According to the National Institutes of Health, impotence or erectile dysfunction – ED - is defined as the inability to attain or sustain an erection adequate for satisfactory sexual intercourse. It occurs when there is reduced blood flow to the penis or nerve damage, both of which can be triggered by a variety of factors.

Scientists once believed that ED was an emotional issue alone and it is was a problem only of the mind and not of the body. But today they know that physical factors are just as important as psychological triggers—stress, marital/family discord, job instability, depression and performance anxiety—in provoking this problem.

Recent data suggests a physical (or organic) cause in more than half of all cases, especially those involving older men. It is important to note that hundreds of medications can also contribute to impotence while they fight allergic reactions, high blood pressure, ulcers, fungal infections, anxiety, depression and psychoses.

Latest surveys estimate that about 30 million American men (representing 50% of men over age 40) suffer from erectile dysfunction. This equates to approximately 1 man in 10, with that number becoming even larger by age 50, at which time, 1 man in 4 is believed to be affected. About 5% of men at the age of forty, and between 15% and 25% of men at the age of sixty-five experience impotence. Some experts suggest the numbers may be underreported since men are still embarrassed by this physical and psychological issue. However, the reassuring news is that it is treatable in all age groups.

Despite the fact that erectile dysfunction increases with age, it is not a foregone conclusion that men must become less sexually active as they age. Erectile dysfunction is not an inevitable part of aging and, the reassuring news is that, it is treatable in all age groups. Awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for erectile dysfunction

A healthy sex life contributes to an improved quality of life and can have profound ramifications on emotional and physical well being.

Libido in its common usage means sexual desire but it can also be defined as the conscious component of sexual function.
Decreased libido manifests as a lack of sexual interest or a decrease in the frequency and intensity of sexual thoughts, either spontaneous or in response to erotic stimulation. Inhibited sexual desire and loss of libido is a low level of sexual interest, a disinterest in sexual contact or complete lack of sexual desire.

Libido is sensitive to testosterone levels as well as to general nutrition, health, and drugs
Reduced libido or sexual desire can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone. It also may be caused by psychological problems, such as anxiety and depression; medical illnesses, such as diabetes and high blood pressure; certain medications, including some anti-depressants; and relationship difficulties.

Low libido is a health concern most people are reluctant to discuss. Yet, it can take a huge toll on emotional health. For men, not being able to perform at an optimal level can interfere with self esteem, quality of relationships and outlook on life in general.

Libido loss doesn’t usually happen suddenly, it can be a gradual process. It is a lack of interest in sex for several months of the past year.

It’s far less common than erectile dysfunction - with which it should not be confused, see erectile dysfunction. Most men with lack of libido can achieve erections, but have lost the desire to have sex. Erectile dysfunction is not the same as inhibited sexual desire and loss of libido, but when you experience one, sooner or later you are likely to feel the other as well. 

Men don’t like to talk about it; neither do their partners. But loss of libido in men or inhibited sexual desire stresses a relationships and marriages more than any other sexual dysfunction. Loss of libido also makes men unhappier about the rest of their lives than it does women.  Only 23% of men with loss of libido say they still feel very happy about life in general.

Losing interest in sex may not be as common an occurrence for men: It affects about 15% to 16% of men.

But loss of libido is not something you have to live with; there is much you can do to regain your sex drive and your happy outlook on life.

Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. Premature ejaculation is also known as, rapid ejaculation, rapid climax, premature climax or early ejaculation

It may result in an unsatisfactory sexual experience for both partners. This can increase the anxiety that may contribute to the problem. Premature ejaculation is one of the most common forms of male sexual dysfunction and has probably affected every man at some point in his life - 25%-40% of men. Estimates vary, but some experts think it affects as many as one out of three men.

Premature ejaculation is a common sexual disorder. Even though it’s a common problem that can be treated, many men feel embarrassed to talk to their doctors about it or seek treatment.

Once thought to be purely psychological, experts now know that biological factors also play an important role in premature ejaculation. In some men, premature ejaculation is related to erectile dysfunction.

Most sex therapists understand premature ejaculation as occurring when a lack of ejaculatory control interferes with sexual or emotional well-being in one or both partners.

Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner, only in certain sexual situations, or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can cause premature ejaculation. In some cases, premature ejaculation may be related to an underlying medical cause such as hormonal problems, injury, or a side effect of certain medicines.

There’s no medical standard for how long it should take a man to ejaculate. The primary sign of premature ejaculation is ejaculation that occurs before both partners wish in the majority of sexual encounters, causing concern or distress.

The problem may occur in all sexual situations, including during masturbation — or it may only occur during sexual encounters with another person.
Doctors often classify premature ejaculation as either primary or secondary:

• You have primary premature ejaculation if you have had the problem for as long as you’ve been sexually active.
• You have secondary premature ejaculation if you developed the condition after having had previous, satisfying sexual relationships without ejaculatory problems.

A continued lack of ejaculatory control may lead to sexual dissatisfaction on the part of either or both partners and may be a factor in sexual tension or discord in the relationship.

Urinary incontinence is the accidental release of urine. It occurs when the muscle (sphincter) that holds your bladder’s outlet closed is not strong enough to hold back the urine. This may happen if the sphincter is too weak, if the bladder muscles contract too strongly, or if the bladder is overfull.
There are a few different types of incontinence:

• Stress urinary incontinence is leakage that occurs when there is an increase in abdominal pressure caused by physical activities like coughing, laughing, sneezing, etc.
• Urge urinary incontinence also referred to as "overactive bladder," is usually accompanied by a sudden, strong urge to urinate and an inability to get to the toilet fast enough.
• Mixed urinary incontinence is a combination of urge and stress incontinence.

