Men's sexual health is a topic that is still rarely discussed. Yet 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 much 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 impact does testosterone have on your potency?
Common Men's Sexual Health Problems
Studies on men's health in Germany show that a significant proportion of men are affected by sexual dysfunction. According to the GeSiD study ("Health and Sexuality in Germany"), 13.3% of sexually active men reported symptoms of sexual dysfunction according to ICD-11 guidelines. The most common problems were erectile dysfunction (6.6%) and premature ejaculation (4.5%) (Briken et al. 2021). However, the actual number is far higher, with some estimates reaching 75% (Majzoub et al. 2019).
Erectile Dysfunction (ED)
Erection problems are among the most common sexual health issues 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 is 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 you can prevent erectile dysfunction and when you should see a doctor in our article "Erectile Dysfunction: A Psychological Issue or a Health Warning Sign?".
Low Libido
In addition to erectile dysfunction, declining sexual desire is 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 the relationship. However, a change in libido can have numerous causes.
Possible Causes of Low Libido:
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Testosterone deficiency: Testosterone is the key hormone for male libido. It acts directly on the brain, especially on 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 obesity and chronic stress – desire for sexual activity may 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 general lack of motivation, which also has a negative impact on intimacy (Zitzmann, 2020).
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Psychological stress: Stress, anxiety, and emotional distress can not only affect overall well-being but also significantly reduce sexual desire. Men who suffer from chronic work-related or personal stress often report reduced 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 exhibit less sexual activity. When sleep is disrupted or shortened, nighttime hormone production suffers, leading to a measurable decline 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 cause erectile dysfunction. These medications work through 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 (PE), others experience delayed or absent ejaculation (DE).
Both problems can significantly impair sexual satisfaction and may 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 rates of up to 75% (Majzoub et al. 2019). It has also been shown that there is a link between erectile dysfunction and premature ejaculation, and that they influence each other (Corona G. 2022).
Sexually Transmitted Infections (STIs)
Sexually transmitted infections (STIs) are a widespread but often underestimated health problem – especially among men. Many infections are asymptomatic, so those affected often do not know they have an STI, increasing the risk of unintentional transmission. Studies show that heterosexual men are more likely than women to be unaware carriers of STIs, thus playing a key role in their spread (Ebbutt 2023). Regular testing is therefore crucial for early detection of infections and to prevent complications.
The Impact of Testosterone on Libido and Potency
Testosterone is the central 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 decline by about 1–2% annually from age 30, while free testosterone levels can drop by 2–3% (Jones 2008). This age-related decline is known as late-onset hypogonadism (LOH).
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From age 40: About 20–30% of men have testosterone levels that are too low (Mulligan et al., 2008).
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From age 50: Around 30% of men have measurably reduced testosterone levels (Tajar et al., 2010).
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From age 60: Up to 50% of men show symptoms of testosterone deficiency (Wu et al., 2010).
Not all symptoms that occur with age are directly due to testosterone deficiency. A medical test is necessary to distinguish a genuine deficiency from normal signs of aging.
Tips for Healthy Sexual Function
Good sexual health is not a given; it requires conscious decisions, 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 low libido (La et al 2017.
Regular physical activity improves blood circulation, which is essential for a stable erection. Physical activity also demonstrably increases testosterone production, which in turn has a direct impact on libido and sexual performance (Yassin & Saad, 2007).
Particularly effective are strength training and endurance training, as they positively influence both hormone levels and vascular health. Men who exercise regularly are significantly less likely to suffer from erectile dysfunction (Pitta et al 2022). Conversely, it has also been shown that excessive training and prolonged strain can lead to reduced libido (Hackney et al 2017).
Particularly positive effects are seen through:
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Strength training (e.g., squats, bench presses, deadlifts), which demonstrably increases testosterone release. It has been shown that training with high volume, short breaks, and large muscle groups has the greatest effect on the release of testosterone and growth hormones after training (Kraemer et al 2005).
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Interval training (HIIT), which improves blood circulation and stimulates metabolism.
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Regular endurance training (running, swimming, cycling), which strengthens vascular health (Pinckard et al 2019).
