What gay men over 50 should know about their sexual health

What sexual health changes should men over 50 expect?

Menopause can hit like a wrecking ball, but so can testosterone loss in men after age 50. Men don’t experience the same steep drop-off that women get with estrogen after menopause, but testosterone levels start declining slowly around age 40, so that by the time you hit your 50s, you may notice the change.

“The most common sexual health issues that men experience after age 50 include erectile dysfunction and low libido due to lower testosterone levels,” says Suzannah Weiss, a sex therapist and resident sexologist for adult toy company Erojoy. “Other common issues are premature and delayed ejaculation and enlarged prostate, which can cause pelvic discomfort including pain with ejaculation.”

According to the Journal of Reproductive Biology and Endocrinology, men’s total serum testosterone decreases by 0.4% annually after the age of 35. This doesn’t even take into account that men’s average testosterone levels have declined by 54% between 1972 and 2019, the European Society of Human Reproduction and Embryology reports.

But a drop in testosterone isn’t the only culprit when it comes to declining sexual health as men age. Cardiovascular health, diabetes, sleep issues, stress, alcohol consumption, mental health concerns, and certain medications like SSRIs are all factors you need to consider with the help of your doctor.

“Men have too often accepted changes in their sex lives as simply ‘what happens to men of a certain age’ when those changes may be a helpful sign that something else in their health profile has also changed,” says Juan Rivera, director and preventative health advocate at CAN Community Health, which provides HIV, Hep C, and STI care in Florida. “I consider these changes as data, not failure. Sexual well-being can change with age but never has to disappear, and appreciating the difference will allow for easier conversations with a healthcare provider.”

What can men over 50 do to improve their sex lives?

Before you look at ways to adjust how you have sex to fit the way your body has changed as you’ve gotten older, get a physical and talk to a health care provider. The worst mistake men make after 50, is “to feel ashamed and put his head in the sand,” says Suzanne Noble, host of the Sex Advice for Seniors podcast and co-creator of a program aimed at men with erectile dysfunction called Stay Firm. “Men can improve their sex life by going to see a good doctor and looking after their health," she says.

Rivera says that taking care of your overall health and treating chronic health conditions will give you a solid foundation for sexual health as you age. It’s also a good idea to start communicating openly with your sexual partners, which “can lessen the pressure to perform,” he says.

“I have seen people worry about sexual changes at the same point that their activity level has decreased, sleep is worse or work stress is greater, yet they only focus on the sexual symptom,” Rivera explains. “This is why I am an advocate for a wider preventive-health mindset: sexual health is linked to the whole body and brain. In fact, getting a better picture of what is going on ‘under the hood’ also matters as much to the conversation as what happens in the bedroom.”

How can you prevent your sexual health from declining?

The biggest factor when it comes to preventing your sexual health from declining as you age is your overall physical health. Eating a healthy diet, getting regular exercise, fixing chronic sleep and stress issues, and getting regular physicals and blood work will all help you hang on to your prowess in the bedroom for as long as possible.

“The more you keep up with your workout routine and healthy diet, the more strength and stamina you will have in the bedroom,” Weiss says.” Stay hydrated and eat foods like leafy greens, berries, and omega-3 fats to improve blood [flow], which enables arousal.”

Avoiding excess weight and treating cardiovascular disease can also help retain erectile function, but for sexually active gay and bisexual men, Rivera also recommends getting routine STI testing for things like HIV and hepatitis.

"If I could change one practical thing, it would be to make routine sexual health conversations part of preventive care rather than waiting until there is a problem,” Rivera says. “Research has shown people are more comfortable talking about changes when the conversation is normalized. Biggest lesson learned: getting older doesn’t have to mean losing the sex life you want — stay educated, engaged with your healthcare, and adapt as your body and circumstances adjust.”

7 tips for having better sex after 50

1. Expand your definition of sex

If your sexual stamina is waning or you're having trouble keeping an erection, it doesn’t have to mean an end to your sex life, you just need to stop having such a narrow idea of what sex should look like. “Expand your definition of sex,” Weiss says. “If you are experiencing erectile difficulties, centering sexual experiences on your partner’s pleasure can take the pressure off. Focus on foreplay, oral sex, manual/digital sex, and full-body caressing.”

Noble agrees and says that now is the time to experiment. “Often it's not until a man faces a significant health issue related to their sexual health that they actually experiment with alternative ways of having sex,” she says.

2. Communication is key

Communication is always a good idea when it comes to sex, but it becomes even more important as your body and what you like change. “Good communication is key to a good sex life,” Noble says. “The more comfortable you feel talking about sex, the more likely you will be able to deal with any challenges that may come along.”

If you’re going to expand your definition of sex, it’s also a good idea to talk to your partner about that. “Many people report in sex research that as they age, sex becomes more of a full-body, full-mind experience, in part because the genitals are sometimes not as easily aroused,” Weiss says. "Spend time connecting and expand your repertoire by having conversations about sexuality.”

3. Experiment in the bedroom

Now that you’ve opened your mind to new ways of having sex, start experimenting. “You can play a sex game like Biird’s Together, complete a Yes/No/Maybe list to discuss what new sex acts you’d be open to, or practice tantric eye-gazing before sex to sync your minds and nervous systems,” Weiss says. “Look into your partner’s eyes, breathe deeply, and slow down your movements for an extra attuned, connective experience.”

4. Try new sex toys

Adding in new sex toys can help bridge the gap between the kind of sex you want to have and what your body can do — plus they’re so much fun! “There are supplements such as nitric oxide that can also help men to maintain erectile health and a good cock ring (I recommend FirmTech's MaxPR) can do wonders for a man's confidence and ability to maintain an erection,” Noble says.

If erectile dysfunction is putting a damper on your sex life, there are plenty of things you can do to make it more enjoyable while you work with your doctor to treat any underlying issues. “To facilitate your own erection, you can utilize sex toys such as Erojoy’s Ride, which fits over the penis and vibrates to keep you hard and enhance your partner’s pleasure,” Weiss says.

5. Don’t forget the lube

Using lube is probably on every list of tips for how to improve your sex life, but it becomes even more crucial as we age. For women and transmasc folks, you’ll need to use it as your natural lubrication production slows down with age, but aging men also need it to prevent micro tears during sex. “As usual, make sure to use lube. This not only prevents discomfort and enhances pleasure but also prevents tears, which is important as STIs are on the rise among people over 50," Weiss says.

6. Consider pelvic floor therapy

For people over 50 within the trans community who are taking hormones, pelvic floor therapy may help with sexual dysfunction and pain. “If you are experiencing any sexual issues and are receiving gender-affirming care, speak to your medical provider as they may be able to make adjustments to your hormones or identify structural issues that can impact your sex life,” Weiss says. “Pelvic floor physical therapists are also super helpful in working through sexual pain or orgasmic difficulties.”

7. Warm up before sex

You may have been able to go from zero to 100 at the drop of the hat when you were 25, but as you age, it may take a little longer to get your engine revving. “You can also engage in mutual masturbation as foreplay; a lot of people know their own bodies best, so it doesn’t hurt to warm yourself up a bit,” Weiss says. “Other arousal aids include watching ethical porn and listening to audio erotica with or without your partner and giving each other full-body sensual massages.”

Sources cited:

Juan Rivera is the director and preventative health advocate at CAN Community Health.

Suzannah Weiss is a sex therapist and resident sexologist for adult toy company Erojoy.

Dr. David Ghozland is a board-certified OB/GYN and the founder of Intimate Health Center.

Suzanne Noble is the host of the Sex Advice for Seniors podcast and co-creator of a program aimed at men with erectile dysfunction called Stay Firm.