Posted on : June 9, 2021 by Clinic One on Sexual Health
Sexual problems are those complications that inhibit people from having optimal sexual satisfaction with their partners. In other words, the sexual problem is referred to any difficulties in having or during sex that prevents people from obtaining the desired level of satisfaction.
The sexual problem may arise at different levels of the sexual reaction cycle namely arousal (erectile dysfunction), or orgasm (premature, or delayed ejaculation).
Hence it is essential to distinguish where and at which state the problem is so that the exact nature of the problem could be ascertained.
As sexual activity is a coordinated function of hormonal, psychological, and neurological systems, thereby it is vitally important that all these pathways are in sync for optimal sexual health.
Moreover, blood vessels, penile integrity, and nerves must also be in shape to obtain an adequate erection and its maintenance during a satisfactory sexual relationship.
Similarly, muscle and nerves coordinate to achieve optimal ejaculation as a physiological passageway for the sperms starting from the testicles into the urethra.
Thus, this is a reason why elucidating a sexual problem could be quite tricky without professional help.
It is estimated that almost 31% of men and 43% of women are subjected to sexual problems.
Some of the most common sexual complications in the male are typically attributed to ejaculation disorders, erectile dysfunction, reduced sexual desire, and Peyronie’s disease.
Although, sexual problems can be seen in people of all ages, nevertheless, older males are more prone to having sexual problems than younger ones. The top 5 sexual problems in males are listed and elaborated below.
1. Erectile Dysfunction
Erectile dysfunction is the inability to get and keep an erection for an extended period for sexual intercourse.
This is a problem seen in males as they age with a study suggesting that it is prevalent in almost 52% of the men between the age group of (40-70). This condition has psychological and physiological origins.
List of conditions that attribute to this condition is cardiovascular disease, diabetes, high blood pressure, high cholesterol levels and obesity, low testosterone levels, stress, anxiety, depression, relationship problem, long term use of certain medications such as for depression or high blood pressure, sleep disorder, prolonged drug use, alcohol use, tobacco use, health conditions such as Parkinson disease or multiple sclerosis, etc.
Nevertheless, cardio-vascular abnormalities that inhibit the blood flow to the penal arteries that would otherwise make the chambers inside the penis rigid, erect and hard are considered one of the most prevalent causes of this condition.
2. Premature Ejaculation
This is a term given to ejaculation that occurs too soon after penetration where an individual has minimal control over ejaculation. Natural chemicals such as serotonin (a chemical that affects the mood) are thought to play a major role in premature ejaculation. Similarly, certain drugs such as anti-depressants may also affect ejaculation along with nerve damage to the back of the spinal cord.
There could be neurological causes of premature ejaculation which could affect either central control of ejaculations, innervations (the process of supplying nerves) to the seminal tract, and sensory innervations to genitalia or prostate. While penile hypersensitivity is considered to be the most noted cause of premature ejaculation.
This can be treated by employing a natural “squeeze” technique where you withdraw from your partner at the moment of climax and ejaculation. This is a kind of a bio-feedback technique with a high success rate that requires you to halt the ejaculation, if you experience premature ejaculation, hindering your sexual satisfaction.
The repeated practice could lead to better control in a long run. Nevertheless, you could apply some spray, for example, “lidocaine” that would reduce the sensitivity of the penis and thereby allows for better control over your ejaculation.
3. Delayed/Retarded or Retrograde Ejaculation
Ejaculation that does not happen or takes a very long time after penetration is generally termed as delayed ejaculation. This is generally observed in peoples with the long-term use of medications especially those from anti-depressants and their side effects.
This can be often treated by reducing the anxiety and having better control over the timing of ejaculation.
Sensate focus exercises where you withhold penetration until you sense that ejaculation is inevitable can be very helpful in this regard.
While on contrast, if the semen is forced back into the bladder instead of getting it out of your penis it is called retrograde ejaculation. This may generally be seen in men with nerve damage due to bladder or prostate surgery or from diabetes.
This condition is also sometimes called a dry orgasm where the semen goes back to the bladder resulting in presence of semen in their first urine.
It can be cured with some medications or from surgery which allows the valve at the base of the bladder to close. Or, instead, you could retrieve the sperm from the bladder for artificial insemination.
4. Low libido/Lack of sexual urge:
A reduced level of male hormone namely testosterone can drastically reduce the sexual drive in a person and this is technically termed as low libido.
This is because testosterone governs a large number of physiological processes such as sex drive, sperm production, muscle, hair and bone formation, and so on.
Hence the reduced level of this hormone in males can negatively affect their adequate sexual health by decreasing their interest.
Moreover, reduced interest in having sex may also sometimes result in an inability in getting an erection.
Nevertheless, depression, anxiety, or relationship difficulties may also be the source of the reduced sexual drive along with the long-term use of medications for high blood pressure, depression.
You could get the hormonal supplements if low levels of testosterone are the cause of your problem. Or either you could get some help from a professional therapist in case of psychological trauma.
