CONDITIONS A-Z

Male Sexual Dysfunction

The inability to achieve or maintain an erection, premature ejaculation or the inability to orgasm are all example of male sexual dysfunction. A survey of men between the ages of 40 and 65 revealed that almost 50% of men suffer from some degree of erectile dysfunction.1

Causes of Male Sexual Dysfunction

Male sexual arousal occurs when the brain sends a message to the nerves in the penis that causes the muscles around it to relax. Blood then flows in and fills the penis causing an erection. Any event that disrupts this process results in male sexual dysfunction.

Men with diseases such as diabetes and high blood pressure are at an increased risk of developing sexual dysfunction.

Vascular diseases such as atherosclerosis, peripheral vascular disease, myocardial infarction and arterial hypertension, result in almost half the cases of men over 50. Decreased testosterone levels, smoking, alcohol and drug abuse, prescription medicines, depression and relationship issues or stress are also causes.

Diagnosing Male Sexual Dysfunction

Both physical and psychological factors are considered when diagnosing male sexual dysfunction.

  • Patient History: A doctor asks questions that may reveal diseases, medications or lifestyle choices that may impair sexual function.

  • Physical examination: The penis, testes and overall physical health of the patient are checked for any abnormalities

  • Laboratory Tests: The patient's blood count, including testosterone levels, are measured to detect any hormonal imbalances or deficiencies.

  • Nocturnal Penile Tumescence: A patients erections are monitored during sleep.

  • Psychological Examination: Interviews with the patient and his sexual partner can help to reveal any psychological issues inhibiting sexual function.

Treatments for Male Sexual Dysfunction

If psychological factors are found to be a cause a doctor will suggest psychotherapy or counselling. In the case of dysfunction due to medications, the doctor may change or discontinue the medication. Other treatment options include the following:

  • Phosphodiesterase (PDE) inhibitors: These are drugs that relax the muscles and increase blood flow in the penis during sexual stimulation.

  • Testosterone Replacement Therapy: Hormone imbalances with pills, injections, skin patches or gels that contain testosterone.

  • Injections: Medications such as alprostadil, are injected into the penis or nsrted into the urethra to increase blood flow.

  • Vacuum Pumps: These pumps are placed onto the penis. They create a partial vacuum, which draws blood into the penis and cause an erection.

  • Penile prosthesis: Surgeons insert devices and into the penis that allows men to manually control erections. This can involve the risks of general anesthesia, infection, and prosthetic malfunction.

  • Acupuncture: In patients with psychogenic sexual dysfunction, acupuncture has been shown effective in helping some men regain sexual function.

References:

1. http://www.merck.com/mmpe/sec17/ch227/ch227c.html

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