What factors account for early onset and progression of Erectile Dysfunction in some men, but not others? Despite the overall association with aging, a number of older men in their eighth and ninth decades continue to enjoy sexual activity and adequate penile erections .
The increased incidence of ED and progressive decline in testosterone levels in aging men is well documented.
Recent findings, in particular, from the MMAS study has demonstrated the remission of Erectile Dysfunction in a significant proportion of men over time, even without specific intervention or the use of oral medications or other ED treatments.
Analyzed data from the MMAS to investigate the natural history of Erectile Dysfucntion, including both progression and remission. 401 men of the original MMAS sample were followed who reported minimal, moderate, or complete ED at T1 (1988–1992). These men were eligible for remission, defined as a lessening of severity by at least one category of ED from T1 to T2 (1996–1998).
- Of the 401 men included in this analysis , 141 subjects (35%) exhibited ED remission by T2 (95% CI: 30%, 40%).
- Of 323 subjects with minimal or moderate ED at T1, 107 (33%) exhibited ED progression (95% CI: 28%, 38%).
The proportion of men with ED experiencing progression, remission, and remaining stable is roughly equivalent.
Age and BMI were associated in this analysis with both progression and remission, while smoking and self-assessed health status were associated with progression only. These observations (which predate development of PDE-5s) suggest that the likelihood of natural remission of ED and its symptoms is more common than previously believed. Furthermore, it provides positive support for the use of lifestyle modification or other nonpharmacological treatments for Erectile Dysfunction. These new findings have important clinical implications, particularly given the fact that increasing numbers of patients prefer nonpharmacologic means of treatment.