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What happens to male sexual health after 40 and what to do about it?
As a natural part of the aging process, recovery takes longer. And there are real, measurable biological changes happening inside your body after 40. Understanding them is the first step to doing something about them.
The following is a practical guide to what's actually going on, what the science says helps, and how to take back control of our masculine identity.
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Testosterone Decline
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Vascular Changes
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Cortisol & Stress
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Sleep & Hormones
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Neurotransmitters & Desire
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Natural Compounds That Help
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Lifestyle Interventions
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Taking Back Control
ATHANASE® — Built for Men Over 40
16 research-supported superfoods in a single daily scoop — including 1,750mg of maca root, KSM-66® ashwagandha, and ginger — designed to support the interconnected systems that drive male health and vitality.
Shop ATHANASE®What Actually Changes After 40
Testosterone Decline
Starting around age 30, testosterone levels decline by approximately 1–2% per year[1]. By 40, most men have lost 10–20% of their peak testosterone. By 50, it can be 20–30% or more.
Here's how the effects compound:
- Reduced libido and sexual desire
- Weaker and less frequent erections
- Lower energy and motivation
- Loss of muscle mass and increased body fat
- Mood changes, irritability, and low-grade depression
- Poorer sleep quality
📊 Research Highlight
The European Male Ageing Study (EMAS), which followed over 3,000 men, found that late-onset hypogonadism — the clinical term for age-related testosterone decline severe enough to cause symptoms — affects a significant proportion of men over 40[3]. A large-scale study in the Journal of Clinical Endocrinology & Metabolism confirmed that total testosterone levels decline progressively with age, and that the decline accelerates after 40[2].
Important context: not every man with declining testosterone will experience symptoms. Genetics, lifestyle, body composition, sleep, and stress all influence how you feel at any given hormone level. Two men with identical testosterone readings can have completely different experiences.
Blood Flow and Vascular Health
Erection quality is fundamentally a vascular event. Healthy erections require strong blood flow, which depends on the health of your blood vessels — particularly the endothelium (the inner lining of your arteries).
After 40, endothelial function naturally declines[4]. The blood vessels become less responsive, nitric oxide production decreases, and the smooth muscle that relaxes to allow blood flow becomes less efficient.
⚠️ Early Warning Sign
Erectile difficulties are now understood as an early warning sign of cardiovascular disease — the penile arteries are smaller than coronary arteries, so they show damage first[5]. If you're experiencing changes in erectile function, it's worth discussing with your GP not just for sexual health, but for your heart.
Factors that accelerate vascular decline include smoking, high blood pressure, elevated cholesterol, excess visceral fat, a sedentary lifestyle, and poor diet.
The good news: vascular health is highly responsive to lifestyle intervention. Exercise, nutrition, and specific natural compounds can meaningfully improve endothelial function at any age.
The Cortisol Problem
Here's something most men don't realise: your testosterone levels don't exist in isolation. They're in a constant tug-of-war with cortisol — your primary stress hormone.
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When cortisol is chronically elevated — from work stress, poor sleep, overtraining, financial worry, or simply the accumulated pressures of life at 40+ — it directly suppresses testosterone production through the hypothalamic-pituitary-gonadal (HPG) axis[6]. Your body essentially prioritises survival (cortisol) over reproduction (testosterone).
This creates a vicious cycle. Stress lowers testosterone. Low testosterone worsens mood and energy. Poor mood and energy make stress harder to manage. Cortisol stays elevated. Testosterone drops further.
For men over 40 dealing with careers, families, financial obligations, and ageing parents — cortisol is often the hidden driver behind sexual health decline. It's not always about testosterone being low. Sometimes it's about cortisol being too high.
ATHANASE contains a triple-adaptogen stack — maca root, KSM-66® ashwagandha, and Siberian ginseng — specifically chosen to help the body manage cortisol and support healthy hormonal balance. Learn more →
Sleep and Hormonal Recovery
Testosterone production peaks during deep sleep, particularly during REM cycles. Studies show that men who sleep fewer than 5–6 hours per night can have testosterone levels equivalent to men 10–15 years older[7].
