Should we tailor the clinical management of erectile dysfunction according to different ages?
Abstract
INTRODUCTION: The impact of erectile dysfunction (ED) on patients' sexual satisfaction and mood profile could differ across different ages. AIM: To investigate the relationship between erectile function (EF), sexual satisfaction, and mood status among patients seeking medical help for ED. METHODS: Data from 765 patients presenting at a single center for ED were analyzed. Patients were categorized as young (≤50 years), middle-aged (>50 and ≤65 years), and old (>65 years) individuals and completed the International Index of Erectile Function (IIEF) and the Beck's Inventory for Depression (BDI). MAIN OUTCOME MEASURES: The IIEF overall satisfaction and intercourse satisfaction domain scores and the BDI score were used to investigate sexual life satisfaction and depressive symptoms (defined as BDI > 11) across ages and according to ED severity. Linear and logistic regression analyses assessed the relationship between satisfaction scores and the risk of depressive symptoms with age and EF. RESULTS: Median (interquartile range) age at first assessment for ED was 50 (38, 59) years. Compared with older men, young and middle-aged patients showed significantly higher IIEF-OS and IIEF- Intercourse Satisfaction scores for increasing IIEF-EF scores. Older men showed no difference in terms of satisfaction scores for mild ED and normal EF status. At linear regression analysis, both IIEF-EF and age were significantly associated with sexual satisfaction (all P < .0001). The interaction term between age and EF was also significant, suggesting that the older the patients, the higher the feeling of sexual satisfaction for the same EF status (P = .004). Overall, 25% of patients reported depressive symptoms. Logistic regression analysis showed a 40% risk of depressive symptoms for patients <45 years with severe ED compared to a risk <20% for a man >65 years of age with the same EF status. CLINICAL IMPLICATIONS: Treating older patients with mild ED may not lead to a further improvement in sexual satisfaction as compared with younger patients with the same ED severity. Younger ED patients suffer more from depressive symptoms compared with older men, regardless of ED severity, thus supporting the need for a comprehensive psychological counseling. STRENGTH & LIMITATIONS: The single-center design and the lack of the assessment of the impact of ED treatment are the main limits. CONCLUSIONS: The clinical management of ED should be tailored according to different ages: younger patients deserve to be investigated and eventually treated for depressive symptoms. Older patients should be counseled for treatment when a sexual satisfaction improvement is expected. Capogrosso P, Ventimiglia E, Boeri L, et al. Should We Tailor the Clinical Management of Erectile Dysfunction According to Different Ages? J Sex Med 2019;16:999-1004.
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Men typically report less distress about changes in their sexual life as they grow older, but stigma around sexuality in later life may confuse them about the impact of the sexual problem on their well-being.
“Although men typically report less distress about changes in their sexual life as they grow older, stigma around sexuality in later life may confuse them about the impact of the sexual problem on their well-being.83,117,118”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [117]
Young men with ED report higher levels of distress and less satisfaction.
“Because young men with ED report higher levels of distress and less satisfaction, they have a special need for psychological treatment.116,117”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [117]
Older men are more likely to accept their ED as a normal part of aging, which might be a barrier to seeking help.
“Older men, on the other hand, are more likely to accept their ED as a normal part of aging, which might be a barrier to seeking help.”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [117]
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Changes in Behavior and Psychology in Diabetes: Interlinking Erectile Dysfunction
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- Authors
- Capogrosso, P., Ventimiglia, E., Boeri, L., Pozzi, E., Chierigo, F., Schifano, N., Abbate, C., Matloob, R., Montorsi, F., & Salonia, A.
- Affiliations
- Vita-Salute San Raffaele University (IT)
- IRCCS Ospedale San Raffaele (IT)
- Corresponding author
- Salonia, Andrea
- ORCID
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-04-30
- Volume
- 16
- Issue
- 7
- Pages
- 999-1004
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W2943164686
- Cited by
- 21
- References
- 22
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- erectile dysfunction, age differences, sexual satisfaction, depressive symptoms, erectile function, International Index of Erectile Function, Beck Depression Inventory, psychological counseling, ED severity, older men, young men, tailored treatment
- MeSH terms
- Adult, Aged, Coitus, Humans, Erectile Dysfunction, Male, Middle Aged, Orgasm, Penile Erection, Surveys and Questionnaires, Sexual Behavior
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