Male Sexual Dysfunction

Last Updated: August 16, 2022

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.

Male Sexual Dysfunction falls under theHealthy Aging & LongevityandMen’s Healthcategories.

What is male sexual dysfunction?

In men, sexual dysfunction typically involves issues with one or more of the following factors:[1][2]

  • Interest in sex/arousal
  • Getting an erection
  • Ejaculation
What are the main signs and symptoms of male 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
  • low-testosterone
How is male sexual dysfunction diagnosed?

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.[2]

What are some of the main medical treatments for male sexual dysfunction?

Depending on the condition, a variety of medical treatments may be used:[2]

ConditionMedical Treatments
Premature ejaculationSelective serotonin reuptake inhibitors (SSRIs) Topical anesthetics (e.g., lidocaine)
Delayed ejaculationCessation of medications that may cause delayed ejaculation (e.g., SSRIs, opioids)
Erectile dysfunctionPhosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, vardenafil, tadalafil)
Low libidoTestosterone replacement therapy and/or cessation of libido-reducing medications (e.g., SSRIs, opioids)

Additionally, sexual dysfunction can be secondary to some other issue, such as depression, cardiovascular disease, or hypogonadism (i.e., low testosterone).

Have any supplements been studied for male sexual dysfunction?

A handful of studies have found maca to improve sexual desire in people with and without sexual dysfunction. Additionally, cocoa extract may improve sexual function by supporting vascular health.

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.

How could diet affect male sexual dysfunction?

In individuals who are overweight, or have diet-related health conditions like type-2-diabetes, weight loss can markedly improve sexual function.[3]

Are there any other treatments for male sexual dysfunction?

Regular exercise can improve erectile dysfunction.[3]

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.[2]

Smoking cessation is probably beneficial for erectile dysfunction.[4][5]

If the sexual dysfunction is secondary to another condition, treating that condition may resolve the sexual dysfunction.

What causes male 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.[6]

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)[7]
  • Sleep disturbances
  • Medications (e.g., SSRIs, opioids, certain blood pressure medications)
  • Recreational drugs

