Erectile Dysfunction in Your 60s: Causes & Treatment

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At a glance

Why erectile dysfunction in your 60s becomes more common

As men age, physical changes in the body make erections more difficult to achieve and maintain. Blood vessels become less elastic, reducing blood flow to the penis, and nerve sensitivity may decline [1]. Testosterone levels also fall gradually, which can affect libido and erectile function, though low testosterone alone is rarely the sole cause of ED [2].

Many health conditions that become more prevalent in your 60s contribute to erectile dysfunction. Cardiovascular disease, high blood pressure, type 2 diabetes, and high cholesterol all damage blood vessels and nerves essential for erections [1][2]. In fact, ED can be an early warning sign of heart disease, so it is important to see your GP if you develop new or worsening erectile problems [1].

Lifestyle factors such as smoking, heavy alcohol use, lack of physical activity, and being overweight also play a significant role [1]. Psychological factors—stress, anxiety, depression, and relationship difficulties—can worsen ED or exist alongside physical causes [2]. Recognising these overlapping factors helps you and your healthcare team choose the most effective treatment approach.

Common causes of erectile dysfunction in your 60s

Chronic health conditions are the leading cause of ED in men over 60. Diabetes damages small blood vessels and nerves, making it harder to achieve an erection [1]. High blood pressure and atherosclerosis (narrowing of the arteries) reduce blood flow to the penis, while heart disease and previous stroke can limit sexual activity due to reduced cardiovascular fitness [2].

Many medicines prescribed for these conditions can contribute to erectile problems. Diuretics (water tablets), some beta-blockers, and certain antidepressants are known to affect erections [2]. If you suspect your medication is causing ED, never stop taking it without speaking to your GP—there may be alternative options that suit you better.

Prostate problems are also common in your 60s. An enlarged prostate (benign prostatic hyperplasia) itself does not usually cause ED, but treatments such as surgery or radiotherapy for prostate cancer can damage nerves and blood vessels [2]. Pelvic surgery and some neurological conditions (such as Parkinson's disease or multiple sclerosis) can also interfere with the signals needed for an erection [1][2].

Medications that can affect erections

Several classes of medicine are associated with erectile dysfunction. These include some blood-pressure tablets (especially older beta-blockers and thiazide diuretics), antidepressants (particularly SSRIs), antipsychotics, and medicines for prostate enlargement [2]. If you are taking any of these and experiencing ED, discuss it with your GP or pharmacist—they may be able to adjust your dose or switch you to an alternative that has less impact on sexual function.

How prescription treatments for erectile dysfunction in your 60s work

The most effective and widely used treatments for ED are oral medicines called PDE5 inhibitors [1][2]. These include sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra). They work by relaxing blood vessels in the penis, allowing more blood to flow in when you are sexually aroused [3][4][5][6]. It is important to understand that these medicines do not cause an automatic erection—you still need sexual stimulation for them to work.

Sildenafil is usually taken about one hour before sexual activity and works for around four to six hours [3]. Tadalafil can be taken on-demand (at least 30 minutes before sex) and its effects can last up to 36 hours, or as a lower daily dose for men who prefer spontaneity [4]. Vardenafil works similarly to sildenafil, while avanafil has a faster onset (15–30 minutes) [5][6]. Your prescriber will help you choose the medicine and dose that best suits your lifestyle and health profile.

All PDE5 inhibitors are prescription-only medicines in the UK and require a clinical assessment by a registered prescriber [2]. At Cured Pharmacy, you complete a confidential online consultation reviewed by a UK prescriber, who checks your medical history, current medicines, and any conditions that might make treatment unsuitable. If approved, your medicine is dispensed by our GPhC-registered pharmacy and delivered discreetly to your door.

What you need to know

• Erectile dysfunction in your 60s affects around half of men and is highly treatable
• Reduced blood flow, diabetes, heart disease, and medication side effects are common causes
• PDE5 inhibitors such as sildenafil and tadalafil are safe and effective for most men
• Lifestyle changes like exercise, stopping smoking, and managing weight support treatment
• See your GP if you have new ED, as it can be an early sign of heart disease

Choosing the right erectile dysfunction treatment in your 60s

The choice of ED medicine depends on your health, other medications, and personal preference. Sildenafil and tadalafil are available as lower-cost generics and are equally effective as their branded equivalents (Viagra and Cialis) [3][4]. Tadalafil is often preferred by men who want flexibility, as its long duration means you do not need to time it as precisely around sexual activity [4].

