“You don’t wake up one morning and realize it is different. It’s a gradual process, but starting around age 40, the changes become more noticeable,” says Madeleine Castellanos, M.D., author of Penis Problems: A Man’s Guide. So what does it mean when a penis looks and acts different?

1. Color

Atherosclerosis, a common problem of aging, restricts blood flow, affecting heart, brain and penis. With less blood in the area, the penis appears lighter in color, says Dr. Castellanos, who is also a sex therapist with a private practice in New York. This is nothing to worry about as long as you have regular checkups that show that everything else is in working order. Also, just as skin everywhere shows effects of aging, so does the penis skin. It may appear more mottled.

2. Size

Touchy subject. The truth is the penis will shrink a little as time goes on from decreased blood flow and testosterone. “By the time a guy is in 60s and 70s, he may lose a centimeter to a centimeter and a half in length,” explains Dr. Castellanos. She adds, if a guy carries belly weight, the penis will appear smaller without it actually being smaller. “The penis starts inside the body. If you have belly fat, it comes down and extends over the base of the penis. The belly covers the base of the penis, making it appear shorter.”

3. Sensitivity

Testosterone helps support nervous tissue. When its levels start to drop, there will be an accompanying decrease in sensitivity, making it more difficult to reach orgasm. Also, the erection won’t be as hard.

“This is a case of use it or lose it,” says Dr. Castellanos. She explains that guys can protect their penile health by having erections every day. They don’t have to be point of orgasm, but daily erections keep the arteries in shape and bring blood flow to the area. “It’s just like if you don’t go to the gym, your muscles will get thinner and your arteries will close up. The same thing happens with a penis,” she adds.

4. Decline in urinary function

Urinary problems — issues with being able to “go,” or with being able to hold back flow — have to do with prostate health. It affects 20% of men in their 40s, 50% to 60% of men in their 60s, and 80% to 90% of men in their 70s and 80s. Preventive actions, courtesy of Dr. Castellanos:

  1. Maintain a healthy weight.
  2. Get on your feet. Sitting all day puts a lot of pressure on the prostate.
  3. Do moderate exercise several times a week to maintain the tone of the pelvic floor muscles. Jogging or brisk walking will do the trick. The Mayo Clinic also recommends Kegel exercises for men.
  4. Make sure you’re getting enough zinc and selenium. 
  5. Limit alcohol consumption. Alcohol increases the conversion of testosterone to estrogen and increases inflammation in the area.
  6. Ejaculate several times a week to flush out the area.

5. Erectile dysfunction (ED)

ED develops in 5% of men at age 40, up to 15% at age 70. It can be the result of a variety of intertwined causes: 

  • Biology – illness, medications, poor health habits of the male partner
  • Psychological – anxiety, depression, stress in either partner
  • Relationship – lack of trust and intimacy, or emotional conflict between the couple
  • Psychosexual skills – lovemaking skills of either partner, or the interplay between the two

Because of this complexity, simply popping a pill such as Viagra or Cialis without addressing the underlying cause as a couple may lead to failure, says Dr. Castellanos. 

“First, go to a physician for a complete checkup to rule out any chronic conditions. If that doesn’t yield any conclusive information, seek the help of a competent sex therapist, who can help you both psychologically and physiologically,” says Dr. Castellanos. You can find recommendations at the American Association of Sex Educators, Counselors and Therapists.