Sexual function of the ageing male

Abstract

With the progressive increase in the proportion of older people, there is an increasing interest in characterizing the modifications of sexual health and the effect of its perturbations as a function of the aging process. The aim of this review is to summarize the available evidence regarding the age-dependent modifications of male sexual function and their interaction with general health and age-dependent modification of endocrine function. Elderly patients are often affected by multiple organic diseases which can interfere with sexual function. Despite this evidence, several studies have indicated that, with advancing age, normal erections are not an absolute prerequisite to remain sexually active. Good physical health, the availability of a partner, and a regular and stable pattern of sexual activity earlier in life predict the maintenance of sexual activity in old age. Conversely, there are no convincing data that hormonal changes, associated with aging, have a primary role in underlying changes in sexual function in healthy aging men. Nonetheless, sexual dysfunctions especially in elderly people are poor investigated. Asking about sexual health remains difficult or embarrassing for many primary care physicians. In addition, many patients find it difficult to raise sexual issues with their doctor. This situation often results in sexual issues not being adequately addressed thus resulting in depression, social withdrawal and delayed diagnosis of underlying medical conditions often resulting in forthcoming cardiovascular events. Education and permission from a health care professional may help to alter such misconceptions. Information from physicians regarding normal age-related changes in sexuality and encouragement, together with advice on how to continue meaningful sexual relations, may play a key role in altering such negative attitudes.

Keywords: aging; erectile dysfunction; hypoactive sexual desire; late onset hypogonadism; orgasmic difficulties; premature ejaculation.