Sexuality is an important component of emotional and physical intimacy that men and women experience through their lives. Male erectile dysfunction (ED) and female sexual dysfunction increase with age. About a third of the elderly population has at least one complaint with their sexual function. However, about 60% of the elderly population expresses their interest for maintaining sexual activity. Although aging and functional decline may affect sexual function, when sexual dysfunction is diagnosed, physicians should rule out disease or side effects of medications. Common disorders related to sexual dysfunction include cardiovascular disease, diabetes, lower urinary tract symptoms and depression. Early control of cardiovascular risk factors may improve endothelial function and reduce the occurrence of ED. Treating those disorders or modifying lifestyle-related risk factors (eg obesity) may help prevent sexual dysfunction in the elderly. Sexuality is important for older adults, but interest in discussing aspects of sexual life is variable. Physicians should give their patient's opportunity to voice their concerns with sexual function and offer them alternatives for evaluation and treatment.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Rent or buy this article
Get just this article for as long as you need it
Prices may be subject to local taxes which are calculated during checkout
Mulligan T, Reddy S, Gulur PV, Godschalk M . Disorders of male sexual function. Clin Geriatr Med 2003; 19: 473–481.
Marandola P et al. Love and sexuality in aging. Aging Male 2002; 5: 103–113.
Gott M, Hinchliff S . How important is sex in later life. The views of older people. Soc Sci Med 2003; 56: 1617–1628.
Matthias RE et al. Sexual activity and satisfaction among very old adults: results from a community-dwelling Medicare population survey. Gerontologist 1997; 37: 6–14.
Jung A, Wolf-Berhard S . Male sexuality with advancing age. Eur J Obstet Gynecol Reprod Biol 2004; 113: 123–125.
Master WH, Johnson VE . Sex and the aging process. J Am Geriatr Soc 1981; 29: 385–390.
Nicolosi A et al. GSSAB Investigators' Group. Sexual behaviour and dysfunction and help-seeking patterns in adults aged 40–80 years in the urban population of Asian countries. BJU Int 2005; 95: 609–614.
Shiri R et al. Prevalence and severity of erectile dysfunction in 50 to 75 year old Finnish men. J Urol 2003; 170: 2342–2344.
Laumann EO et al. GSSAB Investigators' Group. Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005; 17: 39–57.
Rosen R et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the ageing male (MSAM-7). Eur Urol 2003; 44: 637–639.
Eardley I et al. Efficacy and safety of tadalafil in a Western European population of men with erectile dysfunction. BJU Int 2004; 94: 871–877.
Prins J et al. Prevalence of erectile dysfunction: a systematic review of population based studies. Int J Impot Res 2002; 14: 422–432.
Feldman HA et al. Impotence and its medical and psychosocial correlates: result of the Massachusetts male aging study. J Urol 1994; 151: 54–61.
Eardley I et al. The sexual habits of British men and women over 40 years old. BJU Int 2004; 93: 563–567.
Rosen RC . Reproductive health problems in ageing men. Lancet 2005; 366: 183–185.
Nicolosi A et al. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology 2004; 64: 991–997.
Salonia A et al. Women's sexual dysfunction: a pathophysiological review. BJU Int 2004; 93: 1156–1164.
Laumann EO, Paik A, Rosen RC . Sexual dysfunction in the United States. Prevalence and predictors. JAMA 1999; 281: 537–544.
Billups KL et al. Erectile dysfunction is a marker of cardiovascular disease: results of the minority health institute expert advisory panel. J Sex Med 2005; 2: 40–52.
Morley JE, Tariq SH . Sexuality and disease. Clin Geriatr Med 2003; 19: 563–573.
Solomon H, Man J, Jackson G . Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 2003; 89: 251–253.
Kaiser DR et al. Impaired brachial artery endothelium dependent and independent vasodilatation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004; 43: 179–184.
Billups KL et al. Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res 2003; 4: 231–236.
