By Dr Ajit Saxena

All men go through a loss of libido as they get older. While the degree may vary from one individual to the other, most men can maintain their sexual interest into their 60’s, 70’s or even later, if they don’t have any allied medical issues.

Depression, alcoholism, stress and even side effects of certain medication can lead to a loss of sexual desire in men. Whatever be the reason, it’s important that you take care of your penile health because studies have shown that there is a very strong link between erectile dysfunction (ED) and heart disease. Having Ed is as much a risk factor as having a family history of heart disease.

 The male sexual response cycle consists of four stages: desire; arousal and erection; orgasm and refractory period.

The International Index of Erectile Function (IIEF) is a scientific tool developed to assess changes in erectile function. Another tool is used to measure Erection Hardness Score on a scale from 1 to 4. Scores 3 and 4 are sufficient enough for penetration, 4 being a hard erection.

Studies have identified that what women want most is hardness and not length. This hardness score has been designed as follows.

1Penis is large, but not hard

2Penis is hard, but not hard enough for penetration

3Penis is hard enough for penetration but not completely hard

4Penis is completely hard and fully rigid

Non surgical management of ED
Oral Drugs
Hormone therapy
Herbs and micronutrients

Common side effects
Headache
Flushing
Indigestion
Nasal congestion
Altered vision (Viagra only)
Muscle pain (Cialis only)

Surgical management of ED
Revascularisation or restoring blood flow to the clogged penile vessels
Surgical ligation of penile veins
Penile prosthesis implantation (last resort)

Effective Option
Venus leak surgery, improves ability to get and maintain an erection in young men

Takeaway
There is an entire spectrum of treatment available for ED today from oral medication to penile prosthesis.


Dr Saxena is uro-andrologist at Indraprastha Apollo Hospitals, New Delhi. He specialises in treating prostate disease and impotence using a bloodless technique called vapour resection. He is also the founder president of Andrology India