Dear Doctor: Would taking antiestrogens assist an 80-year-old with erectile dystrophy?

Dear Doctor: Would taking antiestrogens assist an 80-year-old with erectile dystrophy? ...

DEAR DR. ROACH: I have a terrible case of erectile dysfunction. I am 80 years old and otherwise in good health. I have received an ad in the mail that said it is not a lack of testosterone, but rather a lot of estrogen in the body. It annoys me to reduce estrogen without further knowledge. What do you know? How can I overcome this problem and enjoy sex again? -- Anon.

ANSWER: Although estrogen is beneficial to male sexual function, it is true that men with erectile dysfunction are more likely to have high estrogen levels, but reducing estrogen with medication (antiestrogens) in men with erectile dysfunction is rarely used as a therapy. Most commonly used drugs, such as sildenafil (Viagra), work mostly on blood vessels, but also have both testosterone levels and estrogen levels in men.

Almost every men with erectile dysfunction, even in their 80s, get success with Viagra and other drugs. I examine testosterone levels and consider testosterone replacement in older men with erectile dysfunction. Especially when fertility is a concern, testosterone can dramatically reduce sperm counts, and antiestrogens increase testosterone levels with less effect on sperm count. I would not prescribe an antiestrogen, but recommend a guy with inadequate response to Viagra-type medications and testosterone to an expert on male sexual function.

DEAR DR. ROACH: My husband is one of five brothers born in the 1940s. Their father died of Parkinson's disease and/or Lewy body dementia. Three of the five brothers have been diagnosed with Parkinson's and/or Lewy body dementia, now my husband (the other brother is 75), but neither he nor my husband have any symptoms. What are the chances that the remaining two brothers will be stricken? L.E.

ANSWER: In the family's history, most Parkinson's disease cases are sporadic rather than familial. However, there are also familial cases, which are more likely when the affected family members are aged 50 or less at the time of diagnosis. I'm also required to believe there is a family association in your family.

I studied several different genes involved in familial Parkinson's disease, and these mutations at some of these genes predispose to Lewy body disease as well. Depending on the gene, the mode of inheritance may be recessive, dominant, or sex-linked. It's not easy to predict precise odds on the development of Parkinson's or Lewy body disease in your husband's case.

Since your husband was older than any individual affected at the time of diagnosis, it is certainly a good indication that he may not develop either of these diseases. Early symptoms may be subtle, and an expert such as a neurologist who deals with movement disorders might make the diagnosis months or years before symptoms become noticeable, although I am sure they are more adept at them.

Many of the identified familial genetic variations have been prescribed genetic tests, however, the interpretation of these findings is difficult. Additionally, since we don't have therapies that can stop or slow the progression of Parkinson's disease, I do not recommend genetic testing for Parkinson's disease.

Dr. Roach regrets that he is not able to answer individual letters, but will include them in the column whenever possible. Readers may send questions to or send an email to 628 Virginia Dr., Orlando, FL 32803.

2022 North America Syndicate Inc.

All Rights Reserved

You may also like: