Many things can affect sexual function as people age. These include physical changes, emotional health, and medications. 

Common Causes

Hormone changes

As people age, the body makes less testosterone and estrogen. These hormones affect desire and sexual response.

Health problems

Conditions such as diabetes, arthritis, infections, incontinence, uterine prolapse, endometriosis, bladder infections, or heart and lung disease can make sex difficult or painful.

Blood flow problems

Conditions like atherosclerosis, high blood pressure, high cholesterol, or diabetes can reduce blood flow. This may lead to erection problems in men.

Nerve conditions

Problems with the back or spine, Parkinson’s disease, multiple sclerosis, or stroke can affect nerve signals during sexual activity.

Mental health concerns

Stress, depression, or relationship problems can reduce interest in sex.

Emotions and body image. 

Changes in weight or surgery may affect how a person feels about their body and can lower confidence.

Past surgeries or treatments

Prostate, gynecologic, or breast surgery may change hormone levels or body function and affect sexual activity.

Medications

Some medicines can lower desire or enjoyment. These include some drugs for depression, allergies, high blood pressure, heart disease, stomach ulcers, and enlarged prostate (such as tamsulosin).

Pain

Any type of pain can make sex uncomfortable or less enjoyable.

Smoking, alcohol, and substance use

These can reduce blood flow and lower sexual desire.

If you notice changes in your sex life after starting a new medication, talk with your healthcare provider. They can help you find a safe treatment or another option that works better for you.

Last Updated May 2026