My greatgrandmther got pregnant at age 50 in the 1920s, had a healthy baby boy at age 51. So I have always been happy that my husband is fixed.
My GYN gave me testosterone cream for libido and offered estrogen cream for dryness and increased UTI. The estrogen thickens the skin of the vagina and keeps it more moist and less susceptible to tearing and infection. You use it every day for a week or two, then once a week forever.
Pretty easy. My husband is lots happier and I am too.