Aspects of an ageing man’s lifestyle and behaviour and androgen deficiency, most often decreasing testosterone levels, may affect sexual function as well. Many factors can contribute to sexual dysfunction in older men, including physical and psychological conditions, comorbidities and the medications used to treat them. The myths that surround the problems of impotence or ED confound the attempts of patients to receive treatment and the attempts of physicians to help them. Thus, nearly all men who live long enough should develop ED. In the MMAS, they found that roughly 50% of men at 50 years old, 60% of men at 60 years old and 70% of men at 70 years old had ED. 1 The reality is that ED is a natural part of ageing and that the prevalence increases with age. The Massachusetts Male Aging Study (MMAS) found that 52% of men between 40 and 70 years old reported having some form of erectile dysfunction (ED). Some primary care physicians think that sexual potency in older men is the norm, and that if it is lacking, it is ‘all in the head.’ This viewpoint has not been supported by current literature. Nearly every primary care physician, internist and geriatrician now understand that many older men retain an interest in sexual activity as they age.
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