The Most Common Regrets Gay Men Have About Their Health in Their 50s

When I meet gay men in their 50s—whether at my clinic, at community events, or in a telemedicine visit—there’s a pattern that appears so consistently it’s almost predictable.
A sense of “I wish I had started sooner.”

Not because they’ve done anything wrong, but because no one ever taught them how their body really works, what longevity actually means, or how gay men’s health differs from the general population.

Based on my clinical work, decades of lived community experience, longevity research, and many of the stories shared directly with me, here are the seven most common health regrets gay men express in their 50s—and more importantly, what you can do about them now.

1. “I wish I had taken my metabolism seriously earlier.”

Many gay men arrive in midlife feeling like their metabolism changed “overnight.”
It didn’t.
It was slowly drifting for decades.

The regret:
Not paying attention to abdominal fat, rising waist size, creeping blood sugar, or declining muscle mass until they suddenly mattered.

What this really reflects:

• Untreated insulin resistance

• Chronically elevated glucose swings

• Loss of metabolic flexibility

• Inconsistent protein intake

• Lack of intentional strength training

What to do now:
A metabolic reset is absolutely possible in your 50s.
The tools are:

• Continuous glucose monitoring (CGM)

• Strength training 3–4 days/week

• High-protein, low-sugar nutrition

• Tracking waist circumference, not just weight

2. “I should have protected my brain earlier.”

Gay men disproportionately face chronic minority stress, sleep disruption, burnout, and cortisol dysregulation.

By the 50s, this shows up as:

• Brain fog

• Forgetfulness

• Poor focus

• Emotional reactivity

• Decreased sleep quality

The regret:
Not treating the brain as a long-term investment.

The truth from modern longevity science:
Brain aging begins in our 40s.
APOE4 risk, sleep quality, metabolic health, and stress load all shape cognitive aging.

What to do now:

• Prioritize sleep as a biological training zone

• Reduce alcohol (and other things)

• Train VO2 max, not just muscles

• Optimize vitamin D, B12, Omega-3

• Address loneliness and social isolation (huge for gay men)

3. “I wish I had kept my strength.”

By 50, most men have lost over 30% of their peak muscle mass unless they actively trained strength.

For gay men specifically:

• Aesthetics often overshadow function in youth

• Cardio is overemphasized

• True strength training is often delayed until too late

The regret:
Not building the “muscle reserve” that determines how well you age after 60.

Medicine 3.0 reality:
Muscle is the most important organ of longevity.

What to do now:

• Heavy strength training 2–3×/week

• Grip, carry, squat, hinge, and pull

• Track your centenarian decathlon movements

• Protein target: 1g per lb of ideal body weight

4. “I wish I had protected my sexual vitality.”

Many gay men in their 50s tell me:
“I thought erectile changes were just part of aging.”

They’re not.

The regret:
Waiting until their 50s to address:

• Erections

• Testosterone changes

• Performance anxiety

• Dopamine-driven exhaustion

• Porn desensitization

• Partner misalignment

• Shame-based avoidance of sexual healthcare

Gay sexual health is both physical and emotional.
Men often suffer silently, believing something is “wrong” with them.

What to do now:

• Assess hormones (don’t guess)

• Address metabolic health (huge for erections)

• Manage performance anxiety and sleep

• Consider Trimix, PDE5 inhibitors, or combination protocols

• Treat sex as part of overall vitality—not a separate topic

5. “I wish I had addressed sleep decades ago.”

Gay men have higher rates of insomnia, inconsistent schedules, nightlife habits, and cortisol shifts related to chronic stress.

By your 50s, poor sleep accelerates:

• Weight gain

• Brain aging

• Hypertension

• Mood instability

• Erectile dysfunction

The regret:
Not understanding that sleep is the most powerful longevity drug we have.

