Nobody warns you about this one. You hear about gray hair, creaky joints, and the metabolism that just decides to retire around 40. But the penis? That’s a conversation most doctors have to bring up themselves, because most men aren’t exactly lining up to ask.
Here’s the reality: the penis you have now will likely look and function differently in 10 or 20 years. Some of it is preventable. Some of it isn’t. All of it is worth knowing about.
“Changes to the penis over time should be viewed as a barometer of overall health,” Ryan Cleary, M.D., a urologist at MedStar Health in Baltimore, told Men’s Health. Basically, what happens down there can reflect what’s happening everywhere else.
1. Everything Droops Eventually
Collagen keeps skin elastic and structured, and it depletes over time. That includes the skin of the penis and, yes, the scrotum. At its most extreme, urologist Brian Steixner, M.D., of AtlantiCare Medical Center in New Jersey, describes what he calls “splashdown syndrome,” where the scrotum actually makes contact with the toilet water when sitting down. The good news is that quitting smoking, eating well, and exercising regularly can significantly slow this process.
2. Size Actually Does Change
Not the temporary, it’s-cold kind of shrinkage. Actual, gradual size reduction. Weight gain accelerates it significantly, since fat accumulating around the penile base buries length under the skin. “For every 30 pounds you shed, you add an effective half-inch in length,” Dr. Steixner said. Worth filing away.
3. Hello, Curvature
Repeated minor trauma from sports and sex can cause scar tissue to build up unevenly along the penis over time. The result is a noticeable and sometimes painful curve, a condition known as Peyronie’s disease. “Into your 60s and 70s, it can get worse,” Dr. Steixner says. “I’ve seen patients whose penises look for all appearances like a question mark.” Injectable treatments are now available to break down scar tissue, so it’s worth talking to a doctor if it becomes significant.
4. The Foreskin Problem
For uncircumcised men, a condition called phimosis, where the foreskin becomes too tight to retract, can develop with age. It can make urination and erections painful. Steroid creams can help, though some cases require circumcision. Good hygiene goes a long way toward prevention.
5. Erectile Dysfunction Becomes More Common
ED in older men generally comes down to reduced blood flow. “Having ED is like having a heart attack of the penis,” Dr. Steixner says. “And preventing it involves pretty much the same advice you give to someone with a heart condition: eat well, exercise.” Medications, vacuum devices, and other treatments exist when lifestyle changes aren’t enough.
6. Skin Cancer Down There Is a Real Thing
It doesn’t get talked about the way prostate or testicular cancer does, but skin cancer on the penis is a real risk, especially for frequent tanning bed users. “Stay out of tanning beds, and if you are uncircumcised, keep the hood clean,” Dr. Steixner says. Any unusual lesion, growth, or ulcer deserves a professional look.
The throughline across all of this, according to both doctors, is lifestyle. Sleep, diet, exercise, stress management. Not exactly a surprise, but apparently, the penis is just as good a reason as any to finally take it seriously.
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