In men, urinary incontinence often is related to a problem or a treatment involving the prostate gland, such as enlargement of the prostate. As men age, the prostate gland grows larger, squeezing the urethra and pushing the neck of the bladder out of position. These changes can lead to incontinence.

Incontinence affects 13 million Americans and, even though incontinence occurs more often in older men than in young men, it is not considered a normal part of the aging process. Urinary incontinence may affect men of all ages.

How many people are affected: About 17% of the 3.4 million men over age 60 are experiencing some type of urinary incontinence.

Urinary incontinence can be an embarrassing problem, and men are sometimes reluctant to seek help. While many men suffer in silence unnecessarily, incontinence can be managed or treated. The incontinence should never be accepted.

Bladder infections are known as cystitis or inflammation of the bladder. A man’s chance of getting cystitis increases as he ages due to in part to an increase in prostate size.

Bladder infections are not serious if treated right away. But they tend to come back in some people. This can lead to kidney infections, which are more serious and may result in permanent kidney damage. So it’s very important to treat the underlying causes of a bladder infection and to take preventive steps to keep them from coming back.

In elderly people, bladder infections are often difficult to diagnose. The symptoms are less specific and are frequently blamed on aging. Older people who suddenly become incontinent or who begin acting lethargic or confused can be diagnosed with a bladder infection.

Most bladder infections are caused by various strains of E. coli, bacteria that normally live in the gut. In recent years, more and more bladder infections come from two sexually transmitted bacteria: chlamydia and mycoplasma.

In men, a bladder infection is almost always a symptom of an underlying disorder and is generally a cause for concern. Often it indicates the presence of an obstruction that is interfering with the urinary tract.

The prostate gland is an essential part of the male reproductive system that consists of about 70% glandular tissue and 30% fibro muscular tissue.

In an adult male, it is about the size and shape of a walnut and weighs about 20 grams. It is located directly beneath the male bladder and in front of the rectum.

A thick fibrous capsule surrounds the prostate.
In the adult male, the glandular tissue of the prostate secretes a fluid that contributes 20-30% of the total volume of the seminal fluid released when a man ejaculates. This prostate fluid is continuously generated by the prostate but increases during sexual excitement.

The major health problems associated with the male prostate gland may be divided into three main categories:

• Prostatitis or inflammation of the prostate.
• Enlargement of the prostate, called benign prostatic hyperplasia (BPH).
• Prostate cancer. Prostate cancer is currently the second leading cause of death from cancer in men.

One change does not lead to another. For example, having prostatitis or an enlarged prostate does not raise your chance of prostate cancer. It is also possible for you to have more than one condition at the same time.

Prostatitis is swelling or infection of the prostate gland. It often hurts. Prostatitis may account for up to 25% of all office visits by young and middle-aged men for complaints involving the genital and urinary systems.
There are several types of prostatitis. They vary based on how long a man has had the problem and what kind of symptoms he has.
Sometimes prostatitis is caused by bacteria, but often the cause is not known.
Symptoms of long-term (chronic) prostatitis are often mild and start slowly over weeks or months. Doctors have seeing and increasing numbers of men, usually aged 35 to 45 years suffering from chronic prostatitis. The symptoms may include:

• An urge to urinate often. But you may pass only small amounts of urine.
• A burning pain when you urinate.
• A problem starting the urine stream, urinating in waves rather than in a steady stream, urine flow that is weaker than normal, and dribbling after urinating.
• Waking up at night to urinate often.
• A feeling of not completely emptying your bladder.
• Pain in your lower back, in the area between the testicles and anus, in the lower belly or upper thighs, or above the pubic area. Pain may be worse during a bowel movement.
• Some pain during or after ejaculation.
• Pain in the tip of your penis.

Symptoms of acute prostatitis are the same, but they start suddenly and are severe. They may also include a fever and chills. Some men may have no symptoms.

It’s a problem that has several names -- enlarged prostate, benign prostate hyperplasia, or simply BPH. According to the National Kidney and Urological Disease Information Clearinghouse, one of the most common diseases in many aging men and the most common prostate problem for men over 50 is prostate enlargement. 

By age 60, over one-half of men have BPH; by age 85, the number climbs to 90%, according to the American Urological Association (AUA).

In men, urine flows from the bladder through the urethra. BPH is a benign (noncancerous) enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra - where urine and semen exit the body.
As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.
Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.
BPH can lead to blockage of urine flow (men will have trouble urinating ) which can not only change the bladder wall, but also ruin bladder function and control and lead to kidney damage or chronic kidney disease.

The prostate grows very little from birth until puberty, but at puberty it undergoes a growth spurt, increasing in weight and doubling its size.

In general, the size of the prostate remains constant for the next 30 or more years. In some men, in fact, the prostate never again increases in size. Unfortunately, however, this is not the case for most men, who will develop BPH.

According to estimates by the American Foundation for Urologic Disease, more than half of men aged 50 and above have enlarged prostates. This number steadily increases with age, and by age 80 it is estimated that 80 percent of men have prostatic enlargement.

Symptoms of enlarged prostate can include:

• A weak or slow urinary stream
• A feeling of incomplete bladder emptying
• Difficulty starting urination
• Frequent urination
• Urgency to urinate
• Getting up frequently at night to urinate
• A urinary stream that starts and stops
• Straining to urinate
• Continued dribbling of urine
• Returning to urinate again minutes after finishing