What medical therapies reliably increase semen volume in men over 50?

1. Treat the cause: urology procedures for obstruction and BPH restore flow when anatomy is the problem

When reduced ejaculate volume reflects true outflow obstruction or significant benign prostatic hyperplasia (BPH), surgical or procedural urology interventions can restore semen flow and therefore volume; prostate and ejaculatory duct pathology are established causes of diminished seminal output and are common with advancing age ^{[2] [3]}. Men whose reduced volume is due to mechanical blockage or severe prostate enlargement are therefore most likely to see reliable gains after appropriate intervention, a conclusion grounded in urology practice rather than supplement marketing ^{[2] [3]}.

2. Hormonal management helps some patients but is not a universal fix

Hormonal therapies—when tailored to a diagnosed hormonal deficiency or specific fertility issue—can improve semen analysis parameters in selected men, as systematic hormonal management programs have shown benefit in men with abnormal concentration, motility or morphology; however, androgen replacement (testosterone) can suppress sperm production and may worsen semen volume, so treatment must be individualized and supervised by specialists ^{[1] [6]}. The net effect depends on the underlying diagnosis: men with hypogonadism under careful endocrine/urology care may gain semen‑related improvements, but unsupervised hormonal use risks harm ^{[1] [6]}.

3. Medication review and lifestyle are practical, evidence‑based first steps

A pragmatic and evidence‑backed approach in older men is to review prescription drugs that reduce ejaculate (antidepressants, certain blood pressure agents, alpha‑blockers) and address reversible contributors such as hydration and smoking, since tobacco and comorbidities are linked to lower semen volume and quality ^{[2] [1]}. Because seminal fluid is produced by multiple glands—seminal vesicles supply roughly half of ejaculate volume—systemic health, gland function and medications materially affect output, so correcting reversible factors is one of the most reliable, low‑risk strategies ^{[2] [1]}.

4. Supplements: promising headlines, weak and conflicted evidence

Numerous over‑the‑counter supplements and herbals (ashwagandha, maca, L‑arginine, coenzyme Q10 and commercial “volume” pills) are promoted with small trials, company‑sponsored studies, or selective citations claiming 20–50% increases; independent experts and critical reviews warn that trials are often small, industry‑backed, or not designed to prove reproducible clinical effects in older men, and that marketing drives many exaggerated claims ^{[7] [4] [8] [5]}. Media and vendor narratives frequently conflate fertility markers, anecdotal reports and short, unblinded studies—an implicit commercial agenda that readers must weigh against the lack of large, robust clinical trials ^{[3] [4]}.

5. Bottom line: reliable gains require diagnosis and targeted medical care

For men over 50 the most reliable increases in semen volume come from identifying and treating medical causes—obstruction, significant BPH, or treatable hormonal disorders—and from stopping or changing medications that impair ejaculate; supplements may help a minority but carry mixed evidence and potential bias, so they should not replace clinical assessment by a urologist or reproductive specialist ^{[2] [1] [3]}. If volume loss is sudden or marked, specialist evaluation is essential because it can signal treatable pathology; otherwise, conservative measures and evidence‑based medical therapies remain the dependable path to improvement ^{[1] [2]}.