Western Australian Centre for Health and Ageing, Western Australian Institute for Medical Research, University of Western Australia, Crawley, WA, Australia.
J Sex Med. 2012 Feb;9(2):442-53. doi: 10.1111/j.1743-6109.2011.02565.x. Epub 2011 Dec 6.
Hypogonadism is associated with impaired libido and erectile dysfunction in young men, but the causes of sexual dysfunction in older men are less well understood.
To determine the prevalence and predictors of sexual problems in older men.
Sexual problems, as assessed by a self-reported questionnaire.
This was a population-based, cohort study of 3,274 community-dwelling men aged 75-95 years (mean 82 years) from Perth, Western Australia. Questionnaires in 2001-2004 and 2008-2009 assessed social and medical risk factors. Sex hormones were measured in 2001-2004. Predictors of sexual problems, measured in 2008-2009, were assessed cross-sectionally in the entire sample, and longitudinally in a subset of 1,744 men with sex hormone data.
Sexual problems were highly prevalent, with 49.4% (95% confidence interval 47.7% to 51.1%) reporting erectile problems, 47.7% (45.9% to 49.4%) lacking interest in sexual activity, 38.7% (37.0% to 40.3%) unable to climax, and 20.4% (19.1% to 21.8%) anxious about their ability to perform sexually. Painful and unpleasurable sex were less common (<5%). Overall, 72.0% (70.5% to 73.6%) reported at least one problem. In multivariate binary logistic regression analyses, cardiovascular disease, diabetes, depression, prostate disorders, and insomnia were the factors most commonly associated with sexual problems. Low testosterone levels were associated with lack of interest in sex, but not with other complaints.
Sexual problems are common in elderly men. Chronic disease, depression, and insomnia appear to be the main modifiable risk factors. Androgen deficiency is unlikely to be a major cause of sexual problems in this age group.
性腺功能减退与年轻男性的性欲减退和勃起功能障碍有关，但老年人性功能障碍的原因还不太清楚。
确定老年男性性问题的患病率和预测因素。
通过自我报告问卷评估的性问题。
这是一项基于人群的队列研究，研究对象为来自澳大利亚西部珀斯的 3274 名年龄在 75-95 岁（平均 82 岁）的社区居民。2001-2004 年和 2008-2009 年的问卷评估了社会和医学危险因素。2001-2004 年测量了性激素。2008-2009 年评估了整个样本中性功能障碍的预测因素，并在有性激素数据的 1744 名男性亚组中进行了纵向评估。
性功能障碍的患病率很高，有 49.4%（95%置信区间 47.7%至 51.1%）报告存在勃起问题，47.7%（45.9%至 49.4%）对性活动缺乏兴趣，38.7%（37.0%至 40.3%）无法达到高潮，20.4%（19.1%至 21.8%）对自己的性能力感到焦虑。疼痛和不愉快的性生活较少见（<5%）。总体而言，72.0%（70.5%至 73.6%）报告至少存在一个问题。在多变量二项逻辑回归分析中，心血管疾病、糖尿病、抑郁、前列腺疾病和失眠是与性功能障碍最常见相关的因素。低睾酮水平与对性的兴趣降低有关，但与其他投诉无关。
性功能障碍在老年男性中很常见。慢性疾病、抑郁和失眠似乎是主要的可改变危险因素。在这个年龄组，雄激素缺乏不太可能是性功能障碍的主要原因。
