Question

I am 76. I am having erectile dysfunction. I am on telmisartan 40 - 1xbd, amlodipine 2.5 mg - 1xbd, gabapentin 300 mg - 1 at bed time, glucosamine 500 mg - 1xbd, thyroxine sodium 62.5 mcg - one early morning. My questions are:
1. Is it due to age?
2. Is it due to medication?
3. Is it partner specific?

Dr.Satyajeet P Pattnaik · Accepted Answer

Erectile dysfunction affects older men more than younger men. About 1% of men in their 40s, 17% of men in their 60s, and nearly 50% of men 75 or older aren't able to achieve an erection sufficient for intercourse.
Sometimes erectile dysfunction develops gradually. One night it may take longer or require more stimulation to get an erection. Another time, an erection may not be as firm as usual, or it may end before orgasm. When such difficulties occur regularly, it's time to talk to a doctor.
The culprit behind erectile dysfunction is often clogged arteries. In fact, in nearly one-third of men who see their doctors about trouble getting or keeping an erection, erectile dysfunction is the first hint that they have cardiovascular disease. Other possible causes of erectile dysfunction include medications and prostate surgery, as well as illnesses and accidents. Stress, relationship problems, or depression can also lead to it.
Regardless of the cause, erectile dysfunction often can be effectively treated. For some men, simply losing weight may help. Others may need medications. If these steps aren’t effective, a number of other options, including injections and vacuum devices, are available. Given the variety of options, the possibility of finding the right solution is now greater than ever before.
Tests for underlying conditions might include:
physical exam. this might include careful examination of your penis and testicles and checking your nerves for sensation.
Blood tests. a sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
Urine tests (urinalysis). like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
Ultrasound. this test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.
This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
Psychological exam. your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.
Oral medications
oral medications are a successful erectile dysfunction treatment for many men. They include:
sildenafil (viagra)
tadalafil (adcirca, cialis)
vardenafil (levitra, staxyn)
avanafil (stendra)
all four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.
Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.
The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.
Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's ok. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes.
Testosterone replacement. some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.
Penis pumps. a penis pump (vacuum erection device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis.
Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device.
The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse.
Psychological counseling
if your erectile dysfunction is caused by stress, anxiety or depression — or the condition is creating stress and relationship tension — your doctor might suggest that you, or you and your partner, visit a psychologist or counselor.
Alternative medicine
before using any supplement, check with your doctor to make sure it's safe for you — especially if you have chronic health conditions. Some alternative products that claim to work for erectile dysfunction can be dangerous.

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