Fung MM, Bettencout R, Barret-Connor E . Heart disease risk factors predict erectile dysfunction 25 years later: the Rancho Bernardo study. J Am Coll Cardiol 2004; 43: 1405–1411.
Esposito K, Giugliano D . Obesity, the metabolic syndrome, and sexual dysfunction. Int J Impot Res 2005; 17: 391–398.
Tan RS, Pu SJ . Impact of obesity on hypogonadism in the andropause. Int J Androl 2002; 25: 195–201.
Esposito K et al. Effect of life style changes on erectile dysfunction in obese men. A randomized controlled trial. JAMA 2004; 291: 2978–2984.
Ponholzer A et al. Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol 2005; 47: 80–86.
Foresta C et al. Erectile dysfunction: symptom or disease? J Endocrinol Invest 2004; 27: 80–95.
Kloner RA . Assessment of cardiovascular risk in patients with erectile dysfunction: focus on the diabetic patient. Endocrine 2004; 23: 125–129.
Doruk H et al. Effect of diabetes mellitus on female sexual function and risk factors. Arch Androl 2005; 51: 1–6.
Nikoobakht M, Nasseh H, Pourkasmaee M . The relationship between lipid profile and erectile dysfunction. Int J Impot Res 2005; 17: 523–536.
Blumentals WA, Gomez-Caminero A, Joo S, Vannappagari V . Should erectile dysfunction be considered as a marker for acute myocardial infarction? Results from a retrospective cohort study. Int J Impot Res 2004; 16: 350–353.
Currey HLF . Osteoarthritis of hip joint and sexual activity. Ann Rheum Dis 1970; 29: 488–493.
Zeiss ERA, Delmonico RL, Zeiss AM, Dornbrand L . Psychological disorder and sexual dysfunction in elders. Clin Geriatr Med 1991; 1: 133–151.
Hansen BL . Lower urinary tract symptoms (LUTS) and sexual function in both sexes. Eur Urol 2004; 46: 229–234.
Gregorian RS et al. Antidepressant-induced sexual dysfunction. Ann Pharmacother 2002; 10: 1577–1589.
Montejo AL, Llorca G, Izquierdo JA, Villademoros F . Incidence of sexual dysfunction associated with antidepressants agents: a prospective multicenter study of 1022 outpatients. J Clin Psychiatry 2001; 62: 10–21.
Damis M, Patel Y, Simpson GM . Sildenafil in the treatment of SSRI-induced sexual dysfunction: a pilot study. Primary care companion. J Clin Psychiatry 1999; 6: 184–187.
Jensen J et al. The prevalence and etiology of impotence in 101 male hypertensive outpatients. Am J Hypertens 1999; 12: 271–275.
Franzen D et al. Effects of beta-blockers on sexual performance in men with coronary heart disease: a prospective, randomized and double blind study. Int J Impot Res 2001; 13: 348–351.
Steiner SS et al. Antihypertensive therapy and quality of life: a comparison of atenolol, captopril, enalapril and propranolol. J Hum Hypertens 1990; 4: 217–225.
Rizvi K, Hampson JP, Harvey JN . Do lipid lowering drugs cause erectile dysfunction? A systematic review. Fam Pract 2002; 19: 95–98.
Johannes CB et al. Incidence of erectile dysfunction in men 40–69 years old: longitudinal results from the Massachusetts male aging study. J Urol 2000; 163: 460–463.
Barret-Connor E . Cardiovascular risk stratification and cardiovascular risk factors associated with erectile dysfunction: assessing cardiovascular risk in men with erectile dysfunction. Clin Cardiol 2004; 4 (Suppl 1): I8–I13.
Wald M et al. Computational models for detection of erectile dysfunction. J Urol 2005; 173: 167–170.
Morley JE et al. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Metabolism 1997; 46: 410–413.
Feldman HA et al. Age trends in the level of serum testosterone and other hormones in middle age men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab 2002; 87: 589–598.
Mulligan T et al. Amplified nocturnal luteinizing-hormone (LH) secretory burst frequency with selective attenuation of pulsatile (but not basal) testosterone secretion in healthy aged men- possible Leydig-cell desensitation to endogenous LH signaling—a clinial research center study. J Clin Endocrinol Metab 1995; 80: 3025–3031.
