Management of Sexual Disorders in Elderly

Summary: The guideline provides a summary of the factors affecting sexual function in male and female older adults. It also discusses the current classification of sexual disorders in line with DSM-5. The typical diagnostic work-up is described, including the approach to medical conditions that manifest with sexual dysfunction (including coronary artery disease or diabetes mellitus).  Subsequently the guideline discusses the role of therapeutic agents, including comparisons of the evidence base, indications and contraindications for the use of various categories of pharmacological agents. These includes a comparison of nitric oxide enhancers sildenafil, vardenafil, tadalafil and udenafil, as well as the role of hormone replacement therapy, other medications (including those from Indian traditional medicine). The key points of various kinds of psychosocial intervention for sexual disorders (those derived from couples, marital and family therapy approaches, cognitive and behavioral techniques and therapies, and dual therapy) are discussed. There are brief discussions of gender incongruence and paraphilias. A unified algorithm for the assessment and management of sexual disorders in this age group are also discussed.

Authors: T. S. Sathyanarayana Rao, Abhinav Tandon, Shivanand Manohar, Supriya Mathur

Year of Publication: February-2018