After 40, sleep architecture naturally changes. Deep sleep stages become shorter and more fragmented. This means even men who sleep 7–8 hours may not be getting the restorative sleep that drives hormonal recovery.
Poor sleep also elevates cortisol the following day, compounding the hormonal disruption.
Neurotransmitters and Desire
A significant driver of sexual desire is neurological. Dopamine, serotonin, and norepinephrine all play roles in arousal, motivation, and sexual pleasure.
As we age, neurotransmitter function can change. Chronic stress depletes dopamine. Mood changes may impact serotonin balance. The result is that even men with adequate testosterone can experience reduced desire, diminished pleasure, or difficulty with arousal.
This is why a purely hormonal approach doesn't always solve the problem. Sexual health is a system — hormones, neurotransmitters, vascular health, sleep, and psychological state all interact.
What the Research Says Helps
The following botanical compounds have clinical evidence supporting their role in male sexual health. We're not talking about miracle cures but ingredients that, when used consistently, may meaningfully support the biological systems that drive sexual function.
Maca Root (Lepidium meyenii)
Maca is arguably the most well-researched natural compound for male sexual health. A cruciferous vegetable native to the Peruvian Andes, it has been used for centuries as a fertility and vitality food.
- Increased Libido: A systematic review of four randomised controlled trials concluded that maca supplementation increases sexual desire in men after 6–12 weeks of use, at doses of 1.5–3g per day[8].
- Enhanced Erectile Function: In men with mild erectile dysfunction, maca extract improved sexual well-being and erectile function compared to placebo in a randomised, placebo-controlled trial[9].
- Improved Sperm Quality: A controlled trial in 69 men found that 2g of maca daily for 12 weeks significantly increased sperm concentration[10].
- Symptom Relief Without Hormonal Disruption: A 2023 double-blind trial in men with late-onset hypogonadism found that 3g of maca daily for 12 weeks significantly improved sexual function scores and Aging Males' Symptoms scores — without altering serum testosterone levels[11].
📊 Key Finding
Maca doesn't work by artificially raising testosterone. It appears to work through adaptogenic and tissue-level androgenic mechanisms — helping your body's existing hormonal system function more effectively[12]. This makes it safer and more sustainable than exogenous hormone interventions.
Effective dose: 1.5–3g per day, with higher benefits seen at 3g+ over 8–12 weeks.
ATHANASE delivers 1,750mg of maca root per serving — right in the clinically-researched range. At 2 daily servings, you're at 3,500mg. Try ATHANASE® →
Ashwagandha (Withania somnifera)
Ashwagandha is a powerful adaptogen — meaning it helps your body regulate its stress response. For men over 40, this is directly relevant to sexual health because of the cortisol-testosterone connection.
- Improved Sexual Function: A randomised, double-blind, placebo-controlled study found that 600mg of KSM-66 ashwagandha daily for 8 weeks significantly improved sexual function in healthy men, including desire, arousal, orgasm, and overall satisfaction[13].
- Cortisol Reduction: The same study found significant reductions in cortisol levels — confirming the mechanism: lower stress → better hormonal environment → improved sexual function.
- Physical Performance: A systematic review and meta-analysis found that ashwagandha at 300–600mg daily for 8–12 weeks enhanced cardiorespiratory fitness, muscle strength, and recovery[14].
- Athletic Recovery: A 2026 clinical trial found that 600mg daily of ashwagandha root extract stabilised cortisol levels in athletes during intense training, with improvements in perceived recovery and fatigue[15].
The mechanism: By lowering chronic cortisol, ashwagandha removes one of the key biochemical brakes on testosterone production and sexual function. It doesn't force your body to produce more testosterone — it creates the conditions where your body can produce it naturally.
Effective dose: 300–600mg of a standardised root extract (KSM-66 is the most researched form) daily.
Ginger (Zingiber officinale)
Ginger's role in sexual health comes primarily through its effects on circulation and inflammation — two factors that directly impact erectile function.
- Testosterone Support: A systematic review found that ginger supplementation significantly improved testosterone levels in men, particularly those with oxidative stress or metabolic conditions[16].
