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Sexual Problems In Men: Causes And Treatments
Sexual dysfunction is a common health issue that can affect men of all ages. A study says that around 31 per cent of men and 43 per cent of women have at least one or other kind of sexual dysfunction. [1]
Sexual functioning is governed by many factors: biological factors such as functioning of neurological, endocrine or vascular systems; psychological factors such stress and depression and psychosocial factors such as religious beliefs, ethnicity and health status. Problems in any of these factors can lead to sexual dysfunction.
Additionally, sexual disorders in men are often categorised into disorders of arousal, desire, orgasm or overlap between these disorders. Though these problems in men are prevalent, they are often under-recognised or under-diagnosed due to embarrassment for seeking medical help or even thinking it as a major problem that can affect the quality of life. [2]
In this article, we will discuss sexual problems in men followed by their causes and treatments. Take a look.
1. Erectile dysfunction
Erectile dysfunction is the inability to maintain or achieve sufficient erection of the penis which is needed for satisfactory sexual performance. It may affect some men occasionally but prolonged failure to maintain an erection can affect the quality of life or cause relationships problems.
Main symptoms of erectile dysfunction include difficulty getting an erection, difficulty keeping an erection and reduced sexual desire. Prolonged erection is also one of the symptoms characterised by persistent erection, usually without sexual arousal.
Causes of erectile dysfunction
Organic causes of erectile dysfunction include the following: [3]
- Cardiovascular diseases
- High cholesterol
- Diabetes
- Obesity
- Hypertension
- Parkinson's disease
- Peyronie diseases, an anatomical disorder of the penis
- Surgical complications
- Injuries in the spinal cord or penile area
- Smoking, substance use or alcoholism
- Prostate disease
- Anxiety
- Lack of emotional awareness
- Stress
- Depression
- Fear of intimacy
- Guilt
- Current life stress
- Manage high blood pressure
- Lower anxiety
- Antidepressants
- Cancer drugs
- Hormonal drugs
Psychological causes of erectile dysfunction include the following:
Certain prescribed medications can also cause the condition. They include medications to:
Treatments of erectile dysfunction
1.
Lifestyle
modifications:
Regular
exercise,
dietary
changes
and
quitting
smoking
and
substance
use.
Improving
cardiovascular
risk
can
treat
around
80
per
cent
of
the
condition.
[4]
2.
Medications:
Prescribed
phosphodiesterase-5
inhibitors
such
as
Viagra,
Stendra
or
Levitra.
3.
Surgery:
It
includes
vascular
surgery
to
correct
the
blood
flow
in
the
penis
and
penile
implants
in
which
a
device
is
put
inside
the
penis
to
get
an
erection.
4.
Intracavernosal
Therapies:
It
includes
injection
therapies,
often
used
when
oral
therapies
don't
work.
2. Ejaculation disorders
Though erectile dysfunction is a well-known disorder in men, ejaculatory disorders are the most prevalent. It is a sexual problem in men related to ejaculation. A person with this disorder may experience ejaculation either too late, too soon or back to his bladder, or no ejaculation at all. It is divided into four categories: [5]
1.
Premature
ejaculation
(PE):
It
is
defined
as
ejaculation
that
occurs
due
to
lack
of
ejaculatory
control.
In
PE,
ejaculation
happens
always
or
nearly
always
before
or
in
just
one
minute
of
vaginal
penetration.
This
causes
problems
in
sexual
satisfaction
of
one
or
both
the
partners
and
may
disturb
their
emotional
well-being.
2.
Delayed
ejaculation
(DE):
Also
termed
as
retarded
ejaculation,
DE
is
defined
as
delay
in
ejaculation
or
absence
of
ejaculation.
The
condition
often
causes
penile
pain,
problems
during
orgasm
or
problems
in
conception.
3.
Retrograde
ejaculation
(RE):
It
is
responsible
for
around
0.3-2
per
cent
of
infertility.
