ABSTRACT
Introduction Erectile dysfunction (ED) is common and increases in incidence with age (Fig. 1). It is estimated that 140 million men worldwide currently experience ED to a variable degree and by 2025 the prevalence is predicted to rise to over 300 million men (1). The Massachusetts Male Aging Study (MMAS) identified a prevalence of ED in 52% of men aged 40 to 70 years. As ED increases with age men over 70 years of age have three times the incidence of men in their forties. ED is an important cause of relationships breaking down with the man losing self-esteem, feeling inadequate, and a failure. The frustration affects the partner, who must not be forgotten as part of the evaluation-it may be a man’s problem but it is usually a couple’s concern. While the commonest cause is organic, it is important not to compartmentalize ED-the organic cause may have psychologic consequences, especially depression, so that the management needs to embrace more than just trying to restore erectile function as a lot of psychosocial support is often needed.