Veldhuis JD, Swart A, Mulligan T, Iramanesh A . Muting of androgen negative feedback unveils impoverished gonadotropin-releasing hormone/luteinizing hormone secretory reactivity in healthy older men. J Clin Endocrinol Metab 2001; 86: 529–535.
MacFarlane GJ et al. The relationship between sexual life and urinary condition in the French community. J Clin Epidemiol 1996; 49: 1171–1176.
Blanker MH et al. Correlates of erectile and ejaculatory function in older Dutch men: a community-based study. J Am Geriatr Soc 2001; 49: 436–442.
Kirby RS, O'Learly MP, Carson C . efficacy of extended-release doxazosin and doxazosin standard in patients with concomitant benign prostatic hyperplasia and sexual dysfunction. BJU Int 2005; 95: 103–109.
Dahn J et al. Sexual functioning and quality of life after prostate cancer treatment: considering sexual desire. Urology 2004; 63: 273–277.
Derby CA et al. Measurement of erectile dysfunction in population-based studies: the use of a single question self-assessment in the Massachusetts male aging study. Int J Urol 2000; 12: 197–204.
Rosen RC . Evaluation of the patient with erectile dysfunction: history, questionnaires, and physical examination. Endocrine 2004; 23: 107–111.
Capelleri JC, Rosen RC . The sexual health inventory for men (SHIM): a 5-year review of research and clinical experience. Int J Impot Res 2005; 17: 307–319.
Torrance GW et al. Development and initial validation of a new preference-based disease-specific health-related quality of life instrument for erectile dysfunction. Qual Life Res 2004; 13: 349–359.
Heineman LA, Saad F, Heineman K, Thai DM . Can results of the aging males's symptoms (AMS) scale predict those of screening scales for androgen deficiency? Aging male 2004; 7: 211–218.
Moynihan R . The making of a disease: female sexual dysfunction. BMJ 2003; 326: 45–47.
Basson R et al. Report of the International Consensus Development Conference on Female Sexual Dysfunction: definitions and classifications. J Urol 2000; 163: 888–893.
Seagraves RT . Female sexual disorders: psychiatric aspects. Can J Psychiatry 2002; 5: 419–425.
Nusbaum MRH, Singh AR, Pyles AA . Sexual healthcare needs of women aged 65 and older. J Am Geriatr Soc 2004; 52: 117–122.
Cayan S, Bozlu M, Canpolat B, Akbay E . The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual function? J Sex Marital Ther 2004; 30: 333–341.
Ichikawa T et al. The female partner's satisfaction with sildenafil citrate treatment of erectile dysfunction. Int J Urol 2004; 11: 755–762.
Clayton AH . Female sexual dysfunction related to depression and antidepressant medications. Curr Womens Health Rep 2002; 3: 182–187.
Turna B et al. Women with low libido: correlation of decreased androgen levels with female sexual function index. Int J Urol 2005; 2: 148–153.
Rights and permissions
About this article
Cite this article
Camacho, M., Reyes-Ortiz, C. Sexual dysfunction in the elderly: age or disease?. Int J Impot Res 17 (Suppl 1), S52–S56 (2005). https://doi.org/10.1038/sj.ijir.3901429
- sexual dysfunction
This article is cited by
What Distresses Sexual Well-Being Among Older Adults in Different Cultures? A Qualitative Study with Slovenian and Portuguese Older Adults
Sexuality Research and Social Policy (2023)
Drug-Induced Sexual Dysfunction: An Analysis of Reports to a National Pharmacovigilance Database
Drug Safety (2022)
The Effect of Dyspnea and Fatigue on Sexual Life and Marital Satisfaction in Individuals With Chronic Obstructive Pulmonary Disease
Sexuality and Disability (2022)
High heels enhance perceived sexual attractiveness, leg length and women’s mate-guarding
Current Psychology (2022)