Sexual problems in men are very common and impact sexual health. Many problems with sexual health can be treated.
Sexual health is an important part of a man’s life, no matter his age, civil status, or sexual orientation. It is also an important part of a couple’s foundation and contributes to the quality of life. It is important for a man to discuss sexual issues with a physician.
The definition of sexual dysfunction is the inability to have a satisfactory sexual relationship. This definition depends on each person’s own interpretation of what he judges as satisfactory. In general, sexual dysfunction can affect the quality of life and, even more importantly, can be the first symptom of another medical or psychological problem. Any sexual complaint should be taken seriously and evaluated.
How does sexual function work?
Sexual activity involves coordination between various systems of the body. Hormones and neurological pathways must be in sync for sexual desire to be present. Blood vessels, nerves, and penile integrity must all be present for an adequate erection and its maintenance during sexual relations.
Muscles and nerves coordinate ejaculation achieved when the physiological passageway for sperm (from the testicles to the urethra) is present. Orgasm is a complex phenomenon that isn’t completely understood, but it involves the coordination of muscles and nerves. When sexual dysfunction is present, the physician must evaluate all the possible problems in this chain of events.
What are the types of sexual dysfunction in men?
Types of sexual dysfunction include disorders like these:
- reduced sex drive;
- erectile dysfunction;
- premature ejaculation;
- disordered orgasm.
Please click the links in the list below to learn more about each type of sexual dysfunction in men.
Some medical conditions can affect two or more disorders at the same time.
1. The definition of low libido is when sexual desire is diminished or absent. The definition also varies according to the patient’s level of satisfaction with his own sexual desire. Some men can be very fulfilled with what some men consider the scarce sexual activity.
The person that lacks sexual desire won’t want to initiate the sexual relation. If the act is initiated, low libido can also present itself as the inability to attain an erection.
2. Erectile dysfunction (ED) is the inability to acquire or maintain a satisfactory erection. The prevalence of erectile dysfunction varies according to the patient’s age. About 16% of men from 50 to 59 years of age will suffer from erectile dysfunction and 44% of those aged 70 to 75 years will, too.
Erectile dysfunction with sudden onset and no previous history of sexual dysfunction suggests a psychogenic cause unless there was a previous surgery or genital trauma. The loss of nocturnal erections will suggest a neurologic or vascular cause.
3. Premature ejaculation is the most common of ejaculatory disorders; approximately 20% to 30% of men will have premature ejaculation. Ejaculation problems involve the improper discharge of sperm, prostatic, and seminal vesicle fluid through the urethra.
Premature ejaculation may be caused by negative conditioning and penile hypersensitivity. The treatment will vary according to the cause of premature ejaculation. Couples’ sexual therapy or psychological therapy can be useful when psychological causes are involved.
4. A disordered orgasm is the inability to reach an orgasm after adequate stimulation. Orgasm is still a phenomenon that is poorly understood.
The causes of disordered orgasm include Psychiatric disorder, Diabetic neuropathy, Multiple sclerosis, Complications from genital surgery, Pelvic trauma, Drugs (alpha-blockers, antidepressants). Anorgasmia will be treated with psychiatric help or by treating the underlying cause.
What are other kinds of sexual dysfunction in men?
Another category of sexual problem is sexual pain. A penile lesion, injury, or skin disease can be the cause among others. Men’s sexual pain occurs less frequently than women’s.
At what age do men experience sexual dysfunction?
There are normal changes in sexual function in the elderly. Older men can have the following symptoms of sexual dysfunction:
- the long delay between stimulation and erection;
- erection is less turgid;
- ejaculation is less strong;
- ejaculatory volume is smaller;
- the time between erections is longer;
- less sensitivity to tactile stimuli;
- lower testosterone;
- orgasm is attained more slowly.
These phenomena can be experienced as patients grow old. Nevertheless, it can be addressed so that those affected can still have a very satisfactory sexual life.
Can sexual problems in men be prevented?
Lifestyle changes can be useful to help treat or improve sexual dysfunction, but more importantly, they can have an impact before the development of the disease itself.
You can prevent the incidence of sexual troubles by having a healthy lifestyle; exercise regularly, eat well, limit alcohol consumption, and quit smoking, if you are a smoker. Lifestyle changes take time and effort, but the results are worthwhile.
What is the prognosis for sexual problems in men? Can they be cured?
Prognosis varies according to the method of treatment and the underlying disease. Nowadays, many innovations have changed the face of male sexual dysfunction giving men multiple options regarding treatment. Not only do men have choices but the developing technologies and medications have also given men a voice to share their experiences.
It’s very important that you speak to your doctor about any concern regarding your sexual function or that of your partner.
Which types of doctors or specialists treat sexual problems in men?
Psychiatrists, psychologists, and sexologists can be involved in the management of sexual dysfunction. Psychiatrists or psychologists can especially help when the cause of the dysfunction is psychogenic. Therapies targeting cognition and behavior usually have good success rates. Sexologists can also contribute to these therapies.
How are sexual problems in men diagnosed?
Evaluation of sexual dysfunction starts with a detailed medical, sexual, and psychological history, followed by a thorough physical examination. The second step must not be overlooked because sexual dysfunction can have many causes. Sometimes, the patient’s partner can also contribute to the evaluation and could provide useful information as well.
A detailed medical, psychological, and sexual history is acquired during the interview with the physician. Some of the questions that are asked can be intimate and might cause you to feel too shy to answer thoroughly. It is imperative to give the proper information, even though it is understandable that it can take time to be comfortable talking about this. Having a good relationship with your physician is always helpful.
Some of the questions the doctor could ask might concern the frequency of sexual relations, your sexual orientation if the frequency or quality of sexual relations is satisfying, and your number of sexual partners, among others. They will also inquire about nonsexual-related complaints.
A complete physical examination is performed including assessing the pulses in the legs and a thorough examination of the external genitalia (penis, scrotum, and perineum) and their reflexes.
One of the possible tests is a nocturnal tumescence test to evaluate nocturnal erections. A physician might also ask for tests for penile blood vessel function or some tests of the nervous system to help differentiate between possible causes of sexual dysfunction.
What is the treatment for sexual problems in men?
The treatment plan depends greatly on the precise cause of the sexual problem. If the cause is psychological, help from a psychiatrist or psychologist can be helpful. Often in this situation, cognitive behavioral therapy is the treatment used. Sometimes the treatment will include couples therapy.
If the cause of the diminished libido is from medications being taken, sometimes there are alternative medications without sexual side effects. For others, hormonal replacement may be suggested. Talk to a doctor about any changes in libido you have experienced.
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