- Improved Blood Flow: Ginger's active compounds (gingerols and shogaols) are potent vasodilators — they relax blood vessels and improve blood flow[17]. This is directly relevant to erectile function.
- Anti-Inflammatory: Ginger inhibits COX-1, COX-2, and NF-κB inflammatory pathways[18]. Chronic inflammation damages the endothelium and impairs the nitric oxide signalling that enables erections.
Effective dose: 500mg–1g daily for circulatory and anti-inflammatory benefits.
Fenugreek (Trigonella foenum-graecum)
Fenugreek has been used in traditional medicine for centuries as a male vitality herb. Modern research supports its role in testosterone and libido.
- Sexual Function & Libido: A 12-week randomised, double-blind trial found that 600mg of fenugreek extract daily significantly improved sexual function, libido, and testosterone levels in healthy men aged 25–52[19].
- Strength & Body Composition: A second trial found that fenugreek supplementation maintained healthy testosterone levels while improving strength and body composition during resistance training[20].
Effective dose: 500–600mg of a standardised extract daily.
Shilajit
Shilajit is a mineral-rich resin found in the Himalayas, containing fulvic acid and over 80 trace minerals. It's classified in Ayurvedic medicine as a rasayana (rejuvenator) and has been used for centuries to support male vitality.
📊 Research Highlight
A 90-day clinical study in healthy men aged 45–55 found that 250mg of purified shilajit twice daily significantly increased total testosterone and free testosterone compared to placebo[21]. Shilajit's fulvic acid content also enhances nutrient absorption and supports mitochondrial energy production[22].
Effective dose: 250–500mg daily of purified extract.
Lion's Mane Mushroom (Hericium erinaceus)
While not a traditional "sexual health" ingredient, Lion's Mane supports the neurological side of desire and arousal.
- Nerve Growth Factor: Lion's Mane contains unique compounds (hericenones and erinacines) that stimulate NGF production — a protein critical for brain cell maintenance and neuroplasticity[23].
- Cognitive Performance: A clinical study in healthy young adults found that Lion's Mane improved processing speed and cognitive performance within 60 minutes of a single dose[24].
- The Connection: If your brain isn't firing properly — if dopamine is depleted, if you're cognitively fatigued — desire suffers regardless of testosterone levels. Lion's Mane supports the mental side of the equation.
Guarana (Paullinia cupana)
Guarana contains natural caffeine alongside theobromine, theophylline, and catechins — compounds that enhance cognitive performance and blood flow.
- Cognitive Enhancement: A randomised trial found that guarana improved reaction time and cognitive performance to a greater degree than caffeine alone, suggesting its additional bioactive compounds provide synergistic benefits[25].
- Sustained Energy: Guarana releases caffeine more slowly than coffee, providing a sustained cognitive lift without the spike-and-crash that increases cortisol[26].
- The Connection: Mental sharpness, confidence, and energy all contribute to sexual desire and performance. Guarana supports the "feeling alive" factor that often diminishes after 40.
All 6 Compounds. One Daily Scoop.
ATHANASE contains maca root, KSM-66® ashwagandha, ginger, fenugreek, shilajit, lion's mane, and guarana — plus 9 more superfoods. One blend targeting the interconnected systems that drive male vitality.
Shop ATHANASE®Lifestyle Factors That Make Everything Work Better
No supplement or ingredient can compensate for fundamentally broken lifestyle habits. These are the foundations that make everything else work:
🏋️ Resistance Training
The single most effective natural intervention for maintaining testosterone after 40. Compound movements — squats, deadlifts, presses, rows — recruit the most muscle mass and trigger the strongest hormonal response. Aim for 3–4 sessions per week. Combine with cardiovascular exercise for vascular health and blood flow[27].
😴 Sleep — Non-Negotiable
Prioritise 7–9 hours in a cool, dark room. Avoid screens 60 minutes before bed. Keep a consistent schedule. If you suspect sleep apnoea — snoring, daytime fatigue, waking unrefreshed — get tested. It's remarkably common in men over 40 and devastates hormonal health.
