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Medical management of erectile dysfunction in ageing males: Is it too late to treat?
August 20, 2019 | Health | By Lisa Smith
You must have heard about Erectile Dysfunction (ED) and in this article, we will be clearing all your doubts regarding Erectile dysfunction (ED) in ageing males. In addition, you will also be getting all the important information about the possible treatments of ED.
Why Erectile Dysfunction occurs in Ageing Males
Actually, ED is a type of health complication which mostly targets older age groups. The main risk factors of ED are diabetes, heart diseases, dyslipidemia, hypertension, etc. As these diseases are very common among elderly people hence ED becomes a more obvious problem in them.
When you are unable to get a penile erection in order to perform a successful sexual intercourse, the condition is known as Erectile Dysfunction (ED). According to reports of Massachusetts Male Aging Study, people who lie in the age group of 40-49 are less prone (1.2% per year) to get ED than those lying in the age group of 60+ (4.6%).
People in the older age group often suffer from heart diseases, diabetes, neuroendocrine and other such disease and these lay a major impact on Erectile Dysfunction (ED), hence elder people are more prone to get ED.
Not only these diseases but also pelvic surgery can be a reason for ED. In simple words, as you get older, the risk of ED increases. However, the best thing is it is never too late to get the effective treatment of ED problems. Let us have a look on the possible medical management of erectile dysfunction in ageing males-
What are the Possible Treatment Strategies of Erectile Dysfunction after 50?
Major treatment strategies of ED in elderly people revolve around two strategies- Non-Pharmacological treatment & Pharmacological procedures.
Non-Pharmacological Treatment
Lifestyle changes and counseling procedures lie in the category of Non-Pharmacological treatments. One of the major steps that the elderly should take in order to treat ED is to change their lifestyle. They need to cut off from harmful activities like alcohol consumption, smoking, etc. Physical exercises must be included in your daily routine and you should focus on a balanced diet. These lifestyle changes will not only help you in treating ED but also benefit you for other cardiovascular diseases.
Life Style Changes
The main cause of ED is sedentary life, obesity and harmful activities like alcohol consumption and smoking. Not only elderly but also people of other age groups should understand the essence of physical exercise, balanced diet, weight loss and quitting smoking and drinking.
These activities will help you to cure ED as well as your vascular diseases. Weight loss will boost the growth of both bound and unbound testosterone levels.
Bariatric surgery and low-calorie diet promote the growth of plasma sex hormone-binding globulin as well as bound and unbound testosterone. Bariatric surgery has been proven to be more helpful than low-caloric diet as Testosterone increase by 8.73 % with bariatric surgery in compared to 2.87 % by low-caloric diet. Decent level of sex hormones and weight loss are the two benefits of surgery in morbid obesity. People who lose more weight experience a rise in androgen levels.
Pharmacotherapy has been proven to be helpful for ED patients and improve sexual functions.
Hypercholesterolemia and addition of a Statin have been beneficial for the treatment of erectile function in ageing males.
Medical Changes
1. Phosphodiesterase type 5 (PDE5Is) drug has been proven to be helpful in ED and these are often prescribed to elderly patients. The person suffering from cardiovascular diseases found these drugs to be safe for them.
- PDE5Is drugs were found to be effective on cardiovascular systems also. People suffering from ED as well as Cardiovascular diseases found these drugs to reduce the risk of cardiac events.
- If the person has a high risk of cardiovascular diseases or if he/she is under nitrate treatment, prescription of PDE5Is should be avoided otherwise clinicians must prescribe these drugs to ED patients.
2. Testosterone replacement therapy can also be adopted if there is testosterone deficiency. This therapy has been proven to be helpful for ED patients as it puts an effect on insulin resistance which has been helpful for patients suffering from ED. Myocardial infarction, as well as stroke risks, were reduced after testosterone replacement therapy in ED patients.
- Studies have also reported that testosterone replacement therapy increased the rate of vascular events as the red cell production increased and hematocrit levels went up whereas other reputed studies proved that there is no such effect of testosterone replacement therapy.
- Certain alteration in prostate histology can be observed due to testosterone replacement therapy. You might be worrying about the risk of prostate cancer due to testosterone replacement therapy but studies have shown that there is no negative effect of testosterone replacement on prostrate because receptors of androgen are saturated. Hence one can prefer testosterone replacement therapy in order to treat ED in elderly men.
3. There are a number of medications that have been found to worsening the condition of ED, these medications include diuretics among which major one is thiazides. Central antihypertensives have been found to be harmful to ED. 1.7-6.4% loss in ED was found when patients were put under the Tricyclic antidepressants. They were also found to be helpful in case of premature ejaculation.
4. Around 350 patients, who were under the medication of selective serotonin reuptake inhibitors, paroxetine, experienced delayed ejaculation or orgasm than fluvoxamine and fluoxetine. Approximately 86 patients experienced improvement in their sexual dysfunction whereas 12 patients found a delayed orgasm which eventually increased their sexual satisfaction.
5. There are a number of drugs like Alcohol, amphetamines, marijuana, etc are the major causes of ED and also worsen the situation hence these should be avoided. A list of such drugs is as follows:
- abused drugs (amphetamines, opiates, cocaine, marijuana, nicotine, and heroin)
- alcohol
- antiarrhythmics
- antidepressants (tricyclics, SSRI, and MAO-inhibitors)
- antihistamines (dimenhydrinate, diphenhydramine, and promethazine)
- antipsychotics: butyrophenones (haloperidol) and phenothiazines (promazine)
- barbiturates
- benzodiazepines
- blockers (dose-dependent; propranolol, atenolol, and carvedilol in decreasing order; nebivolol seems to have beneficial effects)
- central antihypertensives
- 5-reductase inhibitors
- digoxin
- diuretics (thiazide diuretics);(xiv)drugs for Parkinson’s disease
- fibrates (clofibrate, gemfibrozil)
- H2-blockers (cimetidine, ranitidine)
- Lithium
- Muscle relaxers
- Nonsteroidal anti-inflammatory drugs
Wrap Up!
Doctors found out a number of treatment options for ED after thorough consultation with the patients about their health condition, age, and other essentials.
Since patients normally intake nitrates hence PDE-5 and MUSE intake was prohibited.
Papaverine, PGE1 was found to increase the risks such as fibrosis, hence were avoided.
Vacuum device showed positive results after a few days of unhappy experience. They were used to it and achieved positive results as well.
From psychological to medical treatments, Erectile Dysfunction in ageing males can be effectively managed and you just need to take the right courses of actions to enjoy healthy and satisfying sex life.
