Sexual Dysfunction in Men

Sexual Dysfunction in Men

Defined by the impairment of sexual functioning,  male sexual dysfunction can be primarily characterised by the diagnosis of erectile dysfunction (ED), Peyronie’s disease (PD), and premature ejaculation (PE). The condition of male sexual dysfunction is proportional with age i.e., the risk increases with age and is relatively higher with more than 50% of men aged 40-70 years of age describing some degree of erectile dysfunction.

There are various risk factors for male sexual dysfunction such as increasing age, diabetes mellitus (DM) (increased glucose levels in blood), cancer (abnormal cell multiplication), stroke (disrupted blood flow to the brain), hypertension (increased blood pressure), penile trauma, depression, anxiety, and disturbance in central serotonin neurotransmission etc.

During the diagnosis the endocrinologists may pursue the medical history of the patient along with physical examination to establish the correct diagnoses. The establishment of impaired sexual functioning must be crucial to confirm the diagnosis of male sexual dysfunction. The treatment of male sexual dysfunction depends on the cause.

Sexual dysfunction can impact a man’s self-esteem, relationships, and overall quality of life. Also, sexual dysfunction can cause negative psychological effects, including feelings of emasculation and humiliation, decreases in self-confidence and feelings of self-worth, feelings of isolation and loneliness, increases in depression, and decreases in subjective well-being.

Types of Sexual Dysfunction

  1. Erectile Dysfunction (ED): Erectile dysfunction is the consistent or recurrent inability to attain or maintain a penile erection sufficient for sexual satisfaction. Although this is a common condition, many men seldom self-report erectile dysfunction symptoms.
  2. Peyronie's disease: This type of sexual dysfunction is characterised by the formation of plaques (segments of flat scar tissue) seen under the skin of the penis which causes bending or indenting of the penis during erections. The plaques can often be felt through the skin and can be painful.
  3. Premature Ejaculation (PE): This disorder is regarded as a persistent or recurrent pattern of ejaculation within the sexual activity of approximately 1 minute after vaginal penetration. It occurs in at least 75% of sexual encounters for at least 6 months and can be categorized into mild, moderate, severe based on amount of time from to ejaculation.
  4. Delayed Ejaculation: The individual experiences a marked delay or inability to achieve ejaculation despite stimulation and desire. Similar to Premature Ejaculation, Delayed Ejaculation must occur in at least 75% of sexual encounters for at least 6 months.
  5. Low Libido: Reduced interest in sexual activity, often linked to hormonal imbalances, stress, or emotional issues.

Symptoms of Sexual Dysfunction

Men may experience various symptoms depending on the type of sexual dysfunction they are facing. Some common symptoms include:

  • Difficulty achieving or maintaining an erection (ED).
  • Premature or delayed ejaculation.
  • Lack of sexual desire or low libido.
  • Inability to achieve orgasm despite stimulation.

For women, sexual dysfunction can also occur but manifests differently, such as lack of arousal, painful intercourse, or difficulty achieving orgasm. Although this page focuses on men, women experiencing these symptoms should seek medical advice.

Causes of Sexual Dysfunction

Several factors contribute to sexual dysfunction in men. These can include:

  • Physical Causes: Poor health usually corresponds with low levels of sexual desire which can combine with various sexual dysfunctions, such as erectile dysfunction and premature ejaculation. Increasing age, comorbid conditions, such as diabetes mellitus (DM), cancer, stroke, and hypertension, were associated with increased risk for erectile dysfunction.
  • Psychological Causes: There is evidence that psychological factors such as personality, depression, stress, and cognitive interference (e.g., performance worry, shifts in attentional focus) contribute to erectile problems..
  • Medications: It is estimated that up to 25% of all erectile dysfunction problems are related to medication use and may be reversible. 5-α reductase inhibitors and neuropsychiatric medications had the highest reports of erectile dysfunction adverse effects.
  • Hormonal Imbalances: Low levels of testosterone or other hormone-related issues may reduce libido or lead to erectile dysfunction.

When to See a Doctor?

Men should consider seeing a doctor when sexual difficulties persist for a significant period or start affecting their relationships or self-esteem. If sexual dysfunction occurs regularly, impacts daily life, or is linked to an underlying health condition like diabetes, it's crucial to seek expert medical advice. Consult with a specialist to explore the root cause and appropriate treatments.

Risk Factors of Sexual Dysfunction

Several factors may increase the risk of developing sexual dysfunction:

  • Age: Sexual dysfunction becomes more common with age.
  • Chronic Illnesses: Conditions like heart disease, high blood pressure, and diabetes are significant risk factors.
  • Lifestyle Choices: Smoking, excessive alcohol consumption, and lack of physical activity can impair sexual performance.
  • Psychological Stress: Mental health issues, including anxiety and depression, significantly affect sexual function.

Complications & Prevention

Sexual dysfunction can strain personal relationships and lead to low self-esteem and depression. Untreated conditions like erectile dysfunction might signal more severe health issues, such as cardiovascular disease. Preventative measures include maintaining a healthy lifestyle—eating a balanced diet, exercising regularly, and managing stress. Avoiding excessive alcohol and quitting smoking can also reduce the risk.

Diagnosis & Tests

Doctors diagnose sexual dysfunction based on a detailed medical history, physical examination, and various tests, such as:

  • Blood Tests: To check hormone levels, blood sugar, and cholesterol. FSH, LH, Testosterone, Prolactin.
  • Ultrasound: To assess blood flow to the penis.
  • Psychological Assessment: To determine if stress or mental health issues are contributing factors.

Treatments

Several treatment options are available for sexual dysfunction, including:

  • Medications: Oral medications like Viagra, Cialis, or Levitra are commonly used for erectile dysfunction.
  • Hormone Therapy: Testosterone replacement may be prescribed for low libido or hormonal imbalances.
  • Counseling: Therapy can address psychological issues contributing to sexual dysfunction.
  • Surgical Options: In some cases, penile implants or vascular surgery might be necessary for severe erectile dysfunction.

Do's and Don'ts

Do's:

  • Do seek medical advice early if experiencing ongoing sexual problems.
  • Do maintain a healthy lifestyle—exercise regularly, eat a balanced diet, and reduce stress.
  • Do communicate openly with your partner about sexual concerns.

Don'ts:

  • Don’t ignore symptoms of sexual dysfunction, as they could indicate underlying health issues.
  • Don’t use over-the-counter pills or supplements without consulting a healthcare provider.
  • Don’t rely solely on lifestyle changes—medical treatment may be necessary.

Care at Dr. Prudwiraj Sanamandra Endocrinology Clinic

At Dr. Prudwiraj Sanamandra Endocrinology Clinic, expert care for sexual dysfunction is tailored to each patient's specific needs. We provide comprehensive diagnostic services and cutting-edge treatments to address both physical and psychological aspects of sexual health. Our approach is patient-centered, ensuring privacy, compassion, and the highest standard of care.

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