By Dr. G G Laxman Prabhu
It is not uncommon for men to face sexual problems at any age and most of the time they are either unaware of it or too shy to discuss it with their doctors. Sexual problems in men can be due to physical or psychological causes.
Important physical reasons for male sexual dysfunction include diabetes, hypertension, thyroid disorders, cardiac diseases, chronic kidney diseases and at times deformities of the genitalia. Sometimes sexual dysfunction can be entirely due to drugs like anti-depressants and anti-hypertensives. In additiona to this, psychological issues caused by work related stress and anxiety, depression, marital or relationship problems can also lead to sexual dysfunction.
Some Common Sexual Problems Faced by Men
Ejaculation disorders: Ejaculation disorders can be of three types
Premature Ejaculation: This refers to ejaculation that occurs before or soon after penetration.
Inhibited or Retarded Ejaculation: This is when ejaculation is slow to occur.
Retrograde ejaculation: This occurs when at orgasm, the ejaculate escapes back into the bladder rather than through the urethra and out at the end of the penis.
Erectile Dysfunction (ED) is the inability to get and maintain an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence. Occasional ED is not uncommon. Many men experience it during times of stress. Treatment for erectile dysfunction involves determining the underlying cause and specific therapy. This includes various diagnostic tests as well as dealing with life style problems like obesity, smoking, cholesterol, and other risk factors for cardiovascular disease.
Testosterone Deficiency Syndrome: Testosterone deficiency syndrome, or hypogonadism, can affect not only sexual performance, but also adversely impact bone health, energy level, muscle strength, and mood. Testosterone replacement therapy—such as with a gel—can help alleviate symptoms. Regular follow-up, though, is needed to ensure that you reach a reasonable range of testosterone.
Performance Anxiety: Brooding over one’s capability in the bed can most certainly affect sexual performance and this sort of behavior is termed as ‘performance anxiety’. To overcome such problems, it is suggested to use remedies and supplements that would help one unwind.
Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following:
Medical Treatment of Systemic Diseases: This involves treatment of any physical problem that may be contributing to a man’s sexual dysfunction.
Medications: Medications, such as sildenafil, tadalafil and udenafil may help improve erectile function in men by increasing blood flow to the penis. The topical spray is applied to the penis for better ejaculation control
Hormones: Men with low levels of testosterone may benefit from testosterone replacement therapy.
Psychological Therapy: Therapy with a trained counselor can help a person address feelings of anxiety, fear, or guilt that may have an impact on sexual function.
Mechanical Aids: Aids such as vacuum devices and penile implants may help men with erectile dysfunction to resume sexual activity.
Education and Communication: Education about sexual behaviors and responses may help a man overcome his anxieties about sexual performance. Open dialogue with your partner about your needs and concerns also helps to overcome many barriers to a healthy sex life.
Every problem has a solution. Sexual dysfunction is no exception. The key is to identify the exact underlying cause and address it. Better understanding of sexual dysfunctions has made rational therapy a reality. Scientific approach to this problem can help many a men regain sexual health.
(Dr. G G Laxman Prabhu is Urology and Andrology Consultants at Manipal Fertility Centre, Mangaluru)