Physical and Hormonal Changes in Older Men

Your sense of well-being -- your body's ability to respond and function normally -- depends on various organ systems. The organ systems most affected by aging are:

• cardiovascular system: heart and blood vessels
• genitourinary system: kidneys, bladder, genitals, and sexual organs (penis, testicles, and prostate)
• musculoskeletal system: bones, muscles, and joints
• skin and connective tissues beneath the skin.

To function properly, these organ systems depend on:

• a good circulatory system that supplies blood to carry oxygen, nutrients, and hormones (chemicals made by the body) to the tissues of the body
• a healthy nervous system, which ensures an alert mind, good sight and hearing, and efficient response to other bodily needs such as respiration (breathing) and digestion.

The health and well-being of men over 45 years old depend largely on whether they have in the past:

• gotten adequate sleep and exercise
• eaten healthy foods
• avoided abuse of nonprescribed drugs, alcohol, and tobacco.

The Role of Sex Hormones

Human sexuality is a coordinated response of both the nervous system and circulatory system. Sexual response also depends on a balance of hormones, controlled by the pituitary gland, which is located at the base of the brain. The hormones stimulate the testes to produce the male sex hormone testosterone. During childhood and adolescence, male sex hormones are responsible for:

• growth of the genitals (penis and testicles)
• deepened pitch of the voice
• increased muscle mass and tone
• the appearance of body and facial hair.

Decrease in Male Hormone

Testosterone levels decrease normally with age. This may cause men to have erectile problems or to lose sexual interest. Men of all ages receiving supplemental testosterone usually experience a sense of well-being that they attribute to the hormone. Testosterone can enhance physical strength and stamina.

Middle-aged and older men should take testosterone only if their health care provider approves because it may enlarge the prostate. Men taking testosterone should be examined for signs of a tender or enlarged prostate. Men who have to urinate frequently during the day or who are getting up at night to do so should see their health care provider. Men with family histories of prostate cancer may want to have a PSA (prostate specific antigen) test.

Aging and Sexual Response

As men grow older, many continue to have active, enjoyable sexual lives. However, some men find the quickness and intensity of their sexual responses decreased:

• Erections during sleep and at the time of waking are less frequent.
• The erection takes longer to achieve and is usually less rigid.
• Penetration can be difficult without a lubricant.
• An erection is more easily lost.
• Ejaculation is less forceful in older men and may become seepage.