Erectile Dysfunction in the Elderly: An Old Widespread Issue with Novel Treatment Perspectives

Abstract

Erectile dysfunction (ED) is one of the most common chronic diseases affecting men and its prevalence increases with aging. It is also the most frequently diagnosed sexual dysfunction in the older male population. A number of different diseases potentially worsening sexual function may occur in elderly people, together with polypharmacy. Related causes of ED are variable and can include arterial, neurogenic, hormonal, cavernosal, iatrogenic, and psychogenic causes. The aim of the present review was to examine the main aspects of erectile dysfunction going through epidemiology and pathophysiology and revise most of ED in elderly disabled men and in those affected with psychiatric disorders. Lastly we tried to focus on the main aspects of nonpharmacological and pharmacological treatments of ED and the recreational use in the elderly. Phosphodiesterase-5 inhibitors (PDE5-I) are commonly used for on-demand or chronic treatment of ED. It is widely known that PDE5-I have lower response rates in older men than in younger patients, but they have the advantages of ease of use and excellent safety profile, also in the elderly. The old and new PDE5-I as well as the alternative treatments for ED are extensively discussed.

The Old Made New: Natural Compounds against Erectile Dysfunction

“…On a general basis, proved risk factors comprehend hypertension, diabetes mellitus, hyperlipidemia, smoking, and aging in general [20]. The treatment of the risk factors themselves could turn out in a better condition of the patient.…”

“…In general, among nonpharmacological treatments counseling, life style changes (weight loss, increased physical exercise, quitting smoking), and medication changes, as long as some drugs are reported to interfere negatively with sexual function, are described [20]. Concerning, on the other hand, pharmacological treatments, it has to be stressed that current oral drugs used in the ED therapy do not "cure" this condition but provide a general improvement for what concerns symptoms [20]. The main so-called pharmacological treatments comprehend PDE5-I, yohimbine, prostaglandin E1 (PGE1), and papaverin.…”

Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer

“…Additional factors that play a role include patient age 1 and degree of ED before starting cancer treatment. 2 In this article, we discuss how chemotherapy, hormone therapy, surgery, and radiation affect erectile function as well as possible treatment options for ED.…”

Validated Spectrophotometric Method to Determine Vardenafil and Sildenafil in Pharmaceutical Forms Using Potassium Iodide and Potassium Iodate

“…Treatment of erectile dysfunction is based on phosphodiesterase type 5 (PDE-5) inhibitors including sildenafil (SIL), and vardenafil (VAR). PDE-5 inhibitors have high efficacy and safety rates, even in difficult-to-treat populations such as patients with diabetes mellitus [1]. Sildenafil citrate was the first drug approved for the treatment of ED in 1998.…”

“…There are several studies in medical literature reporting the determination of sildenafil citrate in pharmaceuticals, plasma samples, herbal drugs or dietary supplements using liquid chromatography method [1][2][3][4][5][6][7], electroanalytical methods [8,9]gas chromatography [10], Thin layer chromatography [11], capillary electrophoresis [12] and capillary chromatography [13][14][15]. Many spectrophotometric Methods have also been reported [16][17][18][19][20][21][22].…”