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Last updated February 27, 2020. 3 minute read

What causes erectile dysfunction (ED) in men over 50?

ED becomes more common with age. But that doesn’t mean it’s inevitable or a natural part of aging. Rather, it most often develops in conjunction with other chronic diseases that might develop with age.

Self Written by Michael Martin
Reviewed by Dr. Mike Bohl, MD, MPH

If you’re over 50 and have erectile dysfunction (ED), you’re definitely not alone. About one-third of men over age 50 report being bothered by ED (Lindau, 2007), and it’s estimated that more than 30 million American men have experienced it at one time or another (Nunes, 2012). It’s the most common sexual dysfunction there is. The good news is that there are a lot of things you can do about it.

Vitals

  • ED is common after age 50, but that doesn’t mean it’s a natural part of aging.
  • ED is a significant predictor of heart disease.
  • The most common cause of erectile dysfunction in men over 50 is atherosclerosis or hardening of the arteries.
  • Lifestyle changes, such as diet, exercise, and quitting smoking, can be good for your heart and your erections.

What is erectile dysfunction?

ED, previously referred to as impotence, happens when you can’t get or keep an erection sufficient enough for a satisfying sex life. That might include erections that don’t last as long as you want or aren’t as firm as you’d like. These issues with erectile function may affect your sexual desire in addition to your ability to have sex.

Erectile dysfunction and age

ED becomes more common with age. But that doesn’t mean it’s inevitable or a natural part of aging. Rather, it most often develops in conjunction with other chronic diseases that might develop with age.

What’s the main cause of ED in men over 50?

The most common cause of erectile dysfunction in men over 50 is atherosclerosis, or hardening of the arteries (Cleveland Clinic, n.d.). As men age, the linings of arteries become less flexible. That means they don’t expand as easily to let more blood flow through when you need it (like getting an erection).

Plaque can also build-up in the arteries, meaning less blood can flow to the penis. This reduced blood flow can cause ED as well as heart attacks or strokes. Atherosclerosis is so common in men over 50 that it’s responsible for nearly half of ED cases in older men (Ibrahim, 2018).

A 2005 American Medical Association (AMA) study found that “erectile dysfunction is a significant predictor of heart disease” (Thompson, 2005). The AMA tracked 4,247 men without ED over the age of 55 for five years. Every three months, they met with these men and checked for signs of erectile dysfunction and heart disease.

By the end of the five-year study, 57% of men—over 2,400—had developed ED. The men who developed ED had a greater risk of a “cardiac event.” The AMA also estimates that “more than 600,000 men aged 40–69 years in the US develop erectile dysfunction every year, and older men with ED have twice the risk of cardiovascular disease than men without erectile dysfunction.”

Over 70% of sudden cardiac deaths happen in men (Bogle, 2016). The blood vessels in the penis are smaller than other parts of the body. So, problems like high blood pressure or cardiovascular disease can sometimes show up as erectile dysfunction before a heart attack or stroke.

Erectile dysfunction and heart disease share a lot of the same risk factors and symptoms. If you have symptoms of ED, consider getting screened for cardiovascular risk factors.

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Other causes of ED over 50

Of course, ED isn’t only caused by cardiovascular issues. Other physical and mental factors can contribute to ED, including:

  • Diabetes
  • Obesity
  • Multiple sclerosis
  • Parkinson’s disease
  • Anxiety and depression
  • Relationship issues
  • Sleep disorders
  • Peyronie’s disease

How can older men avoid ED?

Your erections will be best when you’re healthy. Making simple lifestyle changes—like getting regular exercise, following a healthy diet, quitting smoking, getting enough sleep, and limiting your alcohol consumption—might be enough to improve ED.

Treatment options for ED

Oral medications for ED are highly effective at improving sexual function. Several are available, including sildenafil (brand name Viagra), tadalafil (brand name Cialis), and vardenafil (brand name Levitra).

Some men have found natural remedies for ED to be effective at improving sexual performance. Some studies have shown that certain supplements (such as DHEA, ginseng, L-arginine, L-carnitine, and yohimbe) may be helpful.