Male Sexual Dysfunction
In men, sexual dysfunction is typically related to problems with arousal, getting an erection, and/or ejaculating. Sexual dysfunction is complicated and can be caused my many things. Improving diet, exercising more, and identifying underlying factors are all important for treating sexual dysfunction.
Men who are experiencing sexual dysfunction may have the following symptoms:
- Lack of interest in sex
- Difficulty becoming aroused
- Difficulty getting or maintaining an erection
- Ejaculating too quickly or too slowly
Because many of the symptoms (e.g., satisfaction with time to ejaculation, level of interest in sex) are subjective, sexual dysfunction diagnoses are primarily based on what an individual identifies as problematic. A person’s emotions and previous experience can contribute to sexual dysfunction, so a full history and psychiatric evaluation may be useful. Similarly, lab tests can be used to identify or rule out physiological causes of sexual dysfunction.
Depending on the condition, a variety of medical treatments may be used:
|Premature ejaculation||Selective serotonin reuptake inhibitors (SSRIs) Topical anesthetics (e.g., lidocaine)|
|Delayed ejaculation||Cessation of medications that may cause delayed ejaculation (e.g., SSRIs, opioids)|
|Erectile dysfunction||Phosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, vardenafil, tadalafil)|
|Low libido||Testosterone replacement therapy and/or cessation of libido-reducing medications (e.g., SSRIs, opioids)|
A number of other supplements have shown some promise (e.g., fenugreek, yohimbine, tribulus-terrestris, Eurycoma Longifolia Jack), but very little research has been conducted on any of these supplements.
Regular exercise can improve erectile dysfunction.
Psychotherapy and sex therapy are also effective for treating sexual dysfunction, especially if the dysfunction is caused by a person’s beliefs, previous experiences, or perception of themselves.
If the sexual dysfunction is secondary to another condition, treating that condition may resolve the sexual dysfunction.
“Normal” sexual function requires vascular, neurological, hormonal, and psychological systems to function together. As such, issues with any of these symptoms may produce issues with sexual function.
Sexual dysfunction can be caused by:
- Neurological issues (e.g., damage to the brain, the spinal cord, or the nerves of the penis)
- Vascular issues (e.g., reduced penile blood flow due to cardiovascular disease)
- Endocrine issues (e.g., low testosterone, high prolactin, high/low thyroid hormones)
- Psychosocial issues (e.g., depression, stress, or relationship issues)
- Sleep disturbances
- Medications (e.g., SSRIs, opioids, certain blood pressure medications)
- Recreational drugs