Sexual Problems :Aging changes in the male reproductive system
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Andropause; Male reproductive changes
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Aging
changes in the male reproductive system may include changes in
testicular tissue, sperm production, and erectile function. These
changes usually occur gradually.
Information
Unlike
women, men do not experience a major, rapid (over several months)
change in fertility as they age (like menopause). Instead, changes occur
gradually during a process that some people call andropause.
Aging changes in the male reproductive system occur primarily in the testes. Testicular tissue mass decreases and the level of the male sex hormone testosterone
stays the same or decreases very slightly. There may be problems with
erectile function. However, this is a general slowing, rather than a
complete lack of function.
Fertility:
The tubes that carry
sperm may become less elastic (a process called sclerosis). The testes
continue to produce sperm, but the rate of sperm cell production slows.
The epididymis, seminal vesicles, and prostate gland lose some of their
surface cells but continue to produce the fluid that helps carry sperm.
Urinary function:
The prostate gland enlarges with age as some of the prostate tissue is replaced with a scarlike tissue. This condition, called benign prostatic hypertrophy (BPH), affects about 50% of men. This may cause problems with slowed urination, as well as with ejaculation.
In both men and women, reproductive system changes are closely related to changes in the urinary system.
EFFECT OF CHANGES
Fertility
varies from man to man, and age is not a good predictor of male
fertility. Prostate function is not closely related to fertility, and a
man can father children even if his prostate gland has been removed.
Some fairly old men can (and do) father children.
The volume of fluid ejaculated usually remains the same, but there are fewer living sperm in the fluid.
Decreases
in the sex drive (libido) may occur in some men. Sexual responses may
become slower and less intense. This may be related to decreased
testosterone level, but it may also result from psychological or social
changes related to aging (such as the lack of a willing partner),
illness, chronic conditions, or medications.
Aging by itself does not prevent a man from being able to enjoy sexual relationships.
COMMON PROBLEMS
Erectile dysfunction
(ED) may be a concern for aging men. It is normal for erections to
occur less frequently than when a man was younger, and aging men often
have less ability to experience repeated ejaculation. However, ED is
most often the result of a medical or psychological problem rather than
simple aging, and 90% of ED is believed to be of medical rather than
psychological origin.
Medications (especially those used to treat hypertension
and certain other conditions) can cause some men to be unable to
develop or maintain enough of an erection for intercourse. Disorders
such as diabetes can also cause ED.
Erectile
dysfunction that is caused by medications or illness is often
successfully treated. Talk to your primary health care provider or a
urologist if you are concerned about this condition.
BPH may
eventually interfere with urination. The enlarged prostate partially
blocks the tube that drains the urinary bladder (urethra). Changes in
the prostate gland make elderly men more likely to have urinary tract infections.
Backup
of urine into the kidneys (vesicoureteral reflux) may develop if the
bladder is not fully drained. If this is not treated, it can eventually
lead to kidney failure.
Prostate gland infections or inflammation ( prostatitis) may also occur.
Prostate cancer becomes more common as men age. It is one of the most frequent causes of cancer death in men. Bladder cancer also becomes more common with age. Testicular cancers are possible, but these occur more often in younger men.
PREVENTION
Many
physical age-related changes, such as prostate enlargement or
testicular atrophy, are not preventable. Getting treatment for health
disorders (such as high blood pressure and diabetes) that lead to
changes in urinary and sexual health may prevent later problems with
urinary and sexual function.
Changes in sexual response are most
often related to factors other than simple aging. Older men are more
likely to have good sex if they have continued to have sexual activity
during middle age.
References
Minaker KL. Common clinical sequelae of aging. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 24.
source:
http://www.nlm.nih.gov/medlineplus/ency/article/004017.htm
