ABSTRACT
Erectile dysfunction (ED) is recognized as the inability to attain or maintain a penile erection sufficient for sexual performance. When evaluating the older patient with ED, one must take a detailed history, with emphasis on the sexual history as well as comorbid conditions that are risk factors for ED. The amount of sex hormone–binding globulin increases with age, resulting in a greater fraction of bound testosterone and a decrease in free testosterone levels. Treatment of hypogonadism is accomplished with the use of testosterone. Older medications used in the treatment of hypertension were commonly associated with ED. Vacuum devices for erections have been utilized in the treatment of ED for over a century. These devices consist of a plastic tube with an opening in one end so the device can fit over the penis. At the other end of the tube is a pump device that generates negative pressure.