What to do now:

• A consistent bedtime (10 PM is ideal)

• Reduce blue light 2 hours before bed

• Target 90 minutes of slow-wave sleep

• Reduce alcohol and late-night eating

• Prioritize parasympathetic recovery (Downstate)

6. “I wish I had gotten my screenings earlier.”

This one is huge.

Gay men often avoid—or are not guided toward—early screening for:

• Colorectal cancer

• Prostate cancer

• Coronary calcium scores

• ApoB and advanced lipid panels

• Sleep apnea

• Liver health

• STI screening

• HIV PrEP management

• Bone density

The regret:
Assuming that “normal labs” mean optimal health.

What to do now:
Medicine 3.0 means testing early, testing deeply, and acting proactively—not reactively.

7. “I wish I hadn’t waited to build a support system.”

By age 50, many gay men discover an unexpected truth:

Longevity requires other people.

Yet:

• Many lived portions of life in secrecy or shame

• Many avoided forming deep community

• Many lost friends to HIV

• Many struggle with midlife dating or partnership

• Many fear being alone as they age

The regret:
Not investing in emotional well-being and community sooner.

The truth:
Loneliness is as dangerous as smoking 15 cigarettes a day.

What to do now:

• Rebuild chosen family

• Create routine contact—weekly dinners, group chats, meet-ups

• Practice vulnerability

• Build friendships around shared health goals

• Work with a longevity physician trained in mental and emotional health

Why These Regrets Matter—And Why They’re Not Fixed Destiny

Here’s the message I give every man who walks into Torre Prime:

Regret is information.
Not punishment.
Not fate.
Just information.

And when you use regret as data, not shame, you gain something incredibly rare in healthcare:

Control.

You can rewrite your 50s.
You can change your trajectory for your 60s.
And your 70s, 80s, and beyond can look radically different than your parents’ generation.

That’s the entire purpose of longevity medicine.

What Torre Prime Does for Gay Men in Their 40s and 50s

At Torre Prime, we treat gay men’s longevity as its own specialty.

Our framework includes:

• Deep-dive metabolic testing

• CGM-guided nutrition

• Hormone and sexual vitality medicine

• Sleep architecture optimization

• The Centenarian Decathlon

• Advanced labs (apoB, Lp(a), insulin, inflammatory markers)

• Early cancer screening

• Stress load analysis

• Cognitive preservation

• Emotional and relational health

• Community-building strategies

Because gay men deserve health care that gets us—not just “tolerates” us.

You don’t have to wait until you’re 60 to start over.

You can start today.

Connection Is Medicine: The Hidden Health Effects of Loneliness

— Gabriel Felsen, MD

When was the last time you felt truly seen — not just in the room with others, but genuinely connected?

We live in one of the most socially connected times in history, yet loneliness and isolation were recently declared a national epidemic. And the truth is, it’s not just an emotional issue — it’s a biological one.

As a longevity physician, I see this every day. People ask about supplements, hormones, and bloodwork. But when we dig deeper, what’s missing isn’t magnesium or testosterone — it’s connection.

Loneliness, it turns out, is as dangerous to your health as smoking 15 cigarettes a day.

Loneliness vs. Social Isolation: What’s the Difference?

These words get used interchangeably, but they’re not the same thing.

• Social Isolation is the objective lack of contact with others — living alone, few friends, or infrequent interactions.

• Loneliness is the subjective feeling of disconnection — that sense of being unseen or misunderstood, even in a crowd.

You can have hundreds of contacts and still feel lonely, or live alone and feel completely fulfilled. The difference lies in meaningful connection — being known, accepted, and valued for who you really are.

The Biology of Disconnection

When we feel lonely, our body reacts as if we’re in danger. It’s an ancient survival mechanism — isolation once meant vulnerability.

That means loneliness triggers the stress response:

• Elevated cortisol, raising blood pressure and inflammation.

• Suppressed immune function, making you more likely to get sick.

• Disrupted sleep cycles, robbing the brain of restorative deep rest.

