The Ageing Male

Reproductive and sexual health changes occur as a man gets older. These changes involve fertility, hormone levels, prostate health and erectile function.


Sperm counts decline with age and the ability of an older man to father a child declines.


Testosterone levels begin to slowly fall from the age of 40 years onwards.

The fall is not as dramatic as the drop in oestrogen that occurs in women at the menopause. Whilst low testosterone may result in a decreased libido, ageing men are at risk of osteoporosis and decreased muscle mass.

Tiredness and irritability may also be a feature of low testosterone.

Ongoing research is aimed at establishing at what level men should be treated with testosterone and at what dose. There is still no general consensus on this issue at this moment in time.


The commonest change with the prostate gland in the ageing man is benign enlargement. This may affect urine flow. A less common change is prostate cancer which may present with the same symptoms as benign prostate disease or no symptoms at all. Regular prostate checks over the age of 50 years is recommended.

Erectile Dysfunction

Erectile dysfunction increases with age. This may be exacerbated by the presence of medical conditions such as high blood pressure, high cholesterol and diabetes. Many new treatments have been developed for erectile dysfunction.