Men's sexual health is a topic that is still rarely discussed, even though it plays a central role in overall well-being and quality of life. Many men are reluctant to talk about challenges in this area – whether with their partner, friends, or doctor.
Sexual health is far more than just the ability to get an erection or father children. It also encompasses hormonal, psychological, and physical factors and affects many areas of your life. But what problems can arise? How can you prevent them? And what influence does testosterone have on your potency?
Common sexual health problems in men
Studies on men's health in Germany show that a significant proportion are affected by sexual dysfunctions. According to the GeSiD study ("Health and Sexuality in Germany"), 13.3% of sexually active men reported symptoms of sexual dysfunction according to the ICD-11 guidelines. The most common problems were erectile dysfunction (6.6%) and premature ejaculation (4.5%) ( Briken et al. 2021 ). However, the number of unreported cases is likely much higher, sometimes estimated at 75% ( Majzoub et al. 2019 ).
Erectile dysfunction (ED)
Erectile dysfunction is one of the most common sexual health problems in men. Studies show that up to 50% of men over 50 are affected by some form of ED ( Goldstein et al. 2019 ). ED is not just an isolated sexual problem, but often an early indicator of serious health issues such as cardiovascular disease, diabetes, or hormonal imbalances ( Dong & Zhang, 2011 ). In addition to physical causes, stress, depression, or relationship problems can also play a role.
Learn more about how to avoid erectile dysfunction and when to see a doctor in our article “ Erectile Dysfunction: All in Your Head or a Health Warning Sign? ”.
Low libido
Besides erectile dysfunction, a decline in sexual desire is also distressing for many men, as sexuality is often associated with masculinity and vitality. A reduced libido can not only affect self-esteem but also put a strain on relationships. However, a change in libido can have numerous causes.
Possible causes for loss of libido:
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Testosterone deficiency: Testosterone is the key hormone for male libido. It acts directly on the brain, particularly the limbic system, which is responsible for emotions, motivation, and sexual arousal. A healthy testosterone level ensures stable sexual desire, influences erectile function, and contributes to overall energy and vitality. If testosterone levels drop—whether due to age or factors such as being overweight and chronic stress—the desire for sexual activity can decrease ( Travison et al. 2006 ). Studies also show that low testosterone levels not only impair libido but can also lead to mood swings, reduced energy, and a general lack of motivation, which also negatively impacts intimacy ( Zitzmann, 2020 ).
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Psychological stress: Stress, anxiety, and emotional strain can not only impair general well-being but also significantly reduce sexual desire. Men suffering from chronic work-related or personal stress frequently report decreased libido or even sexual dysfunction. Stress can affect sexual health on several levels, both through direct physiological changes in hormone levels and through psychological mechanisms that inhibit sexual desire ( McCabe et al., 2022 ).
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Sleep deprivation: Studies show that men with sleep disorders often have lower testosterone levels and reduced sexual activity. When sleep is disrupted or shortened, nighttime hormone production suffers, leading to a measurable decrease in testosterone levels. Even one week of less than five hours of sleep per night can lower testosterone levels by up to 15% ( Leproult & Van Cauter, 2011 ; Shigehara et al., 2021 ; Lapping-Carr et al., 2023 ).
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Side effects of medications: Studies show that antidepressants, blood pressure medications, and opioids in particular can lower libido or even lead to erectile dysfunction. These medications act via various mechanisms in the brain, affecting dopamine release and testosterone production ( Balon et al. 2009 ).
Premature or delayed ejaculation
Ejaculation is a complex physiological process controlled by an interplay of nerves, hormones, blood vessels, and psychological factors. While some men struggle with premature ejaculation (preejaculation, PE), others experience delayed or absent ejaculation (delayed ejaculation, DE).
Both problems can significantly impair sexual satisfaction and have both psychological and physical causes. Studies show that up to 30% of men between the ages of 18 and 59 are affected by premature or delayed ejaculation. Some studies even report figures as high as 75% ( Majzoub et al. 2019 ). Furthermore, it has been shown that there is a correlation between erectile dysfunction and premature ejaculation, and that these conditions influence each other ( Corona G. 2022 ).
Sexually transmitted diseases (STIs)
Sexually transmitted infections (STIs) are a widespread but often underestimated health problem – especially among men. Many infections are asymptomatic, so those affected are often unaware that they have an STI, increasing the risk of unintentional transmission. Studies show that heterosexual men, in particular, are more frequently unknowingly transmitting STIs than women and thus play a key role in their spread ( Ebbutt 2023 ). Regular testing is therefore crucial to detect infections early and prevent complications.
