Sexual problems are difficulties experienced during sexual activity. It can also occur at any phase of sexual activity and at any time of life but is more common as one advance in age.

Sexual problems can also be any physical or psychological experience that prevents you or your partner from getting sexual satisfaction. Sexual health is very important to men regardless of status and age. Apart from the damage it does to the ego, it can also be a sign of an underlying health condition.

MAIN TYPES OF SEXUAL PROBLEMS IN MEN

Low libido

This means decreased desire for sex. This can be caused by low levels of testosterone, depression, anxiety, use of anti depressants or even health conditions like hypertension and diabetes

Peyronie’s  disease

This is a deformation of the penis characterized by narrowing or curvature of the penis which results in pain and inhibits sexual activity.

Treatment can be surgery or use of medication.

Prolonged ejaculation

Erection can be prolonged in some men. In cases like this, help should be sort to prevent irreversible damage. This is usually due to medication intended to treat erectile dysfunction or psychiatric conditions.

Delayed ejaculation

As the name implies, it means ejaculation takes too long to occur. This can be due to stress, depression, surgeries or side effects of medication.

Retrograde ejaculation

This refers to the backflow of an ejaculate into the bladder rather than through the penis at orgasm.

Premature ejaculation

This is the release of semen too soon after penetration.

Erectile dysfunction

This is the inability to get and maintain erection during sexual activity. This could be  as a result of nerve disorders, stress, injury to the penis.

CAUSES OF SEXUAL PROBLEMS

Physical causes

Low testosterone levels: Testosterone is a hormone responsible for male development and sexual functions in men and is produced in the testicles. Decreased level of this hormone can affect sex drive in men and is usally caused by chronic conditions such as diabetes and obesity.

Smoking: Research has proven that sexual drive is better in men that do not smoke compared to men that do. It reduces the desire for sex and damages the smooth muscles of the penis thereby inhibiting erectile function.

Stroke: Sexual desire in men that have suffered a stroke is definitely impaired. This is because stroke causes a damage to the neurological connection between the brain and the penis thereby decreasing libido and inhibiting erectile function.

Substance Abuse and Alcoholism: Alcohol increases the desire for sex, but ironically inhibit performance thereby leading to more substance abuse. This has been found to be due to the effect of alcohol on blood vessels. During sex in a healthy male, blood flows to the penis making it erect and the blood vessels close to prevent back flow of blood and maintain an erection. But in an alcoholic, this is not so. The blood vessels do not close and erection is not being maintained.

Nerve Damage from Diabetes or Surgery: The sexual organs are connected to the brains by nerves. Sexual arousal is experienced when the brain receives an excitatory signal which in turn releases neurotransmitters to facilitate increased blood flow to the penis. When there is damage to these nerves, sexual problems occur.

Prescription Drugs: Just like there are drugs that can improve sexual drive, there are also drugs that inhibit libido. If you are under a medication and are experiencing decreased libido, it is important to talk to your doctor. An example of drugs that can inhibit sexual drive is anti-depressants.

Psychological Causes

Depression: Depression is characterised by decreasing brain activity. The brain, on the other hand, coordinates sexual activity by releasing chemicals that aid erection. Decreased brain activity, as a result, leads to decreased libido.

Concern About performance; When a man is concerned about performance and whether his partner is satisfied or not, he becomes anxious and stress hormones are released in the body. He becomes impatient and finds it difficult to maintain an erection. The whole sexual experience ceases to be an activity that is enjoyed but becomes associated with stress.

Other psychological causes that can affect sexual function in men in similar ways that anxiety and depression would are listed below:

  • Feeling of guilt
  • Past sexual trauma
  • Marital problems

DIAGNOSIS

Though the sexual life of an individual is considered private, it is important to be honest and to give all necessary information so as to enable the physician to give you the best treatment option.

After medical and sexual history is taken and physical examination is done, some tests that could be recommended depending on presenting complaints include;

  • Blood pressure check
  • Rectal examination to assess the prostate
  • Blood test for glucose (diabetes), testosterone level, and cholesterol
  • Examination of the penis and testicles
  • Checking blood flow to the penis
  • Night time rigidity checks
  • Nerve checks for loss of sensation in diabetics

TREATMENT

1. Hormones

Men experiencing low levels of testosterone can be given testosterone replacements therapy.

2. Psychotherapy

This is helpful especially when the underlying cause of sexual dysfunction is psychological such as a feeling of guilt, marital problems and so on. A trained Counselor can help resolve these issues.

3. Mechanical Aids

Mechanical aids such as penile implants can be helpful in the case of erectile dysfunction.

4. Medication

There are various injections, pellets, and gels that can help improve erection. An example is Viagra that improves erection by increasing blood flow to the penis.

5. Treating underlying conditions that may be causing sexual dysfunction.
6. Sex Education

Education on sex can help improve performance as well as the promotion of effective communication between sexual partners.

PREVENTION

Sexual health in men may not be totally prevented but it can be improved by the  ways below thus:

  • Avoiding drug abuse
  • Reducing alcohol intake
  • Avoiding smoking
  • Avoiding stress

 

REFERENCES

Five Embarrassing Male Sexual Issues. (n.d.). http://www.mensfitness.com/women/sex-tips/five-embarrassing-male-sexual-issues

Sexual Dysfunction in Males. (n.d.). https://my.clevelandclinic.org/health/articles/sexual-dysfunction-in-males

Men’s sex  problems. (n.d.). http://www.webmd.boots.com/sexual-conditions/guide/mens-sexual-problems

Sexual Problems in Men. (n.d.). https://medlineplus.gov/sexualproblemsinmen.html

Sexual Problems in Men. (n.d.). http://www.webmd.com/men/guide/mental-health-male-sexual-problems#2