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International Journal of Endocrinology
Volume 2014 (2014), Article ID 878670, 15 pages
http://dx.doi.org/10.1155/2014/878670
Review Article

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

1Elderly Health Care, ASP Catanzaro, Via Spasari, 3, 88100 Catanzaro, Italy
2Geriatrician AUSL Modena, 41120 Modena, Italy
3Department of Medical Pathophysiology, “Sapienza” University of Rome, 00198 Rome, Italy
4Department of Science of Health, School of Medicine, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
5Psychiatry Unit, “Mater Domini” University Hospital, 88100 Catanzaro, Italy

Received 17 November 2013; Revised 6 January 2014; Accepted 7 January 2014; Published 17 March 2014

Academic Editor: Antonio Aversa

Copyright © 2014 Pietro Gareri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.