Hormonal Changes as Men Get Older

How do male hormones change as a man gets older?

Men have less testosterone, the male hormone, as they get older. This may cause problems with erections and less interest in sex.

There’s a good chance you can keep having an active, enjoyable sexual life as you get older. However, you may find that:

• Erections during sleep and when you wake up happen less often.
• It takes longer to have an erection and the erection is usually less firm.
• It’s easier to lose an erection.
• Ejaculation is less forceful.

How is reduced testosterone found and treated?

The level of testosterone in your body can be measured with a blood test. If your level of testosterone is low, your healthcare provider may prescribe testosterone replacement therapy (TRT). You do not have to take replacement treatment. Treatment can improve erections and sexual performance. However, TRT has risks. For example, it may increase your chances of having prostate cancer.

Testosterone replacement therapy is available as shots, patches, or gels. Talk to your healthcare provider about which kind of medicine might work best for you. Also, check your insurance coverage for the different treatments.

TRT may not be right for you if you have high cholesterol or heart disease, or if you are at risk for prostate cancer. TRT may make the prostate get bigger and cause urination problems. Or it might increase your risk for prostate cancer. Take testosterone only if your healthcare provider approves.

Men taking testosterone should be examined for signs of a tender or enlarged prostate. If you have a family history of prostate cancer, you might want to have a PSA (prostate specific antigen) test.

What about DHEA (dehydroepiandrosterone)?

DHEA is a hormone that the body turns into testosterone and estrogen, the female hormone. As a result, DHEA has a mix of male and female hormonal effects. It is a popular supplement in health food stores, but quality control varies. Most of the claims of its anti-aging effects have not been proven in good medical studies. Studies of dementia, overall well-being, muscle size and strength, body fat composition, and bone density show either no or very little effect. Studies do show that DHEA usually lowers the “good” cholesterol—that is, HDL—in most people. Good studies on how DHEA might affect the prostate or heart disease have not been done. Given this body of evidence, many healthcare providers do not recommend DHEA supplements.