Is Age An Important Factor In Determining The Cause Of Impotence?

I am 81, have a triple bypass, have Chronic Obstructive Pulmonary Disease, and high blood pressure. My libido is active but that is all; I am unable to maintain an erection, and in fact have not had sex for about 15 years, possibly longer. Of late, I find myself becoming more interested in women and yet do not do anything about it for fear of being found wanting — with no possible erection.

I have thought of getting help from my urologist for inserts or anything else he might recommend. My internist was in favor of something being done, but the last time I suggested the idea to my urologist, he said to forget it. Shall I forget the idea? Is my age or anything else a problem to be considered? I would value your opinion on this matter.

With the modern treatments that are available to treat impotence, urologists and other experts interested in the condition believe that a man of any age can have an erection unless the arteries supplying the penis are too damaged by arteriosclerosis, or other disease.

Many men of your age do have sexual feelings, and want to act on them, but may be inhibited by fear of failure, previous inability to achieve an erection, lack of a consenting partner, and so on. You don’t mention whether you get erections at night, or are able to masturbate successfully. If either of these is true, then the apparatus is able to function, the blood supply to the penis is adequate, and the nerves supplying the penis are functioning.

You also didn’t mention the drugs that you are taking, and I would suggest that you start there with your internist by reviewing what you are on, and each drug’s tendency to interfere with potency. If none of your medications appear to be responsible, I agree with your internist that something more should be done. The recent availability of sildenafil (Viagra) has transformed the treatment of people like yourself. It is a pill, taken about one hour before expected intercourse. It cannot be taken by someone with heart disease taking nitrates (such as nitroglycerine). If you are able to take it, this would be my first choice.

If Viagra doesn’t help, then I suggest you push your urologist a bit, and if he doesn’t respond positively, ask your internist to help find one who will, or ask around among your friends about urologists who are interested in potency problems. If there is a medical school or teaching hospital near you, you should be able to find a urologist to work with by calling that department in the hospital.

The use of injections into the penis to produce an erection, and the even newer technique of inserting a small pill of medicine into the urethra have made implants a second choice for most experts. You may need to have your testosterone level tested, and consider a testosterone patch. This would not be appropriate if there were any sign that you had prostate cancer, which is common at your age.

Finally you might be amazed at the rejuvenating effects of a tender loving relationship with someone who didn’t expect you to perform to any standard, but was willing to work with you gently and slowly to see what might develop.

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