When you are experiencing male sexual dysfunction it affects both the physical and the mental
Sexual problems in men are common – up to a third of men report difficulty – and include a wide variety of problems which can affect any phase in the sex response cycle, preventing satisfaction and/or functioning. Most men experience some form of dysfunction at some time in their life, fortunately most forms of difficulty are treatable, although many men are reluctant to share with a medical professional, making it difficult to find adequate treatment.
Most Common Types
Premature, inhibited and retrograde ejaculations can be psychological in nature. Diabetes is a common cause of retrograde ejaculation, as well as past bladder neck, prostate or abdominal surgeries. Medications for mood disorders and depression commonly contribute to these problems. Erectile dysfunction is the inability to maintain an erection, and common causes include blood diseases, stress and depression, or chronic illness. Loss of libido – the desire and impulse for sexual activity – is associated with low testosterone, high blood pressure and any above mentioned psychological factors.
Broken down into physical, psychological and behavioral, causes include the following:
- Heart disease
- Neurological disorders
- Medications (more below)
- Chronic liver or kidney diseases
- Drug and alcohol abuse
- Poor communication skills
- Poor sleep
- Lack of exercise
- Poor diet
- Relationship problems
- Past trauma
Medications that don’t mix
Medications inhibiting function most commonly are:
- Antidepressants / Mood stabilizers
- High blood pressure medications
- Pain killers
- Medications treating prostate conditions
Psychological roots are complex. Religious inculcation as a youth can skew perceptions of the “rightness” or “wrongness” of sex. Overthinking or becoming easily distracted as a result of nervousness can emerge from issues with self-confidence or past sexual abuses/experiences. Sex performance anxieties can be confronted through therapy with trained professionals.
At a routine physical exam diagnosis can be made based on medical history and present body conditions (heart rate, blood pressure, etc), but opening up with the physician is the quickest path to a targeted assessment and specialized treatment plan. The doctor may examine the penis and testicles, order blood or urine tests, ultrasounds (monitors blood flow) and perform a psychological evaluation. The psychological component can be very personal. Common as well as infamous, the medications Cialis, Levitra, Stendra, Viagre and Staxyn can improve erectile function through increasing the blood flow to the penis. These treatments act by enhancing the effects of nitric oxide, which relaxes muscles in the penis, leading to increased blood flow.
Sexual stimulation is still required for an erection, contrary to popular myth. Some side effects include flushing, nasal congestion, headaches and upset stomach.
How treatments are administered
Alprostadil can be injected using a fine needle into the base or side of the penis. Generally these injections only last and hour but are not as painful as one might expect. Alprostadil also comes in suppository form, to be placed inside the penile urethra. It is very tiny and is inserted manually using a special applicator. Premature ejaculation can be treated with Promescent, a spray containing lidocaine – a topical anasthetic. Hormone therapy treats low testosterone levels but is best regulated by a doctor, not through over-the-counter supplements or steroid use. Surgically placed implants consist of inflatable or bendable rods and can be controlled manually to both initiate and maintain an erection. This method is highly successful but expensive, and risk of infection can be dangerous.
Alternative medicine, supplements and herbs
Any medications should be discussed with a doctor prior to use. Efficacy of these options are generally not proven nor thoroughly evaluated, and unpredictable side effects or drug interactions can occur. Apart from medical treatments, psychological therapy, sex education and even simple mechanical aids like vacuum devices are often beneficial. Penis pumps are hollow tubes with manual or battery powered pumps which suck air out of the tube and causes blood to be pulled into the penis. A tension ring is then applied to the base of the penis in order to hold blood in. Effectiveness is shorter in duration but often sufficiently long.
Exercise and other activities
Exercise, stress reduction activities (yoga, meditation, stretching) and proper diet are the most controllable influences, and often the most important. Maintaining low cholesterol levels by lean consumption as well as moderate sodium levels will have cumulative benefits. Cultural perceptions and standards of masculinity play a major psychological role in many cases of sexual dysfunction. A partner open to discussing these issues can aid in overcoming more than just sexual inadequacy. Professional therapy is nearly always worth the effort, in addition.
Medical Practitioner (General Practice) with postgraduate diplomas in Cape Town. My special interest is erectile dysfunction.