner is part of treatment.
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Frequently asked questions
Is erectile dysfunction after 50 normal?
It is common but not something you have to accept. The Massachusetts Male Aging Study found some degree of erectile dysfunction in about 52% of men aged 40 to 70, and there is usually a treatable cause.
Are ED tablets safe after 50?
Most men use them safely after a medical assessment, but they must never be combined with nitrates or riociguat, and need care with some blood pressure and prostate medicines.
Do I need testosterone as I get older?
Only if a deficiency is confirmed by two morning tests together with symptoms. Testosterone is not used to boost energy or strength in older men without a confirmed deficiency.
Can prostate medicines affect my sex life?
Some can affect ejaculation or desire. Do not stop a medicine yourself; discuss alternatives with your doctor.
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Book an erectile dysfunction assessment
Prof. Al-Samarrai and Dr. Amer Mousa assess erectile dysfunction at Prof. Al-Samarrai Medical Center, Dubai Healthcare City, and review illnesses and medicines before choosing treatment. Medical consultations are confidential.
This information is for health education and does not replace a medical examination. See our medical content policy.