The influence of testosterone on libido and potency
Testosterone is the key male sex hormone and influences not only libido but also erectile function, muscle mass, and mood. A testosterone deficiency can lead to the following symptoms:
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Reduced sexual desire
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Erection problems
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Mood swings and lack of motivation
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Muscle loss and weight gain
Testosterone levels fluctuate and decrease by about 1–2% annually from the age of 30, while the level of free testosterone even falls by 2–3% ( Jones 2008 ). This age-related decline is known as late-onset hypogonadism (LOH).
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From age 40 onwards: Approximately 20-30% of men have too low a testosterone level ( Mulligan et al., 2008 ).
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From age 50 onwards: Around 30% of men have measurably reduced testosterone levels ( Tajar et al., 2010 ).
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From age 60 onwards: Up to 50% of men show symptoms of testosterone deficiency ( Wu et al., 2010 ).
Not all symptoms that appear with increasing age are directly attributable to testosterone deficiency. A medical test is necessary to distinguish a true deficiency from normal signs of aging.
Tips for healthy sexual function
Good sexual health is not something to be taken for granted; it requires conscious choices, a healthy lifestyle, and active prevention before the first symptoms appear. Current studies show that men who exercise regularly, eat a balanced diet, and reduce stress have significantly fewer problems with erectile dysfunction and loss of libido ( La et al 2017 ).
Regular physical activity improves blood flow, which is essential for a stable erection. Furthermore, physical activity has been shown to increase testosterone production, which in turn has a direct impact on libido and sexual performance ( Yassin & Saad, 2007 ).
Strength and endurance training are particularly effective , as they positively influence both hormonal balance and vascular health. Men who exercise regularly have a significantly lower likelihood of suffering from erectile dysfunction ( Pitta et al., 2022 ). Conversely, it has also been shown that excessive training and prolonged exertion can lead to a reduction in libido ( Hackney et al., 2017 ).
One particularly positive effect is demonstrated by:
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Strength training (e.g., squats, bench press, deadlifts) has been shown to increase testosterone release. Studies have demonstrated that high-volume training with short rest periods and large muscle groups has the greatest effect on the release of testosterone and growth hormones after exercise ( Kraemer et al., 2005 ).
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High-intensity interval training (HIIT) improves blood circulation and stimulates metabolism.
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Regular endurance training (running, swimming, cycling) strengthens vascular health ( Pinckard et al 2019 ).
Nutrition: A balanced diet can promote blood circulation and have a positive effect on libido and potency. Studies have shown that a balanced Mediterranean diet has positive effects on libido as well as on sexual function, erectile dysfunction, and potency ( Oteri et al., 2024 ). Certain foods contain valuable nutrients that support vascular health and promote the production of important hormones. Good blood circulation is essential for healthy sexual function, as it ensures the supply of oxygen and nutrients to the blood vessels and supports testosterone production.
1. Nuts (e.g. walnuts, almonds, hazelnuts)
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Rich in arginine , an amino acid that promotes nitric oxide production in the body, thus widening blood vessels ( Wu et al. 2021 ).
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Contains healthy fats that can contribute to testosterone production.
2. Fatty fish (salmon, mackerel, herring, sardines)
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Contains high amounts of omega-3 fatty acids , which improve blood circulation and reduce inflammation ( Mozaffarian & Wu, 2011 ).
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It supports the production of dopamine, which plays a role in sexual arousal.
3. Dark chocolate (at least 70% cocoa solids)
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Flavonoids in dark chocolate improve the elasticity of blood vessels and increase blood flow ( Aprotosoaie et al. 2016 ).
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Contains phenylethylamine, which stimulates the release of endorphins and serotonin.
4. Berries (blueberries, strawberries, raspberries, blackberries)
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High content of antioxidants and anthocyanins , which protect the blood vessels and inhibit inflammation, leading to a reduced risk of erectile dysfunction ( Cassidy et al., 2016 ).
5. Beetroot
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Contains a lot of nitrate , which is converted into nitric oxide in the body and can dilate blood vessels ( Lidder & Webb, 2012 ).
In addition to a balanced diet rich in protein and vegetables, sufficient sleep is also important for maintaining sexual function ( Leproult & Van Cauter, 2011 ). Furthermore, smoking should be avoided and alcohol consumed only in moderation, as this damages blood vessels and reduces testosterone production ( Hahad et al., 2023 ). Again, prevention is key for long-lasting healthy sexual function.
You can find out which foods are particularly important for a balanced hormonal system in men in our article “ The best foods for men – How to optimize your diet ”.
