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Men experience different sexual problems at some point in their lives. Either you are heterosexual (straight), homosexual (gay), or bisexual, sexual dysfunction or problems can affect your life. Though these problems are more common in aging men, different physical, psychological, or environmental causes can trigger male sexual dysfunction.
A sexual problem or dysfunction refers to physical or psychological difficulties that prevent a man (and his partner) from experiencing satisfaction from sexual intercourse. These problems can occur during any phase of the sexual response cycle that includes arousal (excitement), desire (libido), orgasm, and resolution.
The National Health and Social-Life Survey (NHSLH) conducted a study to evaluate the prevalence of sexual dysfunction in the U.S. that shows, about 31% of men and 43% of women have reported experiencing some sort of sexual difficulties. Though men hesitate to share their sexual issues, in most cases sexual problems are easily curable with the right method of treatment.
Though sexual difficulties don’t impact physical health much, such issues can cause mental health issues and disrupt the quality of life greatly. These problems affect men by causing the following effects:
Erectile dysfunction or ED is the inability to achieve and sustain a penile erection strong enough to perform penetrative sex. This problem is also known as impotence.
According to the Massachusetts Male Aging Study, the prevalence of erectile problems increases with age. Several studies show that ED affects about 40% of men in their 40s and affects 70% of men in their 70s. Also, the chances of experiencing complete ED increases from 5% (in 40-year-old men) to 15% (in 70-year-old men).
But according to more recent studies, ED issues are increasing in young men too. According to an article published in The Journal of Sexual Medicine, about 26% of men who are less than 40 are ED patients. And about 8% of men who are between 20-29 have reported experiencing difficulty with erections.
Most men experience erection-related issues occasionally. Usually, tiredness, stress, anxiety, depression, nerve disorders, or lifestyle choices like alcohol abuse, lack of exercise, trouble with sleeping can cause ED. Also, side effects of medications for diabetes, kidney disease, blood pressure, etc. or even drug combinations can cause ED. But if this issue becomes frequent then it’s time to seek medical help.
There are mainly 2 types of ED:
Premature ejaculation or PE is a sexual issue where ejaculation happens before or within about 1 minute during penetrative sex. This condition is also known as rapid ejaculation, fast orgasm, early ejaculation, premature climax, quick discharge, etc.
About 1 in every 3 men or 30%-70% men in the U.S. experience PE, making it the most common type of male sexual dysfunction. According to the American Urological Association, approximately 30%-40% of men around the globe between the ages of 18-59 suffer from PE issues.
Different biological and psychological factors are responsible for causing early ejaculation in men. Also, relationship issues and performance anxiety play a big role in causing PE.
Early discharge can be categorized into 2 types:
According to the National Institutes of Health (NIH), approximately 10% of men report facing difficulty with orgasm. But according to a clinical study, about 8% of men are estimated to experience delayed ejaculation. Generally, Anorgasmia is a more common health issue in women than men and it’s especially uncommon in the young population.
Though delayed ejaculation mainly occurs due to psychological factors, certain chronic diseases, side effects of medications, or surgeries can cause this issue in men.
There are mainly 4 types of orgasmic disorder:
Inhibited sexual disorder (ISD) or Hypoactive sexual desire disorder (HSDD) refers to the medical condition of low sexual desire. A man with ISD or HSDD hardly engages in sexual activity and doesn’t respond to his partner’s sexual stimulations.
Low sex drive is considered to affect around 30% of men at some point in their lives. Different studies and analysis show that man can experience a low sex drive if he is interested in other people rather than his partner. Also, in general cases, men with ISD don’t feel interested in anyone. In extreme cases, men with ISD not only struggle with low sexual desire but also may find sex disturbing.
The main cause of low sex drive is low testosterone. According to a clinical study, about 4 out of 10 men (over age 45) have low testosterone. Factors like alcoholism, fear of intimacy due to childhood abuse, male menopause, etc. cause low sex drive, Also, prescription drugs and psychological distress can contribute to ISD or HSDD.
Theoretically, this disorder can be classified into 3 types:
Retrograde ejaculation is a male sexual condition where the semen enters the urinary bladder instead of getting out of the penis during an orgasm. Though it feels like a normal orgasm, no secretion or ejaculation happens. That’s why it’s also known as a dry orgasm.
Men’s urine and semen both pass through the urethra. A muscle called the sphincter (located in the bladder neck) contracts to keep the bladder closed during the time of an orgasm so that the urine and the semen don’t get mixed up. In men with retrograde ejaculation, this muscle stays relaxed and fails to contract, as a result, the semen enters the bladder.
Though this is one of the most common ejaculation disorders, it isn’t a painful or harmful condition and the man experiences sexual pleasure just like a normal man. But men with retrograde ejaculation cannot impregnate their fertile female partner naturally. Medical treatments are required to solve this problem. Sometimes stopping specific types of medications can cure this issue.
Retrograde ejaculation can occur due to bladder or prostate surgery. Also, diabetes, Parkinson’s diseases, spinal cord injury, medications to control high blood pressure or cure enlarged prostate, etc. can cause this dysfunction.
Retrograde ejaculation can be easily cured if it’s caused by certain medications. But if this condition appears due to surgery or severe nerve damage (neuropathy) or muscle damage, it can become permanent.