• Even shorter telomeres — the protective caps on your DNA that shrink as you age.

Over time, chronic isolation increases your risk for:

• Heart disease and stroke

• Dementia and cognitive decline

• Depression and anxiety

• Premature mortality

In short: loneliness accelerates aging.

When we talk about longevity, we often focus on diet, exercise, or supplements. But connection is the original longevity medicine — it lowers inflammation, boosts immunity, and restores nervous system balance.

The Intersection of Chronic Illness, HIV, and Depression

For many in our community, loneliness is compounded by chronic illness and stigma.

HIV, for example, carries unique emotional weight. The ongoing need for disclosure, fear of judgment, and fatigue from long-term care can deepen isolation — even in people with strong medical support. Yet research shows that social connection improves medication adherence and even immune function among people living with HIV.

Depression works the same way — it both causes and worsens loneliness. The brain literally processes emotional pain through the same regions as physical pain. That’s why rejection or disconnection can feel like a punch to the gut.

And for LGBTQ+ individuals, minority stress — the chronic strain of navigating stigma, discrimination, or invisibility — takes a measurable toll on both mental and physical health. Many of us find belonging through chosen family, but when those bonds shift through aging, relocation, or loss, the risk of isolation increases again.

How to Recognize the Warning Signs

Loneliness doesn’t always look like sadness. Often, it shows up as fatigue, irritability, or self-neglect.

Common risk factors include:

• Living alone or losing a partner

• Retirement or loss of daily structure

• Chronic illness or physical limitations

• Major life transitions (divorce, relocation, coming out later in life)

And warning signs can be subtle:

• Skipping social gatherings

• Neglecting appearance or hygiene

• Expressing feelings of hopelessness or being “invisible”

• Spending hours online without real contact

If you recognize these in yourself or someone you love, it’s not a weakness — it’s a signal. The body is asking for connection.

Connection as a Longevity Prescription

The antidote to loneliness isn’t just “getting out more.” It’s rebuilding your body’s capacity for connection — physically, emotionally, and spiritually.

Here’s where I start with patients:

1. Reset your nervous system.
Rest and recovery aren’t indulgent — they’re essential. Deep sleep, time in nature, and slowing down all help your body re-enter what sleep expert Sara Mednick calls the Downstate — the healing mode where connection becomes possible again.

2. Anchor yourself with rituals of connection.
Have a weekly dinner, join a walking group, volunteer, or start attending community events. Rituals build rhythm — and rhythm builds belonging.

3. Aim for one genuine connection per day.
A real conversation. A phone call. Eye contact with someone at the café. These micro-moments of presence stimulate oxytocin, the hormone of trust and safety.

4. Seek professional or peer support when needed.
Therapy, support groups, and telehealth check-ins are valid medical interventions. For LGBTQ+ adults, spaces like the Pride Center at Equality Park, SAGE, or peer HIV navigator programs offer structured ways to reconnect.

5. Reframe loneliness as biology — not failure.
Feeling lonely doesn’t mean you’re broken; it means your system is sending a survival signal. You are wired to belong.

Connection Is Medicine

Loneliness isn’t cured by willpower — it’s healed through relationship.

When you reconnect — with people, purpose, and community — you shift your body back into balance. Your hormones, immune system, and heart all respond.

So as you think about your own health this week, ask yourself:
Who will I reach out to — not out of obligation, but out of care?

Because connection is medicine. And every meaningful interaction is a dose that helps you live longer, stronger, and more fully alive.

Local Resources:

• The Pride Center at Equality Park — social and support groups for all ages and identities

• SAGE South Florida — community and programs for LGBTQ+ older adults

• NAMI Broward County — mental health support groups

• Torre Prime Longevity — integrative care focused on longevity, vitality, connection, and purpose

Dr. Gabe Felsen
Men’s Longevity and Vitality Physician
Torre Prime — Start Strong, Rise Higher.