As lifestyle drug production and medical interest in geriatrics increase, the medicalization of aging and sexuality have become intertwined. Drugs like Viagra naturalize lifelong performance of phallocentric sex as a marker of healthy aging. Yet despite the ubiquity of medical aids for having “youthful” sex in older age, this article argues that having no or less sex can be a conscious strategy for embodying respectable aging. Based on ethnographic research in a Cuernavaca, Mexico, hospital urology department, this article shows that despite the traditional association of penetrative sex with successful masculinity, many older, working-class Mexican men faced with erectile difficulty reject “youthful” sexuality and drugs that facilitate it in order to embody a “mature” masculinity focused on home and family. This article argues that social encouragement and structural disincentives for medicalizing erectile difficulty encouraged men to interpret decreasing erectile function as natural and appropriate.