Most men have wondered, at one point or another, whether it’s possible for their penises to shrink. While this sounds like something out of a sci-fi movie, unfortunately, this fear does have some truth to it. While it’s not really possible for penises to gradually shrink inch by inch, it’s true that due to age and lifestyle choices, your penis could potentially lose the ability to maintain a consistent level of tumescence.

So what is tumescence? Well, it’s basically a fancy word for erection firmness, says Mary Samplaski, MD, urologist and the director of male infertility at the University of Southern California. If you measure the length of your penis when it’s erect, over time it can very much appear as if your penis has shrunk. But changes in penile size over time are tough to gauge.

“There’s not really a medical tool for measuring penis shrinkage,” says Dr. Samplaski. “What we do know is that smoking and age can cause a decline in testosterone production.” Smoking damages the blood vessels, disrupting the flow of blood to the penis and preventing it from reaching peak hardness. And while doctors still don’t fully understand the connection between testosterone and erectile dysfunction, studies have shown that a decline in testosterone can affect the strength of erections.

Does Your Penis Size Matter?:

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Dr. Samplaski says that conditions such as cardiac disease, diabetes, or thyroid issues can also cause changes in erectile strength. Heart problems can affect erections due to the change in the lining of the blood vessels, and changes in hormones as the result of thyroid issues can lead to a decrease in erectile function.

Leslie Deane, M.D., professor and chief of urology at Howard University, says that for many men, a decline in erectile function due to such underlying conditions is what will motivate them to finally see a doctor. “The alarm bells ring not because of chest pain, but because of difficulty with erections and with their intimate lives,” Dr. Deane says.

If your penis isn’t as hard as it used to be, it is usually a good idea to see a doctor. Although there are many innocuous causes for erectile dysfunction, ranging from performance anxiety to cat scratches, it can also be a sign of a serious condition, such as heart disease. A softer penis may also signify that you need to make some major lifestyle changes, such as quitting smoking or getting your butt to the gym.

If your erections aren’t as strong as they used to be, first things first: relax, because stress is not conducive to a hard penis. You should also take on an exercise routine, as exercise helps to remove plaque, which can calcify and prevent blood vessels from stretching. Dr. Samplaski advises exercising at least three times per week, in large part because exercise can also help increase testosterone.

Obesity can be another culprit: fat contains an enzyme that converts testosterone into estrogen, explains Dr. Samplaski, which can cause erectile issues and testicular shrinkage. “Exercise is a natural means of achieving a rise in a man’s testosterone. Testosterone is important for the health and well-being of the male functional organs,” says Dr. Deane.

Unfortunately, even if you’re totally healthy, don’t smoke, and exercise regularly, some loss in erectile function is simply part of the aging process. Medications like Viagra or Cialis, which work by increasing blood flow to the penis, can be an option for men concerned about losing their erections. (That said, stay far, far away from the “natural Viagra” and other supplements often sold at gas stations, as they are usually not approved by the FDA.) Botox is also a potential option, though its efficacy has not been confirmed.

Death and natural loss of erectile function with age may be inevitable, but don’t hasten the demise of your youthful erection: instead, hit the gym, quit your smoking habit, and understand that your sex life goes on, even if your erection loses some of its strength.