Priapism is a persistent and painful erection that sustains for hours (more than four hours) without any kind of sexual stimulation. During normal sexual arousal, certain penile muscles relax to increase blood flow in the penis to produce an erection that drains after reaching an orgasm. But in priapism, the blood gets trapped and the man suffers from an unwanted erection for a prolonged period.
This condition can occur in men of all ages. According to a report, this condition is most common in boys between 5-10 years old and in men who are between 20-50 years old. Even healthy newborns can experience this issue, which is clinically called Neonatal priapism.
In young adults and adult males, priapism can lead to pain, scarring, and permanent erectile dysfunction if not treated immediately. The most common cause of priapism (usually in boys) is blood disorders like sickle cell disease, leukemia, etc. Drugs are taken to cure erectile dysfunction like sildenafil, tadalafil, and avanafil can cause priapism. Also, prostate cancer, injury in the penis, or in the spinal cord can cause this issue.
There are 2 types of priapism:
A penile erection requires specific hormones, healthy veins and arteries, and strong blood flow in the penile chambers. A problem in any of the mentioned aspects can cause male sexual problems. Various physical, psychological, and lifestyle based factors can trigger sexual dysfunction in men.
The most common physical causes of sexual problems are:
Sometimes medication side effects can lead to different sexual difficulties like erectile dysfunction, low sexual desire, retrograde ejaculation, etc.
The most common class of medication that cause sexual problems in men are:
Psychological factors play a huge role in male sexual issues. You may experience different sexual problems if you have any of the following conditions:
Men might face sexual irregularities if there’s no private place to relax to indulge in sexual activities. Also, long office hours and busy work schedules can leave a man, stressed, tired, and irritated to enjoy sex.
Apart from the mentioned issues, several environmental factors can cause sexual problems in men:
The male sexual function includes the following 4 components:
All these mentioned aspects and organs and systems related to these components need to work harmoniously to keep the sexual function active and healthy.
Different hormones, neurotransmitters, and nervous systems must be in sync to boost sexual desire or libido. Blood vessels, nitric oxide levels, nerves, and penile veins and muscles must work properly to produce and maintain an erection firm enough to enjoy penetrative sex.
The sympathetic nervous system controls ejaculation. Muscles and nerves from testicles to the urethra and the rhythmic contractions of pelvic floor muscles need to coordinate adequately to ensure ejaculation. Orgasm is the erotic sensation that happens in the brain simultaneously during ejaculation.
This is the whole process of how male sexual function works. In the case of sexual dysfunction, the urologist must evaluate all the possible problems in this particular chain.
Though sexual problems cannot be prevented, following some specific tips can help to maintain a healthy sexual function:
Your health care provider may begin the diagnosis with a detailed medical, sexual, psychological history along with a thorough physical examination.
During the interview, your physician may ask you personal and intimate questions that might seem embarrassing, such as:
But keep in mind, answering these questions with utmost truth is very important to get the most effective treatments. Your doctor can also refer you to other specialists upon diagnosing the issue.
In the physical examination, your doctor may check your- penis, scrotum, perineum and their reflexes, pulses on legs, etc.
The general physical tests may include:
Also, your doctor may ask to take a test for penile blood vessel function or certain tests of the nervous system to diagnose the causes accurately.
In most cases, sexual dysfunction can be easily improved by treating the underlying causes. Male sexual problems can be easily cured with the following treatment options:
Oral medications and supplementations: Medications such as Cialis, Levitra, Staxyn, etc. are known treatments for erectile issues that improve erectile function by improving blood flow in the penis. Also, several dietary supplements offer to cure different sexual dysfunctions.
Topical solutions: Topical spray, gel, oil, wipes can give immediate yet temporary solutions to sexual issues like ED and early ejaculation.
Testosterone therapy: Men with ISD or low sex drive may get benefits from hormone treatments or testosterone replacement therapies.
Psychological therapy: Male sexual dysfunctions are mostly psychological. Counseling or therapy can help to heal the psychiatric disorders associated with sexual dysfunction.
Sex education: Knowledge about sexual behavior, response, and sex itself can improve men’s self-confidence and performance in bed. Joining a sexual health program can help to do so.
Devices and surgeries: Enlargement devices such as extenders, vacuum erection devices, etc. can help men to fight ED. Also, penis implant surgery is known to cure ED.
Yes, in most cases sexual problems can be cured. Proper diagnosis of sexual dysfunction plays a big role in curing the problem. If any physical condition is responsible for the dysfunction and if that condition can be easily reversible then there’s nothing to worry about. But if the condition is caused by psychological issues, the treatment might require more time and patience along with counseling, therapy, and open communication with the partner.
Also, Kegels, pelvic floor exercises, stop-start technique, etc. can help to improve male sexual stamina and reproductive functions.
If any sexual dysfunction sustains for months, the risk factors increase. That’s why it’s best to take quick steps to treat such issues as soon as possible.
All men experience some kind of sexual problems occasionally. But if the problems become more persistent and frequent, it’s time to get an appointment with health professionals. Because ignoring these issues not only causes stress and anxiety disorder but also causes relationship concerns. Also, most sexual dysfunctions are interrelated, so if not treated immediately one problem can lead to another one. That’s why if you have a concern about any sexual irregularities or symptoms it’s better to consult your doctor.
Most men struggle with sexual problems in their lives. But due to the sensitivity of the issue, men often feel uncomfortable sharing these problems with close ones even with doctors. But to enjoy an active and healthy sex life, it is important to take care of physical, psychological, and sexual health. But if you feel uncomfortable consulting a doctor about your private .
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