🧘 Stress Management
Chronic stress is the silent destroyer of male sexual health. Meditation, prayer, walking in nature, breathwork, journaling, time with friends — the method matters less than the consistency. Manage cortisol and you remove the biggest brake on your body's natural testosterone production.
⚖️ Body Composition
Excess visceral fat contains the enzyme aromatase, which converts testosterone into oestrogen[28]. The more visceral fat you carry, the more testosterone you lose. Losing even 5–10% of body weight can meaningfully improve testosterone levels and sexual function.
No supplement can compensate for poor sleep, chronic stress, and a sedentary lifestyle. Get the foundations right — then let the right ingredients amplify what your body is already capable of.
Why We Made ATHANASE for Exactly This
Everything described in this article — the hormonal decline, the stress-cortisol cycle, the vascular changes, the neurotransmitter changes, the need for comprehensive nutritional support — is why ATHANASE exists.
ATHANASE isn't a testosterone booster. It's not a libido pill. It's a daily blend of herbs, adaptogens, mushrooms and algae designed to support the interconnected systems that drive male health and vitality:
| Ingredient | Per Serving | Primary Role |
|---|---|---|
| Maca Root | 1,750mg | Libido, sexual function, endurance |
| Guarana | 500mg | Focus, cognitive energy, blood flow |
| Siberian Ginseng | 250mg | Adaptogenic stress resistance |
| Ginger | 250mg | Circulation, anti-inflammatory |
| Spirulina | 200mg | Micronutrient density, antioxidants |
| Camu-Camu | 125mg | Vitamin C, immune support |
| Agave Inulin | 125mg | Gut health, nutrient absorption |
| KSM-66® Ashwagandha | 100mg | Cortisol regulation, recovery |
| Activated Charcoal | 75mg | Detoxification support |
| Lion's Mane Mushroom | 50mg | Neuroprotection, cognition |
| Fenugreek | 50mg | Testosterone support |
| Shilajit | 25mg | Nutrient absorption, cellular energy |
| Turmeric | 12.5mg | Anti-inflammatory |
| Biotin | 5mcg | Hair, skin, nails |
| Lemon Juice Extract | 750mg | Flavour, Vitamin C |
| Date Powder | 750mg | Natural sweetness, minerals |
The primary active ingredients — maca root at 1,750mg and guarana at 500mg — are dosed at levels where clinical research has demonstrated real benefits. The supporting ingredients work synergistically to address cortisol, inflammation, vascular health, cognition, gut health, and immunity.
Sexual health after 40 isn't about one ingredient or one quick fix.
It's about supporting the whole system — hormones, stress response, blood flow, brain health, sleep, and nutrition — consistently, every single day. That's what ATHANASE was made to do.
Take Back Control
Try ATHANASE® — our acclaimed all-in-one herbal blend for men, as seen in Men's Health magazine and certified by Informed Sport.
2,200+ five-star reviews · 16 ingredients · One daily scoop
Shop ATHANASE®Make Your Ancestors Proud. ⚔️
📚 References
[1] Feldman HA et al. (2002). Age Trends in the Level of Serum Testosterone and Other Hormones in Middle-Aged Men. Journal of Clinical Endocrinology & Metabolism, 87(2), 589–598.
[2] Harman SM et al. (2001). Longitudinal Effects of Aging on Serum Total and Free Testosterone Levels in Healthy Men. Journal of Clinical Endocrinology & Metabolism, 86(2), 724–731.
[3] Wu FC et al. (2010). Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men. New England Journal of Medicine, 363(2), 123–135.
[4] Celermajer DS et al. (1994). Aging is Associated with Endothelial Dysfunction in Healthy Men. Journal of the American College of Cardiology, 24(2), 471–476.
[5] Montorsi F et al. (2003). Erectile Dysfunction Prevalence and Association with Risk Factors in 300 Patients with Coronary Artery Disease. European Urology, 44(3), 360–365.
[6] Cumming DC et al. (1983). Acute Suppression of Circulating Testosterone Levels by Cortisol in Men. Journal of Clinical Endocrinology & Metabolism, 57(3), 671–673.