RE
is
a
condition
in
which
the
semen
retrogrades
back
to
the
bladder
instead
of
coming
out
from
the
penis.
A
person
with
the
condition
may
reach
sexual
satisfaction
but
the
semen
produced
will
be
little
which
may
cause
problems
in
conception.
4.
Anejaculation/anorgasmia:
It
is
defined
as
a
complete
failure
of
achieving
ejaculation.
Men
who
often
avoid
sexual
intercourse
due
to
irritation
or
exhaustion
are
also
placed
in
this
section.
Causes of ejaculation disorders
Ejaculation disorders can have many potential causes such as:
- Inadequate sexual stimulation
- Loss of sexual excitement
- Poor body image
- History of traumatic masturbation
- Relationship stress and conflicts
- Religious taboos
- Damage to pelvic nerves
- Medications such as antidepressants, antipsychotics or those that increase circulating serotonin.
- Diabetes
- Low testosterone
- Hypothyroidism
- Spinal cord injuries
- Urinary tract infection
Treatments of ejaculation disorders
1.
Discontinuation
of
drugs:
Medications
that
interfere
with
orgasm
or
ejaculations
should
be
stopped
or
modified
after
consulting
a
doctor.
[6]
2.
Psychological
counselling:
To
address
mental
health
issues
which
are
indirectly
affecting
the
ability
to
ejaculate.
3.
Sex
education:
It
includes
relaxation
techniques
and
various
methods
to
get
sexual
satisfaction
without
ejaculation.
It
also
includes
behavioural
modification.
4.
Surgery:
It
is
usually
carried
out
in
RE
to
correct
the
muscles
so
that
ejaculation
can
happen
outside
the
penis.
3. Sexual desire disorders (Loss of sexual desire)
Sexual desire disorders are among the under-diagnosed disorders due to their private and awkward nature. It is defined as recurrent or persistent lack of sexual or erotic thoughts and loss of desire for sexual activity. It includes hypoactive sexual desire and sexual aversion disorder.
Sexual response cycle includes four phases: desire, arousal, orgasm and resolution. Problems in any of these factors can cause sexual desire disorders. [7]
Causes of sexual desire disorders
Biological causes of sexual desire disorders include:
- Low testosterone
- Hypothyroidism
- High levels of prolactin
- Medications such as antidepressants
- Neurological disorders such as multiple sclerosis
- Inflammatory bowel disease
- Renal failure
- Age-related problems
- HIV
- Heart disease
- Depression and anxiety
- Having a partner with low sexual desire
- Long term relationships
- Negative body image
- Performance anxiety
- Family concerns
- Sexual trauma
- Lack of appropriate sexual stimulation from the partner
- Having different preference for sexual activity
- Feeling of negativity towards the partner
- Religious background or rules towards sexuality
Psychological causes of sexual desire disorders include:
Treatments of sexual desire disorders
1.
Assessment:
It
includes
private
meetings
with
the
couples
individually
so
that
they
can
openly
discuss
their
suppressed
desire
or
thoughts
or
any
problems
which
can
be
the
cause
of
lack
of
sexual
desire.
2.
Testosterone
replacement
therapy:
Low
testosterone
can
be
the
primary
cause
of
decreased
sexual
desire.
The
therapy
causes
testosterone
levels
to
rise
up
and
increases
sexual
desire.
3.
Psychological
treatment:
It
includes
approaching
the
emotional
and
behavioural
problems
which
are
causing
interference
with
sexual
desire.
4.
Other
treatments:
Include
restraining
the
use
of
drugs
that
are
causing
low
libido,
providing
communication
training
so
as
to
establish
connection
between
partners
and
building
a
strong
relationship
to
get
sexual
satisfaction.
To Conclude
Sexual problems in men are as common as other health issues. However, discussing these problems is still a taboo in the society, which is also the main cause of a large number of under-diagnosed cases. Remember, addressing the sexual problems at an early stage can prevent the condition and improve the quality of life.
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