Like the rest of the body, your penis changes as you get older — in appearance, function, and potential for health problems.

Most of these changes are normal and don’t require medical attention. In many cases, the penis changes because of conditions affecting the rest of your body, such as reduced circulation, hormonal shifts, changes in the nature of your skin, and other factors.

But there are symptoms that can affect the sexual and urinary functions of the penis to the point where a medical evaluation may be necessary.

It’s helpful to know what to expect so that you won’t be surprised or overly worried — a number of age-related problems can be treated, while others can be prevented or delayed.

Once the penis stops growing and maturing — usually in your early 20s — it doesn’t change much for the next several years. But as plaque starts to build up in the arteries throughout the body and testosterone levels start to dip (typically in your 40s), changes to the penis can become apparent.

Physical appearance

Penis shrinkage can occur with aging, but this does not affect the function of the penis and does not need to be addressed with medical treatment unless you’re concerned with the function of your penis.

Testicular atrophy (shrinkage of the testicles) is also a normal part of aging. Combined with the loss of skin elasticity throughout the body and the effects of gravity, the scrotum and penis can both sag and look more wrinkled with age.

A reduction in blood flow may also lighten the color of the penis later in life.

Sexual function

As you get older, you may notice changes in sexual function, particularly in the frequency and nature of erections.

The inability to achieve and maintain an erection long enough for all partners to be satisfied, or erectile dysfunction (ED), is more common among older adults. You may also be concerned with the perception that your erections aren’t as firm as they were when you were younger, another aspect of ED.

The penis also tends to become somewhat less sensitive through the years. That means it may take you more time and more stimulation to become aroused than it did years ago.

Desensitization is common and typically does result in ED as well as more trouble achieving orgasm. Sometimes, these orgasms may also feel less satisfying. And the natural enlargement of the prostate as you age can also reduce your semen volume, making you feel that you’re not as potent as you once were.

According to a study in the International Journal of Impotence Research, your odds of developing curvature of the penis — a condition known as Peyronie’s disease — increases when you reach your 50s. But Peyronie’s disease can occur at just about any age.

Urinary function

As you get older, a growing prostate can squeeze against your bladder and urethra.

You may have to urinate more frequently, but notice a weaker stream with less urine released when you pee.

Physical symptoms

Medical conditions affecting the penis may become more common as you age.

You may experience pain when urinating or when you have an erection, which can both be brought on by a number of chronic or temporary medical conditions.

Lesions or rashes on the penis can be signs of infection or other health concerns. Likewise, the appearance of dark spots on the penis could be harmless penile melanosis or, in rarer cases, signs of penile cancer.

Prostate cancer

This is the most common cancer in people with penises aside from skin cancer. If left untreated, prostate cancer can cause changes in:

  • the appearance of the penis
  • urination
  • sexual function

When you’re older than 50, you should see a doctor at least once a year for a prostate cancer screening. You may consider starting these screenings earlier if you have a family history of prostate cancer or other risk factors.

Penile cancer

Penile cancer is a rare complication that almost exclusively happens in older people with uncircumcised penises. Common early symptoms of penile cancer include:

  • foreskin can’t retract back over the penis shaft
  • foreskin feel stuck in place
  • sore or lesion appears on the foreskin or glans (head) of the penis

See a doctor immediately if you notice any of these symptoms.

Why does aging cause all these changes to the penis? It’s often a result of normal aging, with much of it caused by:

  • reduced blood flow caused by plaque buildup in the arteries and a loss of elasticity of the blood vessels throughout the body as you age
  • loss of smooth muscle cells in the penis — these are largely replaced by collagen cells, according to research in Arab Journal of Urology
  • declining levels of testosterone — the hormone that drives sexual desire, positive mood, and many bodily functions

Sharp, chronic pain in your penis can indicate an issue requiring medical attention. If pain occurs when urinating, the cause may include:

  • infection
  • kidney or bladder stones
  • sexual transmitted disease
  • penile cancer
  • priapism (erection that lasts 4 or more hours)

Peyronie’s disease, which causes a curvature of the penis, usually develops after years of scar tissue buildup from rough sex, sports injuries, or other accidents that can cause the penis to bend slightly.

The amount of ejaculate tends to diminish as you get older. But if you notice a sudden change, especially in the texture and color and the amount of ejaculate that comes out during a single ejaculation, talk with a doctor. Generally, this change occurs gradually and is simply a result of aging.

Another change you may see as you age is hematospermia. This happens when your semen becomes tinged with blood and appears reddish in color. This can indicate an inflammation or infection of your prostate (prostatitis). This is relatively common as you age.

If you’re no longer able to achieve an erection or become sexually aroused, then ejaculation may no longer be possible either.

But with erectile dysfunction treatment, the ability to ejaculate late in life is still possible for most people with penises.

The following changes should prompt you to visit a doctor or urology specialist:

  • sudden changes in sexual desire and/or sexual function
  • bleeding with urination or ejaculation
  • lesions, rashes, bumps, or other noticeable changes to the penis’ appearance
  • abnormal curve or bend in the penis
  • discharge from the penis
  • pain in the penis or scrotum

Treating conditions associated with an aging penis are usually aimed at improving function and managing symptoms.

Some common treatments include:

  • ED medications and other treatments, such as surgical implants of penile prosthetics, to help treat the symptoms of erectile dysfunction. These treatments are not cures for the underlying causes of ED.
  • Surgery or injections of medications for Peyronie’s disease to disrupt collagen formation in the penis to help reduce penis curvature and relieve other symptoms.
  • Antibiotics or medications to address urinary symptoms associated with a urinary tract infection (UTI) or an abnormally enlarged prostate and to help improve your urine flow.
  • Kegel exercises after prostatectomy to help you hold in urine if you have prostate issues or other urinary conditions that cause incontinence.
  • Surgery to remove masses or tissues that may affect penis appearance and function or contain cancerous cells.

Like the rest of the body, the penis changes with age. But changes in appearance don’t necessarily mean any changes in the health of your penis.

The health of the penis and your reproductive and urinary systems are the most important considerations when deciding whether to seek treatment for changes to an aging penis. ED is not inevitable, but several effective treatments help many people with ED.

And if you adopt a healthy lifestyle and work with a doctor to help prevent or quickly diagnose other conditions that affect the penis, you may be more likely to adapt to these changes before they become more severe or problematic over time.