Sexual dysfunction can affect men of all ages, but is especially common in older men. The most common problems associated with sexual dysfunction include ejaculation disorders, erectile dysfunction and suppressed sex drive. These problems can often be corrected by treating the underlying cause.
- 1 What is sexual dysfunction in men?
- 2 What causes sexual dysfunction in men?
- 3 Low libido (decreased sex drive)
- 4 How to diagnose male sexual dysfunction?
- 5 How is male hypogonadism treated?
- 6 Can male sexual dysfunction be prevented?
What is sexual dysfunction in men?
Sexual dysfunction is any physical or psychological problem that prevents you or your partner from achieving sexual satisfaction. Male sexual dysfunction is a common health problem that affects men of all ages, but is more common with increasing age. Regular treatment can help men with sexual dysfunction.
The main types of male sexual dysfunction are:
Erectile dysfunction (difficulty getting/keeping an erection).
Premature ejaculation (reaching orgasm too quickly).
Slow or inhibited ejaculation (reaching orgasm too slowly or not at all).
Low libido (decreased interest in sex).
What causes sexual dysfunction in men?
Physical causes of overall sexual dysfunction can be:
Low testosterone levels.
Prescription drugs (antidepressants, high blood pressure medications).
Blood vessel disorders such as atherosclerosis (hardening of the arteries) and high blood pressure.
Stroke or nerve damage from diabetes or surgery.
Alcoholism and drug abuse.
Psychological causes may include:
Concerns about sexual activity.
Problems with marriage or relationships.
Effects of past sexual trauma.
Work-related stress and anxiety.
How does sexual dysfunction affect men?
The most common problems men face with sexual dysfunction are difficulty in ejaculating, erection, and decreased sex drive.
Problems with ejaculation are:
Premature ejaculation (PE): Ejaculation occurs before or too soon after penetration.
Inhibited or delayed ejaculation: Ejaculation does not occur or takes a very long time.
Retrograde ejaculation: During orgasm, the ejaculate is forced backward into the bladder rather than through the end of the penis.
The exact cause of premature ejaculation (PE) is not known. In many cases, PE is caused by performance anxiety during sex, other factors can be:
History of sexual repression.
Lack of communication or unresolved conflict with a partner.
Studies suggest that the breakdown of serotonin (a natural chemical that affects mood) may play a role in PE. Certain medications, including some antidepressants, can affect ejaculation, as well as damage to nerves in the back or spinal cord.
Physical causes of inhibited or delayed ejaculation can include chronic (long-term) health problems, drug side effects, alcohol abuse, or surgery.
Problems can also be caused by psychological factors such as depression, anxiety, stress, or relationship problems.
Retrograde ejaculation is most common in men with diabetes who have diabetic nerve damage. Problems with the nerves in the bladder and bladder neck force ejaculation to flow backwards. In other men, retrograde ejaculation may be a side effect of certain medications, or occur after bladder or prostate surgery.
Erectile Dysfunction (ED)
Erectile dysfunction (ED) is the inability to get and keep an erection for sexual intercourse. ED is fairly common, with studies showing that about half of all American men over the age of 40 are affected. Causes of ED include:
Diseases that affect blood flow such as hardening of the arteries.
Stress, relationship conflict, depression, and performance anxiety.
Damage to the penis.
Chronic diseases such as diabetes and high blood pressure.
Unhealthy habits such as smoking, drinking too much alcohol, eating too much and being inactive.
Low libido (decreased sex drive)
Low libido means your desire or interest in sex has decreased. This condition is often related to low levels of the male hormone testosterone. Testosterone maintains sex drive, sperm production, muscle, hair, and bones. Low testosterone can affect your body and mood.
Reduced sex drive can also be caused by depression, anxiety, or relationship difficulties. Diabetes, high blood pressure, and certain medications like antidepressants can also contribute to low sex drive.
How to diagnose male sexual dysfunction?
Your doctor may begin the diagnostic process with a physical exam. Physical exams may include:
Blood tests to check testosterone levels, blood sugar (for diabetes) and cholesterol.
Check blood pressure.
Rectal exam to check your prostate.
Examine your penis and testicles.
Other tests can show whether you have problems with blood flow to the penis.
Your doctor may also ask questions about your symptoms and medical and sexual history. While these questions may seem very personal, don’t be shy. It is important to answer honestly so that the best treatment can be recommended. You may be sent to another type of doctor (for example, a urologist, endocrinologist, or sex therapist) who can help you.
How is male hypogonadism treated?
Many cases of sexual dysfunction can be corrected by treating the mental or physical problems that are causing it. Treatment includes:
Medications: Drugs that improve sexual function by increasing blood flow to the penis. Sildenafil (Viagra®), vardenafil (Levitra®), and tadalafil (Cialis®) are safe and effective for most men.
Hormone therapy: Low testosterone levels are raised with hormone replacement therapies including injections, patches, or gels.
Psychotherapy: Psychotherapists help you deal with feelings of anxiety, depression, fear or guilt that may be affecting sexual function.
Mechanical aids: Vacuum devices and penile implants can help some men with erectile dysfunction.
Can male sexual dysfunction be prevented?
While male sexual dysfunction cannot be prevented, addressing the causes of the dysfunction can help you better understand and deal with the problem when it occurs. To help maintain good sexual function, you should follow the same program recommended for maintaining heart health.
Follow your doctor’s treatment plan for any of your medical/health conditions.
Limit alcohol intake.
Quit smoking .
Eat a heart-healthy diet (the Mediterranean diet is often recommended).
Regular aerobic exercise and weight gain.
Get treatment if needed for any emotional or psychological problems such as stress, depression and anxiety.
Communicate better and more often with your partner.