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  1. ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
  2. ^Cleveland ClinicSexual Dysfunction
  3. ^Bhanu P Gupta, M Hassan Murad, Marisa M Clifton, Larry Prokop, Ajay Nehra, Stephen L KopeckyThe effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysisArch Intern Med.(2011 Nov 14)
  4. ^Chunlei Wu, Haiying Zhang, Yong Gao, Aihua Tan, Xiaobo Yang, Zheng Lu, Youjie Zhang, Ming Liao, Mengjie Wang, Zengnan MoThe association of smoking and erectile dysfunction: results from the Fangchenggang Area Male Health and Examination Survey (FAMHES)J Androl.(Jan-Feb 2012)
  5. ^Gholamreza Pourmand, Mohammad Reza Alidaee, Sohrab Rasuli, Ameneh Maleki, Abdolrasoul MehrsaiDo cigarette smokers with erectile dysfunction benefit from stopping?: a prospective studyBJU Int.(2004 Dec)
  6. ^Dirk Rösing, Klaus-Jürgen Klebingat, Hermann J Berberich, Hartmut A G Bosinski, Kurt Loewit, Klaus M BeierMale sexual dysfunction: diagnosis and treatment from a sexological and interdisciplinary perspectiveDtsch Arztebl Int.(2009 Dec)
  7. ^Qian Liu, Youpeng Zhang, Jin Wang, Sen Li, Yongbiao Cheng, Jialun Guo, Yong Tang, Hanqing Zeng, Zhaohui ZhuErectile Dysfunction and Depression: A Systematic Review and Meta-AnalysisJ Sex Med.(2018 Aug)
  8. ^Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri CStress management and erectile dysfunction: a pilot comparative study.Andrologia.(2014-Aug)
  9. ^Boloña ER, Uraga MV, Haddad RM, Tracz MJ, Sideras K, Kennedy CC, Caples SM, Erwin PJ, Montori VMTestosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials.Mayo Clin Proc.(2007-Jan)
  10. ^Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson KPhysical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies.Sex Med.(2018-Jun)
  11. ^Damiano Pizzol, Jacopo Demurtas, Brendon Stubbs, Pinar Soysal, Corina Mason, Ahmet Turan Isik, Marco Solmi, Lee Smith, Nicola VeroneseRelationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-AnalysisAm J Mens Health.(Nov-Dec 2019)
  12. ^Shamloul R, Bella AJImpact of cannabis use on male sexual health.J Sex Med.(2011-Apr)
  13. ^Smith AM, Ferris JA, Simpson JM, Shelley J, Pitts MK, Richters JCannabis use and sexual health.J Sex Med.(2010-Feb)
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  2. Testosterone - G Cavallini, S Caracciolo, G Vitali, F Modenini, G BiagiottiCarnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male agingUrology.(2004 Apr)
  3. Erections - V Gentile, P Vicini, G Prigiotti, A Koverech, F Di SilverioPreliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetesCurr Med Res Opin.(2004 Sep)
  4. Erections - Giorgio Cavallini, Fabio Modenini, Giovanni Vitali, Aleardo KoverechAcetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomyUrology.(2005 Nov)
  5. Sperm Quality - Khaw SC, Wong ZZ, Anderson R, Martins da Silva Sl-carnitine and l-acetylcarnitine supplementation for idiopathic male infertility.Reprod Fertil.(2020-Jul)
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  7. Erections - Mamidi P, Thakar ABEfficacy of Ashwagandha (Withania somnifera Dunal. Linn.) in the management of psychogenic erectile dysfunctionAyu.(2011 Jul)
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  9. Erections - Ernst E, Pittler MHYohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trialsJ Urol.(1998 Feb)
  10. Testosterone - Gonzales GF, Córdova A, Vega K, Chung A, Villena A, Góñez CEffect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy menJ Endocrinol.(2003 Jan)
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  13. Testosterone - Conaglen HM, Suttie JM, Conaglen JVEffect of deer velvet on sexual function in men and their partners: a double-blind, placebo-controlled studyArch Sex Behav.(2003 Jun)
  14. Testosterone - Biswas TK, Pandit S, Mondal S, Biswas SK, Jana U, Ghosh T, Tripathi PC, Debnath PK, Auddy RG, Auddy BClinical evaluation of spermatogenic activity of processed Shilajit in oligospermiaAndrologia.(2010 Feb)
  15. Testosterone - de Andrade E, de Mesquita AA, Claro Jde A, de Andrade PM, Ortiz V, Paranhos M, Srougi MStudy of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunctionAsian J Androl.(2007 Mar)
  16. Erections - Hong B, Ji YH, Hong JH, Nam KY, Ahn TYA double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary reportJ Urol.(2002 Nov)
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  18. Testosterone - Steels E, Rao A, Vitetta LPhysiological Aspects of Male Libido Enhanced by Standardized Trigonella foenum-graecum Extract and Mineral FormulationPhytother Res.(2011 Feb 10)
  19. Erections - W Cherdshewasart, N NimsakulClinical trial of Butea superba, an alternative herbal treatment for erectile dysfunctionAsian J Androl.(2003 Sep)
  20. Erections - Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LS, Holmberg ARThe use of Butea superba (Roxb.) compared to sildenafil for treating erectile dysfunctionBJU Int.(2010 Jan)
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  22. Erections - Hossein Mohammadzadeh-Moghadam, Seyed Mohammad Nazari, Ali Shamsa, Mohammad Kamalinejad, Habibollah Esmaeeli, Amir Abbas Asadpour, Abdoljavad KhajaviEffects of a Topical Saffron (Crocus sativus L) Gel on Erectile Dysfunction in Diabetics: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled TrialJ Evid Based Complementary Altern Med.(2015 Oct)
  23. Erections - Safarinejad MR, Shafiei N, Safarinejad SAn open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatmentInt J Impot Res.(2010 Jul-Aug)
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  27. Penile Girth - Horita H, Sato Y, Adachi H, Suzuki N, Kato R, Hisasue S, Suzuki K, Tsukamoto TEffects of levodopa on nocturnal penile tumescence: a preliminary studyJ Androl.(1998 Sep-Oct)