Abstract and Introduction
Abstract
Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options.
Introduction
Advances in health care are allowing individuals to live longer, healthier lives. However, longer lifespans create new health-related issues and problems that must be addressed. Older adults increasingly focus on quality of life concerns. Sexuality is a significant qualityof-life consideration for all individuals, older adults included (Hyde et al., 2012). Research reveals that sexual desire does not necessarily decline with age and that continued sexual activity in older adults can convey additional health benefits (Gledhill & Schweitzer, 2013). While sexual activity can have positive outcomes on general health, sexual dysfunction can have negative effects on mood and emotional state (Corona, Rastrelli, Maseroli, Forti, & Maggi, 2013).
Erectile dysfunction (ED) is defined by the National Institutes of Health (NIH) Consensus Development Conference on Impotence as "the inability to achieve or maintain an erection sufficient for satisfactory sexual performance" ("Impotence," 1992). ED is projected to affect 322 million men worldwide by the year 2025 (Alberson, Orabi, & Lue, 2012). In a recent study of ED prevalence and management, 77% of men over 70 years of age reported ED compared with 61% of men 40 to 69 years of age. There was a linear correlation of ED with age, with older men reporting more severe symptoms than younger men. More than half of the men had not discussed their ED with their health care provider, and 72% had never received any type of treatment (Wagle, Carrejo, & Tan, 2012).