If you are taking other medicines, your prescriber will check for interactions. PDE5 inhibitors must never be used with nitrates (such as GTN spray or isosorbide tablets), nicorandil, riociguat, or recreational drugs called 'poppers', because the combination can cause a dangerous drop in blood pressure [3][4][5][6]. If you take alpha-blockers for prostate symptoms (such as tamsulosin or doxazosin), you may still be able to use a PDE5 inhibitor, but you will need to start on the lowest dose and be stable on your alpha-blocker [3][4].

Men with certain health conditions—such as recent heart attack or stroke, unstable angina, severe heart failure, very low blood pressure, or a history of sudden vision loss (NAION)—may not be suitable candidates for PDE5 inhibitors [2][3][4]. Your prescriber will review your full medical history during the consultation to ensure treatment is safe for you. If oral medicines are not suitable or effective, your GP can discuss alternative options such as vacuum devices, alprostadil injections or cream, or referral to a specialist [2][7].

Starting treatment safely

Always start with the dose recommended by your prescriber and follow the instructions in the patient information leaflet. Take the tablet on an empty stomach or after a light meal for best results—heavy or fatty meals can delay absorption [3][4]. Avoid excessive alcohol, as it can make ED worse and increase the risk of side effects such as dizziness [3]. If the first dose does not work, do not increase it yourself; speak to your prescriber, as it can take several attempts to find the right dose and timing.

Lifestyle changes that support treatment for erectile dysfunction in your 60s

Prescription medicines work best when combined with healthy lifestyle habits. Regular physical activity improves cardiovascular health, blood flow, and stamina, all of which support erectile function [1][2]. Aim for at least 150 minutes of moderate exercise (such as brisk walking, cycling, or swimming) each week. Pelvic floor exercises (Kegels) can also strengthen the muscles involved in erections and are recommended by the NHS [1].

If you smoke, stopping is one of the most effective steps you can take. Smoking damages blood vessels and significantly worsens ED [1]. Your GP or pharmacist can offer support and prescribe nicotine replacement therapy or other stop-smoking medicines. Reducing alcohol intake, maintaining a healthy weight, and managing stress through relaxation techniques or counselling can all improve erectile function and overall wellbeing [1][2].

Managing underlying health conditions is equally important. Keep your blood pressure, cholesterol, and blood sugar levels within target ranges by taking prescribed medicines regularly and attending routine check-ups [2]. If you have diabetes, good glucose control can prevent further nerve and blood vessel damage. Open communication with your partner about ED can reduce anxiety and strengthen your relationship, which in turn can improve sexual confidence and performance [2].

When to get urgent help

• Chest pain during or after sexual activity
• Erection lasting more than four hours (priapism)
• Sudden loss of vision or hearing after taking ED medicine
• Severe dizziness, fainting, or difficulty breathing
• New or worsening erectile problems alongside chest pain, breathlessness, or other heart symptoms

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

When to speak to a doctor about erectile dysfunction in your 60s

You should see your GP if you develop new or persistent erectile problems, as ED can be an early sign of cardiovascular disease or diabetes [1][2]. Your doctor will take a medical history, check your blood pressure, and may arrange blood tests to measure cholesterol, blood sugar, and testosterone levels. This assessment helps identify any underlying conditions that need treatment in their own right.

Seek urgent medical help if you experience chest pain during sexual activity, as this may indicate heart disease [1]. If you take a PDE5 inhibitor and develop an erection lasting more than four hours (priapism), sudden loss of vision or hearing, or severe dizziness, stop the medicine and seek immediate medical attention [3][4][5][6]. These are rare but serious side effects that require prompt treatment.

If you are already using ED treatment but it stops working or causes troublesome side effects, contact your prescriber. They can adjust the dose, try a different medicine, or investigate whether a new health problem or medication is interfering with your treatment [2]. At Cured Pharmacy, our prescribers are available for follow-up consultations to ensure your treatment remains safe and effective. Remember, erectile dysfunction is common, treatable, and nothing to be embarrassed about—seeking help is a positive step toward better health and quality of life.

What to expect from your consultation

During an online consultation at Cured Pharmacy, you will be asked about your medical history, current medicines, and any symptoms you are experiencing. The prescriber will check for conditions or drug interactions that might make PDE5 inhibitors unsuitable, and recommend the most appropriate treatment and dose for you. If approved, your prescription is dispensed by our registered pharmacy and delivered in discreet, unbranded packaging. You can message the pharmacy team at any time if you have questions or concerns about your treatment.

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