Male sexuality with advancing age

People aged 60 years or older are commonly given the image of grandparents who are sexually rather inactive. However, a high percentage of men over 60 years have sexual desires and are sexually active. Aging men need more time and more direct stimulation of the penis to achieve full erection. The risk of developing erectile dysfunction increases with age. Almost one man in 22 aged 60-69 years without previous erection problems develops erectile dysfunction within 1 year. Hormone replacement therapy is only indicated if testosterone deficiency is combined with the syndrome of the "aging male" and lack of other disorders that are possibly causative and could be treated. For hormone replacement therapy testosterone gel preparations are preferable because they have a short half-time and can be immediately discontinued in the event that a pre-existing occult prostate carcinoma is stimulated.