Aging and sexual function
Aging and sexual function in men
Aging is a natural phenomenon. However the rate of aging and its attendant sequelae vary greatly among different individuals. One of the various problems that are faced by aging men is sexual dysfunction, which is multidimensional as well as multifactorial in origin. The commonest sexual inadequacy experienced by aging men is erectile dysfunction (ED). ED is increasingly being used as a marker for underlying diseases. In a study of 980 men seeking medical help for ED, many of them were found to have undiagnosed Hypertension (18%), Diabetes (16%), BPH (15%), Ischemic heart disease (5%), Carcinoma prostate (4%), Depression (1%). As has been aptly said that the sexual function men changes from “Tri weekly” in young men to “Try weakly” as the age advances. Various etiological reasons can be sited for this shift of the sexual function as enumerated below.
Most of the erectile dysfunction encountered in aging males is organic in nature.
The Massachusetts Male Ageing Study found that after age adjustment, men with heart
disease, diabetes or hypertension are up to four times more likely to develop some
degree of ED compared with men who do not suffer from these disorders. It has been
estimated that 39% to 64% of male patients with cardiovascular disease suffer from
ED. As the age advances, arteriosclerosis sets in the vascular tree and atherosclerosis
and other vascular diseases further compound the situation. Any such disease involving
the vasculature from aorta to pudendal vessels can cause ED by restricting the blood
flow. It has been found that ED is not only more prevalent in patients with Hypertension
than in an age matched general population, it is also more severe in those with
hypertension than in general population. In men with hypertension, mild ED was found
in 7.75%, moderate ED in 15.4% and severe in 45.2%. It has been postulated that
the NO-cGMP mediated hemodynamic mechanism of erection and the NO-cGMP mediated
pathway of vasodilatation that play a vital role in blood pressure regulation are
impaired in both ED and Hypertension.