5. Peyronie’s disease
A rare condition where deformity of the connective tissue affects the curvature of your penis that becomes the cause of pain during sexual intercourse or an erection.
This deformity is generally the result of the deposition of scar tissue that does not allow for the normal stretching of the connective tissue of the penis.
This as a result generally leads to the upward bend of the penis in most cases leading to deformity.
Peyronie’s disease is as common as 1 in every 11 men suffering from it but lacks public awareness.
Sometimes peoples also are likely to have lumps or bumps at the top or bottom of their penis which could also be the source of the pain.
It could simply be treated by injecting medications to dissolve bumps or surgery could be another option.
Causes of Sexual Problem in males
Sexual complications can stem from the physiological/biological, sociological, and psychological make-up of an individual that can affect their sexual pleasure, bonding, intimacy, and reproduction.
Therefore, it is wise to consult a therapist or your health care provider to outline the appropriate guidelines to work on the appropriate cause of the problem. Some of the factors relating to these are listed below.
- Low testosterone levels and hormonal imbalances
- Long term use of prescription drugs such as antidepressants, high blood pressure medicine
- Blood vessels disorders such as atherosclerosis (hardening of arteries) and high blood pressure
- Stroke or nerve damage from diabetes or surgery
- Nervous system disorders like multiple sclerosis, or Parkinson’s disease
- Health conditions such as diabetes, high blood pressure, high cholesterol, hormonal imbalances, or heart problems
- Smoking, alcoholism, or drug abuse
- Aging may in large part reduce the sexual urge and desire and even the performance
- Marital problem or relationship problem
- Anxiety about the sexual performance.
- Depression and feeling of guilt
- Effects of past sexual trauma
- Work-related stress or anxiety
- Low self-confidence
- Unresolved conflict with the partner
Diagnosis of Sexual Problems in male
Diagnosis starts with the physical and verbal inquiry and examination regarding you or your partner’s sexual history.
Consequently, doctors might want to first ascertain the fact about your vascular health especially about the flow of blood to your penis and any complications that you might have experienced.
These inquiries might relate to your symptoms, medical and sexual history.
Since these inquiries could be personal but it will be recommended for you to answer them as honestly as possible without getting embarrassed so that you could get the best treatment available.
You might be referred to various specialists namely a urologist, endocrinologist, or sex therapist to pinpoint the exact nature of your sexual problem.
Some of the different types of tests your doctors might suggest are listed below.
- Blood tests to check your testosterone level, blood sugar (for diabetes), and cholesterol.
- Evaluation of your Blood pressure.
- Prostate evaluation by rectal exam.
- Examination of your reproductive organs such as penis or testes.
Preventive Methods for Sexual Problems in Male
Maintaining good cardiovascular health is vital to prevent any upcoming sexual complications in the future.
Moreover, getting to know about the causes is a prerequisite to help prevent the problem in the first place.
Since cardiovascular health is inherently linked to sexual health, maintaining a good healthy routine and lifestyle for good cardio-vascular health is highly recommended.
Here are some preventive tips to adhere to improve your sexual health.
- Limiting alcohol intake or quitting smoking
- Maintaining a good healthy lifestyle with regular exercise for example aerobics, running, or yoga
- Keeping up with healthy eating habits of lots of green vegetables
- Getting treatment with a counselor for any psychological or emotional trauma such as stress, anxiety, or depression, if that is the root cause of your sexual problem. Cognitive-behavioral therapy is the best for people having such origins to their sexual problem.
- Resolving any relationship issues with your partner
Treatment for Sexual Problems in Male
Sexual problems can be treated simply by managing the underlying problem that’s causing it in the first place.
These can be mental and physiological which will most likely be ascertained by your doctor after a brief inquiry.
Here are several ways, in which your physician could advise you to go ahead to treat your problem.
- Medications: Some drugs that help improve the blood flow to your penis and hence relieve you of your problems could be Sildenafil (Viagra), Vardenafil (Levitra), and Tadalafil (Cialis), etc.
- Hormone therapy: Your testosterone levels can be raised by using some injections, patches, or gels if low levels of your hormone are thought to be the cause of the problem.
- Psychological therapy: You might need the help of a counselor to help address the problems of anxiety, depression, fear, or guilt that could be affecting your sexual function. You could get help from either a psychotherapist, couple therapist, or sex therapist depending upon the nature of your emotional trauma.
- Mechanical aids: You could be recommended for vacuum devices or penile implants in case of erectile dysfunction.
- Cleveland Clinic (2019), Sexual dysfunction in males, Article
- Dr. Dirk Rosing et al (2009), Male Sexual Dysfunction, Deutsches Arzteblatt International
- Kevin C. Jorn and William C. Shiel Jr. (2019), Sexual Problems in Men, MedicineNet
- Sabrina Felson (2021), Understanding Male Sexual Problem-Diagnosis and treatment, WebMD
- Neha Pathak (2021), Sexual Problems in Men, WebMD
- John Hopkins Medicine, Peyronie’s Disease, Health article
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