Diet: A balanced diet can promote blood circulation and have a positive effect on libido and potency. It has been shown that a balanced Mediterranean diet has positive effects on libido as well as 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 oxygen and nutrient supply 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 and thus dilates blood vessels (Wu et al. 2021).
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Contain 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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Supports the production of dopamine, which plays a role in sexual arousal.
3. Dark chocolate (min. 70% cocoa content)
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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 in antioxidants and anthocyanins, which protect 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, adequate sleep is also important for maintaining sexual function (Leproult & Van Cauter, 2011). Smoking should also be avoided, and alcohol should only be consumed in moderation, as it damages blood vessels and reduces testosterone production (Hahad et al 2023). Here too, prevention is key to long-lasting healthy sexual function.
You can find out which foods are particularly important for a balanced hormone balance in men in our article “The best foods for men – How to optimize your diet”.
Sexual health at every age: What men should know
Needs and challenges regarding sexual health change over the course of 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 term. Here is an overview of what you should pay attention to at different stages of life:
20s and 30s: Laying the foundation for long-term health
In your younger years, physical performance is often the focus. At the same time, stress, performance pressure, or unhealthy habits such as lack of sleep and poor diet can have initial effects on sexual health. Now is the ideal time to create a stable foundation: A balanced diet with healthy fats, sufficient protein, and important micronutrients such as 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. In addition, effective stress management, e.g., through mindfulness, meditation, or sufficient rest periods, helps to avoid hormonal fluctuations that can have a negative effect on libido.
40s and 50s: Recognizing changes and taking targeted countermeasures
With increasing age, testosterone levels decrease slightly, which can affect libido, energy, and physical performance. Blood circulation can also decrease, which can lead to erectile dysfunction. Those who take active countermeasures now can maintain their sexual health in the long term. Regular exercise, especially strength training, helps to support muscle building and keep the hormone balance stable. A healthy, nutrient-rich diet with plenty of fruit, vegetables, omega-3 fatty acids, and antioxidant foods such as berries or dark chocolate can promote vascular health. Regular health checks are equally important to detect changes early – whether in the hormone balance, cardiovascular health, or metabolism. Mental health also plays a role: Open communication with your partner can help to better cope with possible insecurities or changes.
60+ years: Stay active and discover new ways
A fulfilling sex life is possible even in later years – 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 speak openly with your doctor about possible 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 take care of their body early on, exercise regularly, reduce stress, and focus on a nutrient-rich diet can maintain their potency and well-being well into old age. Changes are part of life, but with the right measures, you can actively help promote 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 topic for many men. Many hesitate to talk to a doctor about changes or problems, whether due to shame, insecurity, or fear of not being taken seriously. However, asking questions about sexual health is just as normal as asking about any other medical topic. Doctors are trained to handle such concerns professionally and discreetly.
An open conversation with a doctor can not only reduce insecurities but also help identify possible causes of symptoms 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 the appointment, it is helpful to become aware of which changes or symptoms are occurring. 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 when symptoms started and possible triggers should also be noted to enable the doctor to make an accurate assessment.
Speak openly about concerns
It is understandable that intimate topics can be uncomfortable. However, doctors approach such conversations with professionalism and experience. Those who feel insecure can start with a general question:
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“I have noticed changes in my sex life and would like to know if it needs to be treated.”
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“I have heard that testosterone plays a role. Could my problem be related to it?”
The more specific the description, the more targeted the doctor can help.
Discuss medications and lifestyle
Some medications, including blood pressure medications or antidepressants, can affect sexual function. Factors such as stress, lack of sleep, alcohol or tobacco consumption also play a role. This information is important to identify possible connections.
Ask about tests and treatments
It makes sense to ask specifically about examinations or treatment options:
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Testosterone blood test: Clarifies whether hormonal changes are present.
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Cardiovascular check: Erection problems can indicate vascular issues.
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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 of diet and exercise, as well as regular health checks and open communication about sexuality, is the key to a fulfilling and healthy life.
An important building block of prevention is the regular monitoring of key health markers. Adon Health offers innovative blood tests with which you can conveniently analyze important values – including your testosterone level – from home. This gives you valuable insights into your health status and allows you to take targeted measures to actively support your well-being.
