Sexual dysfunction in men
Common and treatable
Virtually every man will have difficulty with sexual function at some point in his life. Sexual problems in men can occur at any age and can be temporary or chronic (i.e. long-lasting).
The most well known sexual problem in men is erectile dysfunction (ED), defined as difficulty attaining or maintaining and erection that permits satisfactory sexual intercourse. Over 50% of men between the ages of 40 and 70 have some degree of ED; this percentage increases as men get older but can occur in men of any age.
While ED is the best known and most talked about male sexual problem, many other issues may interfere with a man’s enjoyment of sex, including trouble with ejaculation (such as premature or delayed ejaculation) or loss of sexual desire (decreased libido). These conditions can also cause significant disturbances in sexual life.
Sexual problems are rarely caused by a single issue. Both biological factors (such as vascular diseases, history of pelvic surgery or side effects of medications) and psychosocial factors (including life stress, conflict with sexual partner and performance anxiety) can contribute to the problem.
Regardless of the cause, sexual problems can be extremely frustrating and detrimental to mood, self-esteem and overall quality of life for both the man and his partner. They may also be warning signs of a serious medical condition, such as coronary artery disease, peripheral vascular disease, diabetes, high blood pressure, depression or others.
Men who have regular or recurring sexual problems that interfere with his and/or his partner’s enjoyment of sexual activity should speak to their health care provider. A primary care physician can provide an initial assessment and possibly treatment for some sexual problems. In more complex situations or when initial therapy does not work, referral to a specialty clinic such as UC Davis Urology may be warranted. In some cases referral to a psychologist or psychiatrist may also be helpful for problems related to stress, anxiety, depression or conflict with one’s sexual partner.
Types of sexual dysfunction in men
- Sexual Desire: Issues can include hypoactive (decreased or absence of) sexual desire and, less frequently, hyperactive sexual disorder (excessive sexual desire) and sexual aversion disorder (phobia or disgust in response to sexual activity).
- Erectile Dysfunction (ED): The most common issue, ED is the inability to attain or maintain an erection.
- Ejaculatory Dysfunction: Premature or rapid ejaculation is a persistent or recurrent condition in which ejaculation occurs with minimal stimulation before, on or shortly after penetration. The opposite, delayed ejaculation or anorgasmia, is a situation in which a man cannot reach sexual climax despite prolonged sexual stimulation.
- Priapism: Defined as an erection that lasts 4 hours or longer, priapism is not associated with sexual excitement. This painful condition can lead to long-term penile damage that can result in ED.
- Sexual Pain: Some men may experience pain with sexual intercourse or ejaculation. Though not a common problem, it may be related to physical or psychological causes.
How sexual dysfunctions are evaluated
A trusting and confidential relationship between the patient and his health care provider is key in the treatment of sexual concerns. Many providers may ask you to complete a short, highly confidential questionnaire to help screen for sexual problems and facilitate open, honest and confidential communication.
All questionnaires, documents or notes are fully protected by law as part of your medical record, and will be viewable only by the members of your health-care team.
The most important component of the evaluation is a thorough history—including the nature of the problem, how long it has been present and any factors associated with its onset—accompanied by a physical examination. Your physician may ask for details of your most recent sexual encounter to help make an accurate diagnosis.
Available treatment options
UC Davis Urology offers a number of treatments for erectile dysfunction, premature ejaculation, abnormally reduced libido and other sexual dysfunctions.
PDE5 inhibitor medications such as sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) can help to enhance and sustain erections. A men’s health provider can help identify the most appropriate medication for your specific issues, goals and overall health status.
For men who cannot take or do not respond to PDE5 inhibitor medications, alternative medical and non-medical treatments such as injection therapy, vacuum erection devices and penile implants are also available. Testosterone therapy may also improve sexual desire and erectile function in some men with low blood testosterone levels. There are also treatment options for other sexual concerns in men.
In situations where there are relationship conflicts or psychological stressors, referral to a therapist or counselor may be of benefit.
For more information or to request an appointment, call 800-2-UCDAVIS.