Erectile dysfunction, the current term used for impotence, is defined as the inability to achieve or maintain an erection. It affects 15 million to 20 million men in the United States. In the past, this condition was thought to be caused mainly by psychological factors, but more recent studies have shown that an organic cause exists in 70 percent to 80 percent of cases. Although erectile dysfunction can occur at any age, 25 percent of men older than 60 suffer from the condition. This paper will look at the causes and effects of erectile dysfunction in the elderly and the treatments available.
Understanding erectile dysfunction requires understanding the male reproductive system and how it works. The external genitalia of the male consist of the penis and the testes (testicles). Baldwin (1991) describes the male reproductive system in detail. The penis consists of a shaft, the root of which lies within the pelvis and anchors the organ and supports it during erection (p. 11). The shaft of the penis is composed of three tubes known as the corpus cavernosa. The upper two tubes become engorged with blood during sexual arousal, resulting in an erection. The lower tube surrounds the urethra, the tube leading from the bladder to the tip of the penis. The three tubes are surrounded by a thick membrane which limits the growth of the penis during erection. The surface skin is highly elastic to accommodate the growth of the organ when in the aroused state (p. 11).
During an erection, 26 times more blood flows into the penis than when it is in the unaroused state. Arousal stimulates the release of neurotransmitters which relax the smooth muscle in the walls of the arteries to increase the volume of blood flow into the penis from vessels in the pudendum (genital area). The increased blood flow is paired with a decreased outflow, caused in part by pressure on the veins from the expanding corpus cavernosa, and results in a growt...