[7] Leproult R, Van Cauter E. (2011). Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men. JAMA, 305(21), 2173–2174.
[8] Shin BC et al. (2010). Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complementary and Alternative Medicine, 10, 44.
[9] Zenico T et al. (2009). Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction. Andrologia, 41(2), 95–99.
[10] Gonzales GF et al. (2001). Lepidium meyenii (Maca) improved semen parameters in adult men. Asian Journal of Andrology, 3(4), 301–303.
[11] Becerra AD et al. (2023). Efficacy and Safety of Maca in Patients with Late-Onset Hypogonadism. Phytotherapy Research. — PubMed
[12] Memorial Sloan Kettering Cancer Center. Maca — Integrative Medicine Information. — MSKCC
[13] Lopresti AL et al. (2019). A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (KSM-66) in Aging, Overweight Males. American Journal of Men's Health, 13(2).
[14] Bonilla DA et al. (2021). Effects of Ashwagandha on Physical Performance: Systematic Review and Bayesian Meta-Analysis. Journal of Functional Morphology and Kinesiology. — PMC
[15] NutraIngredients (2026). KSM-66 ashwagandha shows sex-specific benefits in athletes. Nutrients; doi: 10.3390/nu18020230.
[16] Banihani SA. (2018). Ginger and Testosterone. Biomolecules, 8(4), 119.
[17] Nicoll R, Henein MY. (2009). Ginger — Its Role in Xenobiotic Metabolism. ICFJ.
[18] Black CD et al. (2010). Ginger Reduces Muscle Pain Caused by Eccentric Exercise. The Journal of Pain, 11(9), 894–903.
[19] Rao A et al. (2016). Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease. Aging Male, 19(2), 135–142.
[20] Wankhede S et al. (2016). Beneficial effects of fenugreek glycoside supplementation in male subjects during resistance training. Journal of Sport and Health Science, 5(2), 176–182.
[21] Pandit S et al. (2016). Clinical evaluation of purified Shilajit on testosterone levels in healthy volunteers. Andrologia, 48(5), 570–575.
[22] Carrasco-Gallardo C et al. (2012). Shilajit: A Natural Phytocomplex with Potential Procognitive Activity. International Journal of Alzheimer's Disease.
[23] Mori K et al. (2009). Nerve Growth Factor-Inducing Activity of Hericium erinaceus. Biological and Pharmaceutical Bulletin, 31(9), 1727–1732.
[24] Docherty S et al. (2023). The Acute and Chronic Effects of Lion's Mane Mushroom Supplementation on Cognitive Function, Stress and Mood in Young Adults. Nutrients, 15. — PMC
[25] Gurney T et al. (2023). Randomised trial: guarana improved reaction time with greater cognitive benefits than caffeine alone.
[26] Pharmacy Times (2025). Caffeine vs Guarana: bioactive compounds and slower caffeine release kinetics. — Pharmacy Times
[27] Vingren JL et al. (2010). Testosterone Physiology in Resistance Exercise and Training. Sports Medicine, 40(12), 1037–1053.
[28] Cohen PG. (1999). The Hypogonadal-Obesity Cycle: Role of Aromatase in Modulating the Testosterone-Estradiol Shunt. Medical Hypotheses, 52(1), 49–51.
⚠️ Important Information
ATHANASE® is a food supplement and should not be used as a substitute for a varied diet and healthy lifestyle. Do not exceed the stated recommended daily dose. Contains 15mg caffeine per serving. If you are taking medication or have a pre-existing medical condition, please consult with your doctor. Keep out of reach of children. If you are experiencing persistent sexual health issues, consult your GP — erectile dysfunction can be an early indicator of cardiovascular disease and should be investigated.
The World's First Superfood Blend For Men
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MAKE YOUR ANCESTORS PROUD® with ATHANASE®. A blend of herbs specially formulated for men, to help conquer 7 areas:
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MALE HEALTH |
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ATHLETICISM |
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MOOD & COGNITION |
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RECOVERY & SLEEP |
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GUT HEALTH |
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IMMUNITY |
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AESTHETICS |
As seen in Men's Health Magazine and Certified by Informed Sport.
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