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Erectile Dysfunction May Be a Normal Consequence of Aging
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By Will Boggs, MD
NEW YORK (Reuters Health) Aug 04 - Erectile dysfunction, but not urinary or bowel dysfunction, may be a feature of normal aging in men, according to a report in the July issue of Urology.
"I had expected that the association between urological function and age would be stronger," Dr. Ida J. Korfage from Erasmus MC, University Medical Center Rotterdam, The Netherlands told Reuters Health.
Using data from more than 3,800 participants in the European Randomized Study on Screening for Prostate Cancer, Dr. Korfage and colleagues assessed whether urinary, bowel, and sexual dysfunction "and the associated bother" were part of the "normal" aging process, and if so, then to what extent?
The men - all of whom were cancer-free -- were divided into five roughly equivalent-sized groups by age: 58-61, 62-64, 65-67, 68-70, and 71 years and older.
According to the investigators, older men had a significantly higher prevalence of erectile dysfunction, with more older men reporting either that they were sexually active but having problems with erections, or sexually inactive because of erectile problems.
Although urinary function was poorer and more bothersome in older age groups, the between-age group differences did not exceed the minimal important difference, defined as "the smallest change in a patient-reported outcome that is perceived by patients as beneficial or that would result in a change of treatment."
Bowel problems were uncommon, with no significant differences among age groups, the report indicates.
These findings in their cancer-free subjects lead the investigators to conclude that in patients treated for localized prostate cancer, "decreasing urinary or bowel function is thus not attributable to age, but may well be related to prior treatment."
The researchers caution that decreasing erectile dysfunction "may be attributable to other causes as well."
Dr. Korfage added, "I like to stress that sexual inactivity is not necessarily the same as erectile dysfunction. Reasons for not being sexually active can also be not being interested (anymore) or not having a partner. Not everybody who is sexually inactive is in need of medication."
Urology 2008;72:3-9.
