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Effects of Aging on the Male Reproductive System

By

Irvin H. Hirsch

, MD, Sidney Kimmel Medical College of Thomas Jefferson University

Last full review/revision Mar 2021| Content last modified Mar 2021
CLICK HERE FOR THE PROFESSONAL VERSION

It is not clear whether aging itself or the disorders associated with aging cause the gradual changes that occur in men's sexual functioning. The frequency, duration, and rigidity of erections gradually decline as men age (see Erectile Dysfunction Erectile Dysfunction (ED) Erectile dysfunction (ED) is the inability to attain or sustain an erection satisfactory for sexual intercourse. (See also Overview of Sexual Dysfunction in Men.) Every man occasionally has... read more ). Levels of the male sex hormone (testosterone) tend to decrease, reducing sex drive (libido) Decreased Libido in Men Decreased libido is a reduction in sex drive. Possible causes include psychologic factors (such as depression, anxiety, or relationship problems), drugs, and low blood levels of testosterone... read more . Blood flow to the penis decreases. Other changes include

  • Decrease in sensitivity of the penis

  • Decrease in volume of fluid released during ejaculation

  • Reduced forewarning of ejaculation

  • Orgasm without ejaculation

  • After orgasm, penis becomes limp (detumescent) more quickly

  • After orgasm, longer period before an erection can occur (refractory period)

Beginning at about age 20, the production of testosterone (the main male sex hormone) in men usually begins to decrease an average of 1 to 2% per year. The period later in life when testosterone production has decreased enough to cause significant symptoms is sometimes described as male menopause, or andropause. However, the gradual hormone decline in men differs greatly from what women experience in menopause Menopause Menopause is the permanent end of menstrual periods and thus of fertility. For up to several years before and just after menopause, estrogen levels fluctuate widely, periods become irregular... read more Menopause , during which female hormones almost always decline rapidly over just a few years. The rate of testosterone decline varies greatly among men. Some men in their 70s have testosterone levels that match those of the average man in his 30s.

Testosterone-Replacement Therapy

Many men with normal testosterone levels are interested in taking testosterone to slow or reverse development of characteristics of low testosterone. However, currently testosterone replacement therapy (TRT) is recommended only for men with both symptoms of low testosterone and abnormally low blood levels of testosterone, a condition called hypogonadism Decreased Libido in Men Decreased libido is a reduction in sex drive. Possible causes include psychologic factors (such as depression, anxiety, or relationship problems), drugs, and low blood levels of testosterone... read more . Recent studies have found conflicting evidence suggesting a possible increased risk of heart attack and stroke in men who take TRT.

Side effects of testosterone-replacement therapy

Currently, testosterone treatment is thought to have no effect on the development or progression of prostate cancer Prostate Cancer The risk of prostate cancer increases as men age. Symptoms, such as difficulty urinating, a need to urinate frequently and urgently, and blood in the urine, usually occur only after the cancer... read more Prostate Cancer . However, this subject is not entirely understood, and men should talk with their doctors about their risk of developing prostate cancer.

Follow-up to testosterone-replacement therapy

Men taking testosterone need to be checked every few months for changes in their blood count and for prostate cancer. Such testing may detect cancers early, when they are more likely to be curable. Some men with prostate cancer may take testosterone treatment, but they should be checked even more frequently by their doctor.

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSONAL VERSION
CLICK HERE FOR THE PROFESSONAL VERSION
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Decreased Libido in Men
Which of the following is the most frequent cause of persistently low libido, or sex drive, in men?
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