Factors in impotence

Townsend Letter for Doctors and Patients,  Dec, 2004  by Robert A. Anderson

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The Massachusetts Male Aging Study found a 52% incidence of mild, moderate and complete impotence in 1,290 men age 40-70. At age 70, only 30% of men were not impotent. Age was the strongest associated factor with impotence (p<.0001). Compared to a 10% incidence of the sample as a whole, depression was associated with a 59% incidence, anger with a 35% incidence and drug categories as follows: 26% hypoglycemics; 14% antihypertensives; 36% vasodilators; 28% cardiac drugs. The data was gathered from a self-administered sexual activity questionnaire, psychological and physiological indices, socio-demographic variables, blood samples and information on health status. The prevalence of complete impotence tripled from age 40 to 70. After adjustment for age, impotence was still correlated with heart disease, hypertension, diabetes, associated medications, and indices of anger and depression. Inverse correlations were found with an index of dominant personality, high-density lipoprotein cholesterol and serum dehydroepiandrosterone.

Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994 Jan; 151(11):54-61

COMMENT: The incidence of impotence with aging is extremely high. There is less data about the incidence of impotence in aging men who consider it a problem. My personal experience with hundreds of aging men would indicate that a fair portion of them, with concurrence of their partners, do not consider the partial decline or complete absence of sexual potency a significant problem. In order to recognize those for whom it is a problem, one must inquire. And numerous studies indicate that this is a topic about which there is considerable discomfort on the part of many practitioners. Then, in situations where the issue assumes importance, the pharmaceutical, hormonal, psychological and disease factors deserve a multiple-pronged (pun probably not intended) approach in therapy.

COPYRIGHT 2004 The Townsend Letter Group
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