Sexual changes and impotence in elderly men.

Physicians and patients frequently misunderstand the sexual changes that are normal in elderly men. These include increased time and stimulation to attain an erection, decreased ejaculatory volume, rapid detumescence after intercourse and a prolonged refractory period before further erection is possible. Coupled with medical or psychologic illnesses, these changes may precipitate impotence. Surgical, pharmacologic and psychologic modes of therapy may be effective in treating impotence in elderly men.