Impotence in elderly men

Impotence in not a concomitant of aging. A diligent search must be undertaken to determine the cause, which may be endocrine, pharmacologic, vascular, neurologic, psychological, or miscellaneous (eg, chronic illness). Many therapies are available for elderly impotent men. Some are based on pharmacology (eg, testosterone supplementation, thyroid replacement, self-injection), some on surgery (eg, vascular reconstruction), and some on a prosthesis (semirigid, inflatable, or mechanical). In choosing the type of treatment, the physician must consider the patient's underlying medical condition, activities of daily living, social life, and partner's expectations in addition to the cause of the impotence.