Normal physiologic changes occur with age that affect male sexuality.
The etiology of these problems is often vascular but may be influenced
by medications, neurologic conditions, or endocrinopathies, and/or ia
trogenic factors. Penile sensitivity and erectile responses decline wi
th age, and patients may present with concerns about ejaculatory disor
ders and erectile dysfunction. Physicians need to know the pharmacolog
ic, surgical, and educational solutions. Treatment modalities for erec
tile dysfunction include vacuum erection, devices, intracavernosal or
intraurethral alprostadi injections, and penile implants.