From the Guidelines
I strongly recommend consulting with a healthcare provider for personalized treatment of erectile dysfunction in older men, and based on the most recent evidence from 1, phosphodiesterase type 5 inhibitor (PDE5i) medications, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), are the most effective treatment options. These medications work by increasing blood flow to the penis, helping achieve and maintain erections when sexually stimulated. Some key points to consider:
- Typical dosing for sildenafil is 25-50mg taken 30-60 minutes before sexual activity, while tadalafil may be taken daily at 2.5-5mg or as needed at 10-20mg.
- Side effects can include headache, flushing, and indigestion.
- It's essential to discuss your complete medical history with your doctor before starting these medications, especially if you have heart conditions or take nitrate medications, as dangerous interactions can occur.
- Lifestyle modifications like regular exercise, maintaining healthy weight, reducing alcohol consumption, and managing stress can also improve sexual function alongside medication.
- The choice of a specific PDE-5 inhibitor should be based on individual preferences, ease of use, cost of medication, and adverse effects profile, as suggested by 1. It's crucial to prioritize your health and consult with a healthcare provider to determine the best course of treatment for your specific condition.
From the FDA Drug Label
The efficacy and safety of tadalafil in the treatment of erectile dysfunction has been evaluated in 22 clinical trials of up to 24-weeks duration, involving over 4000 patients. Tadalafil, when taken as needed up to once per day, was shown to be effective in improving erectile function in men with erectile dysfunction (ED) Results in ED Population in US Trials — The 2 primary US efficacy and safety trials included a total of 402 men with erectile dysfunction, with a mean age of 59 years (range 27 to 87 years) The population was 78% White, 14% Black, 7% Hispanic, and 1% of other ethnicities, and included patients with ED of various severities, etiologies (organic, psychogenic, mixed), and with multiple co-morbid conditions, including diabetes mellitus, hypertension, and other cardiovascular disease.
- Tadalafil is a medication that has been shown to be effective in improving erectile function in men with erectile dysfunction (ED) 2.
- The medication has been studied in a population with a mean age of 59 years, which is close to the age of 60 years mentioned in the question.
- Tadalafil has been shown to be effective in improving erectile function in men with ED of various severities and etiologies, and with multiple co-morbid conditions.
- However, it is essential to consult a healthcare professional to determine the best course of treatment for a 60-year-old man, as they can assess individual needs and health status.
- Tadalafil may be a suitable option for a 60-year-old man with ED, but it is crucial to follow the guidance of a healthcare professional.
From the Research
Treatment Options for Erectile Dysfunction
- Phosphodiesterase type 5 inhibitors (PDE5i) such as sildenafil, tadalafil, vardenafil, and avanafil are effective treatments for erectile dysfunction (ED) in men, including those with hypertension, diabetes mellitus, and other comorbid medical conditions 3, 4, 5.
- These medications have been shown to be successful in 60-65% of men with ED, including those with underlying medical conditions 3.
- Patient-administered intracorporal injection therapy using vasodilator drugs such as alprostadil is an effective treatment for men who fail to respond to oral pharmacological agents 3, 6.
- Combination therapy with topical alprostadil and PDE5i may be more effective than topical alprostadil alone in men with ED who do not respond to PDE5i monotherapy 6.
Safety and Efficacy of PDE5i
- Sildenafil has been shown to be a safe and effective treatment for ED, with a success rate of 82% in patients with organic underlying disease 4.
- Vardenafil and tadalafil have also been shown to be effective treatments for ED, with efficacy data comparable to sildenafil 4.
- The safety of PDE5i has been established, with no increase in mortality rate among users compared to the general population 4.
Considerations for 60-Year-Old Men
- ED is a common condition in older men, and treatment options should be tailored to the individual's underlying medical conditions and health status 3, 5.
- Lifestyle modifications, such as weight loss, exercise, and smoking cessation, may also be beneficial in improving ED symptoms 5.
- Men with ED should be screened for cardiovascular risk factors, as ED can be a precursor to cardiovascular disease 5.