Sexual health at any age: What men should know
Sexual health needs and challenges change throughout life. Hormones, physical changes, and life circumstances influence how we experience desire, arousal, and intimacy. Those who take care of their health early on can benefit from a fulfilling sex life in the long run. Here's an overview of what you should pay attention to in different phases of life:
20s and 30s: Laying the foundation for long-term health
In our younger years, physical performance is often paramount. At the same time, stress, pressure to perform, or unhealthy habits like lack of sleep and poor diet can begin to impact sexual health. Now is the ideal time to establish a solid foundation: A balanced diet with healthy fats, sufficient protein, and essential micronutrients like zinc and magnesium can support testosterone production. Regular exercise, especially strength and endurance training, not only keeps the body fit but also improves blood circulation—a key factor for healthy sexual function. Additionally, effective stress management, such as mindfulness, meditation, or sufficient rest, helps prevent hormonal fluctuations that can negatively affect libido.
40s and 50s: Recognizing changes and taking targeted countermeasures
As we age, testosterone levels decline slightly, which can affect libido, energy, and physical performance. Blood flow can also decrease, potentially leading to erectile dysfunction. Taking proactive steps now can help maintain sexual health in the long term. Regular exercise, especially strength training, helps support muscle growth and keep hormone levels stable. A healthy, nutrient-rich diet with plenty of fruits, vegetables, omega-3 fatty acids, and antioxidant-rich foods like berries or dark chocolate can promote vascular health. Regular health checkups are equally important to detect changes early—whether in hormone levels, cardiovascular health, or metabolism. Mental health also plays a role: Open communication with your partner can help you better manage any uncertainties or changes.
60+ years: Stay active and discover new paths
A fulfilling sex life is possible even in old age – however, the way intimacy is experienced often changes. A healthy lifestyle with sufficient exercise and a heart-healthy diet can help promote blood circulation and maintain vitality. At the same time, it can be helpful to talk openly with your doctor about potential challenges such as erectile dysfunction or hormonal changes. In many cases, simple lifestyle adjustments or medical support can help preserve sexual health.
Prevention is key
Regardless of age, a conscious and healthy lifestyle plays a crucial role in sexual health. Those who pay attention to their bodies early on, exercise regularly, reduce stress, and focus on a nutrient-rich diet can maintain their potency and well-being well into old age. Change is a part of life, but with the right measures, you can actively contribute to promoting your sexual health at every stage of life.
How do I talk to my doctor about sexual health?
Despite increasing awareness, sexual health remains a sensitive and often taboo subject for many men. Many hesitate to talk to a doctor about changes or problems, whether due to shame, insecurity, or the fear of not being taken seriously. However, asking questions about sexual health is just as normal as asking about any other medical issue. Doctors are specialized in addressing such concerns professionally and discreetly.
An open conversation with a doctor can not only alleviate uncertainties but also help identify possible causes of discomfort and initiate targeted measures to improve sexual health. The earlier changes or problems are addressed, the better the chances of finding a suitable solution.
Note symptoms and changes
Before your appointment, it's helpful to be aware of any changes or symptoms you're experiencing. This will also help you to address your symptoms specifically. These include:
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Decreased sexual desire
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Erection problems or changes in morning erections
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Premature or delayed ejaculation
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Loss of energy or general weakness
The time of onset and possible triggers should also be noted to enable the doctor to make an accurate assessment.
Talk openly about concerns
It's understandable that intimate topics can be uncomfortable. However, doctors approach such conversations with professionalism and experience. Anyone who feels unsure can start with a general question:
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"I have noticed changes in my sex life and would like to know if this requires treatment."
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"I've heard that testosterone plays a role. Could my problem be related to that?"
The more specific the description, the more targeted the doctor can be in helping.
Addressing medication and lifestyle
Some medications, including blood pressure medications and antidepressants, can affect sexual function. Factors such as stress, lack of sleep, and alcohol or tobacco use also play a role. This information is important for identifying potential connections.
Ask about tests and treatments
It is advisable to specifically ask about examinations or treatment options:
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Testosterone blood test: Determines whether hormonal changes are present.
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Cardiovascular check: Erectile problems can indicate vascular problems.
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Psychological factors: Stress or anxiety can affect sexual function.
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Medication options: If necessary, the doctor can recommend suitable treatments.
Conclusion: Your well-being is in your hands.
Sexual health is an important part of your overall well-being. Those who actively take care of their physical and mental health also benefit in this area. A conscious lifestyle encompassing nutrition and exercise, along with regular health checkups and open communication about sexuality, are key to a fulfilling and healthy life.
A key component of prevention is the regular monitoring of key health markers. Adon Health offers innovative blood tests that allow you to conveniently analyze important values – including your testosterone levels – from the comfort of your home. This provides valuable insights into your health and enables you to take targeted steps to actively support your well-being.
