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Updated: Jun 17, 2026

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

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Published on: April 27, 2016

Endothelial dysfunction and erectile dysfunction in the aging man.

Antonio Aversa¹, Roberto Bruzziches, Davide Francomano

¹Department of Medical Pathophysiology, Sapienza University of Rome, Rome, Italy. antonio.aversa@uniroma1.it

International Journal of Urology : Official Journal of the Japanese Urological Association

|December 17, 2009

Summary

This summary is machine-generated.

Erectile dysfunction (ED) in aging men is linked to endothelial dysfunction and reduced nitric oxide (NO) production. Testosterone levels and phosphodiesterase type 5 inhibitors may offer new treatment strategies for ED and cardiovascular health.

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Published on: June 3, 2019

Area of Science:

Cardiovascular Medicine
Sexual Medicine
Aging Research

Background:

Endothelial dysfunction, an early sign of atherosclerosis, is closely linked to erectile dysfunction (ED).
Reduced nitric oxide (NO) bioavailability due to decreased endothelial NO synthase (eNOS) activity contributes to both conditions, particularly with aging.
ED is increasingly recognized as a symptom of underlying systemic disease, necessitating a multidisciplinary approach involving various medical specialists.

Purpose of the Study:

To review the pathophysiology of endothelial dysfunction and its relationship with ED in aging men.
To explore the impact of aging on arterial structure and function, including steroid level decline.
To discuss potential therapeutic strategies for improving arterial function and managing sexual dysfunction.

Main Methods:

Literature review focusing on the interplay between endothelial function, aging, and erectile dysfunction.
Analysis of the role of nitric oxide (NO) and phosphodiesterase type 5 (PDE5) in penile erection.
Examination of the influence of hormonal changes, such as testosterone decline, on erectile function and treatment efficacy.

Main Results:

Aging is associated with endothelial dysfunction, decreased NO production, and arterial changes, contributing to ED.
Testosterone influences penile PDE5 isoenzyme expression, suggesting a role in ED pathogenesis and treatment.
Chronic phosphodiesterase type 5 inhibitor (PDE5i) administration may enhance erectile and endothelial responsiveness, even in non-responsive patients.

Conclusions:

ED in aging men is often a manifestation of underlying endothelial dysfunction and systemic vascular disease.
Testosterone modulation and PDE5 inhibitors represent promising avenues for managing ED, particularly in men with comorbidities.
Improving endothelial function is crucial for addressing ED and potentially mitigating cardiovascular risk in aging men.