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Erectile failure in the aged: evaluation and treatment
1Medical College of Virginia, Richmond.
Journal of the American Geriatrics Society
|January 1, 1988
Summary
Aging men often experience erectile dysfunction, leading to a "libido-potency gap." Effective evaluation and diverse treatments are available for age-related sexual health concerns.
Area of Science:
- Gerontology
- Urology
- Sexual Medicine
Background:
- Aging is associated with significant changes in male libido and erectile function.
- A notable "libido-potency gap" exists, with most aged men interested in sex but few maintaining regular intercourse, primarily due to erectile failure.
- Penile erection involves complex autonomic, cardiovascular, and neurotransmitter interactions, all susceptible to age-related decline.
Purpose of the Study:
- To explore the causes of erectile dysfunction in aging men.
- To outline the diagnostic evaluations for impotence in the elderly.
- To present the range of available treatment options for age-related erectile dysfunction.
Main Methods:
- Review of physiological changes affecting erectile function with aging, including gonadal steroid decline, reduced nerve conduction velocity, and decreased vascular compliance.
- Discussion of how superimposed diseases further impair erectile function in older men.
- Description of diagnostic approaches including drug history, hormonal assays, penile vascular and neurologic assessments, and nocturnal erectile function evaluation.
Main Results:
- Aging-related physiological declines can interfere with normal erections.
- Co-existing medical conditions exacerbate erectile dysfunction in elderly males.
- Comprehensive evaluation allows for tailored treatment selection.
Conclusions:
- Erectile dysfunction in aging men is multifactorial, influenced by physiological changes and comorbidities.
- A systematic evaluation is crucial for identifying the underlying causes of impotence.
- A variety of noninvasive and invasive treatment options are available, enabling personalized management based on etiology, associated disorders, and patient preference.