Yes, pelvic floor exercises can still help erectile dysfunction after 50. In the best-known trial, men with an average age in their late 50s saw real improvement after three months of training. They work best when the problem is partly about blood draining out of the penis too quickly or weak muscle support. They won’t fix narrowed arteries, side effects from medication or low desire, so they’re one part of the plan, not the whole thing.
If you’re new to this, start with our main guide to pelvic floor exercises for erectile dysfunction, which explains the muscles involved and how the training works. This article covers what changes after 50 and how to adjust for it.
Health disclaimer: This article is for general information only and isn’t medical advice. Any doses mentioned are amounts used in research or listed on product labels, not a personal recommendation. Supplements and medications can cause side effects and interact with other drugs or health conditions, so check with your doctor or pharmacist before starting anything new, especially if you’re pregnant, breastfeeding, on medication or managing a health condition. Stop and get medical help if you have a reaction. See our full medical disclaimer.
Why ED Gets More Common After 50
ED is common, and it becomes more common with age. In the Massachusetts Male Aging Study (Feldman et al., 1994, Journal of Urology), about half of men aged 40 to 70 reported some degree of erectile dysfunction, and complete ED became roughly three times more common between 40 and 70.
The usual reasons pile up together:
- Blood vessels. High blood pressure, high cholesterol, diabetes and smoking all damage the small arteries that fill the penis.
- Muscle loss. Like other skeletal muscles, the pelvic floor tends to lose strength and endurance with age and inactivity.
- Medications. Some blood pressure drugs, antidepressants and prostate medications can affect erections or ejaculation.
- Prostate issues. An enlarged prostate, and treatment for prostate cancer, can both affect sexual function.
- Hormones. Testosterone falls slowly with age. Low testosterone is more closely tied to low desire than to how erections work mechanically.
Pelvic floor training directly addresses only the second point. That’s why results vary so much from one man to the next.
What the Research Shows for Older Men
Most trials on pelvic floor training for ED have recruited middle-aged and older men, so the evidence applies fairly well to men over 50.
| Study | Who | What they found |
|---|---|---|
| Dorey et al., 2004 (British Journal of General Practice) | 55 men with ED for 6+ months, average age late 50s | After pelvic floor exercises with biofeedback plus lifestyle advice, 40% regained normal function and about a third more improved |
| Dorey et al., 2004 (BJU International) | Same group of men | The training also reduced dribbling after urination, a common complaint with age |
| Esposito et al., 2004 (JAMA) | Obese men aged 35 to 55 | About a third regained normal erectile function through weight loss and more activity, without any specific pelvic floor work |
Two points stand out. First, the Dorey trial used a physiotherapist and biofeedback, which is more structured than doing a few squeezes in the car. Second, about a quarter of men didn’t improve at all, which usually points to a cause the exercises can’t reach, such as advanced artery disease.
How to Adjust the Exercises After 50
The basic method is the same at any age. If you’ve never found the right muscles, our guide to Kegel exercises for men walks through it step by step. What changes after 50 is how you build up.
- Start lying down. Gravity makes the muscles work harder when you’re standing. Begin on your back with your knees bent, then progress to sitting, then standing.
- Prioritise quality over count. A full squeeze with a full relaxation beats 30 half-hearted reps. If you can only hold for 3 seconds at first, that’s your starting point.
- Train both types of contraction. Slow holds build endurance, and quick, strong squeezes build the reflex that helps keep blood in the penis during an erection.
- Relax fully between reps. Some older men, especially those with pelvic pain or urinary urgency, have muscles that are too tight rather than too weak. If squeezing makes symptoms worse, stop and get checked.
- Be patient. Most programmes run for at least 3 months. Our realistic timeline for ED exercises covers what to expect week by week.
What Matters as Much as the Exercises
After 50, blood flow is usually the main issue, so the rest of your routine matters at least as much as pelvic floor work.
- Cardio. Regular aerobic exercise improves the health of the blood vessels, including those in the penis. See cardio for erectile dysfunction.
- Strength training. Keeping muscle mass helps blood sugar and body composition. See strength training and ED.
- Medication review. Ask your doctor or pharmacist whether anything you take could be contributing. Don’t stop a prescribed drug on your own.
- Alcohol and smoking. Both make ED worse, and cutting back helps at any age.
Pelvic floor exercises can also be used alongside ED tablets such as sildenafil or tadalafil if your doctor prescribes them. There’s no conflict between the two approaches.
When to See a Doctor
After 50, new ED is worth a proper check-up, not just a new exercise routine. In a large study of men aged 55 and over (Thompson et al., 2005, JAMA), those who developed ED had a higher risk of later heart attack and stroke. ED can be an early warning sign of heart disease.
See your GP or doctor if:
- ED has started recently or is getting worse
- you have chest pain, shortness of breath on exertion, or known heart, blood pressure or diabetes problems
- you have urinary symptoms such as weak flow, getting up at night or difficulty starting
- you have pain in the pelvis, testicles or penis, or a new curve in the penis
- you’ve had prostate surgery or radiotherapy (see pelvic floor exercises after prostatectomy)
A pelvic health physiotherapist can confirm that you’re contracting the right muscles. That alone makes a big difference to results.
FAQ
Is it too late to start pelvic floor exercises at 60 or 70?
No. Muscles respond to training at any age, and the trials that support this approach included men in their 60s and 70s. Progress may be slower, and the exercises won’t override serious artery disease.
Can pelvic floor exercises help ED over 50 without pills?
For some men, yes. In the Dorey trial, 40% regained normal function without medication. For others, especially with diabetes or heart disease, exercises work best alongside treatment from a doctor.
How often should older men do pelvic floor exercises?
Trial programmes usually used several short sessions a day, most days, for at least 3 months. Consistency matters more than intensity, so pick a routine you can keep up.
Do pelvic floor exercises help with dribbling after peeing?
Yes. A trial in the same group of men (Dorey et al., 2004, BJU International) found pelvic floor training reduced post-urination dribble, which is a common problem with age.
The Bottom Line
Pelvic floor exercises are a reasonable, low-risk first step for ED after 50, and the evidence includes men in this age group. Expect a programme of at least three months, focus on doing each contraction properly, and pair it with cardio, strength work and a medication review. Because ED at this age can signal heart or blood vessel problems, get checked by a doctor rather than relying on exercises alone.