Sexual Dysfunction in Elderly Men

The clinical studies of sildenafil for the ageing male

Erectile dysfunction (ED) represents an important quality-of-life issue for many ageing men. Low serum testosterone level and other factors may be involved. Sildenafil is effective and well tolerated in patients with ED of various aetiologies, showing an efficacy of about 75%. However, few efficacy and adverse effect studies have focused specially on ageing men. In 150 patients below 65 years and 44 patients over 65 years, sildenafil was used to treat ED. Efficacy in the younger group (89.1%) was greater than in the older group (65.7%; p < 0.01). Mean serum luteinizing hormone (LH) and follicle-stimulating hormone concentrations (11.0 and 18.9 mIU/mL, respectively) in the older group were higher than in younger group (5.2 and 8.7 mIU/mL, respectively; p < 0.01). Serum testosterone and prolactin (PRL) were similar between groups. Older patients showed higher prevalence of diabetes mellitus, hypertension, and benign prostatic hyperplasia. Only diabetes appeared to decrease efficacy of sildenafil in older patients (p=0.019). A high prevalence of diabetes might be one of the many causes of lower efficacy rate of sildenafil in older men, although efficacy in patients even without diabetes in older men was relatively low. Sildenafil can be used safely and it is still effective for ageing male, because nearly two-thirds of our older subjects had a good response to the drug and no adverse effect was specific to older patients.

Older adults and sexuality: a multidimensional perspective

The purpose of this study was to describe the multidimensional nature of sexuality in men and women age 55 and older and compare these men and women on selected dimensions of sexuality. The community-based sample of 161 older adults (men = 69, women = 92) completed a 77-item, anonymous questionnaire. Gender differences were found for selected demographics, health and health-related variables, and selected aspects (sexual interest, participation, and satisfaction) of sexual activities. MANOVA yielded a significant multivariate F indicating men and women differed on the combination of seven dependent variables (self-esteem, intimacy, and sexual knowledge, attitudes, interest, participation, and satisfaction) while univariate Fs did not yield significant gender differences on each of the dependent variables. Study results described a multidimensional view of sexuality and aging which can be used to increase nurses' understanding of selected gender differences of older adults' sexuality.

Pathophysiology of erectile dysfunction

During the past decade, our knowledge of the hemodynamics, functional anatomy, neurophysiology, and neuropharmacology of erectile function has evolved substantially. The change of smooth muscle tone has emerged as a key factor in erection and detumescence. However, future studies are needed to elucidate the cellular and molecular basis of erectile physiology. With insight into normal physiology we will understand the pathologic process and be able to treat it.