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Sexual
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Sexual dysfunction is any physical or psychological
problem that prevents you or your partner from getting sexual satisfaction.
What is sexual dysfunction?
Sexual dysfunction is any physical
or psychological problem that prevents you or your partner from getting sexual
satisfaction. Male sexual dysfunction is a common health problem affecting men
of all ages, but is more common with increasing age. Treatment can often help
men suffering from sexual dysfunction.
The main types of male sexual dysfunction are:
- Erectile
dysfunction (difficulty
getting/keeping an erection)
- Premature
ejaculation (reaching orgasm too quickly)
- Delayed
or inhibited ejaculation (reaching orgasm too slowly or not at all)
- Low
libido (reduced interest in sex)
What causes sexual dysfunction?
Physical causes of overall sexual dysfunction may
be:
- Low
testosterone levels
- Prescription
drugs (antidepressants, high
blood pressure medicine)
- Blood
vessel disorders such as atherosclerosis (hardening of the arteries)
and high blood pressure
- Stroke
or nerve damage from diabetes or surgery
- Smoking
- Alcoholism and drug
abuse
Psychological causes might include:
- Concern
about sexual performance
- Marital
or relationship problems
- Depression, feelings of guilt
- Effects
of past sexual trauma
- Work-related
stress and anxiety
How does sexual dysfunction affect men?
The most common problems men face with sexual
dysfunction are troubles with ejaculation, getting and keeping an erection, and
reduced sexual desire.
Ejaculation
disorders
Problems with ejaculation are:
- Premature
ejaculation (PE) — ejaculation that occurs before or too soon after
penetration
- Inhibited
or delayed ejaculation — ejaculation does not happen or takes a very long
time
- Retrograde
ejaculation — at orgasm, the ejaculate is forced back into the bladder
rather than through the end of the penis
The exact cause of premature ejaculation (PE) is not known. While in many cases
PE is due to performance anxiety during sex, other factors may be:
- Stress
- Temporary
depression
- History
of sexual repression
- Low
self-confidence
- Lack
of communication or unresolved conflict with partner
Studies suggest that the breakdown of serotonin (a
natural chemical that affects mood) may play a role in PE. Certain drugs,
including some antidepressants, may affect ejaculation, as can nerve damage to
the back or spinal cord.
Physical causes for inhibited or delayed ejaculation may include chronic
(long-term) health problems, medication side effects, alcohol abuse, or
surgeries. The problem can also be caused by psychological factors such as
depression, anxiety, stress, or relationship problems.
Retrograde
ejaculation is most common in males with diabetes who
suffer from diabetic nerve damage. Problems with the nerves in the bladder and
the bladder neck force the ejaculate to flow backward. In other men, retrograde
ejaculation may be a side effect of some medications, or happen after an
operation on the bladder neck or prostate.
Erectile
dysfunction (ED)
Erectile dysfunction (ED) is the inability to get
and keep an erection for sexual intercourse. ED is quite common, with studies
showing that about one half of American men over age 40 are affected. Causes of
ED include:
- Diseases
affecting blood flow such as hardening of the arteries
- Nerve
disorders
- Stress,
relationship conflicts, depression, and performance anxiety
- Injury
to the penis
- Chronic
illness such as diabetes and high blood pressure
- Unhealthy
habits like smoking, drinking too much alcohol, overeating, and lack of
exercise
Low
libido (reduced sexual desire)
Low libido means your desire or interest in sex has
decreased. The condition is often linked with low levels of the male hormone
testosterone. Testosterone maintains sex drive, sperm production, muscle, hair,
and bone. Low testosterone can affect your body and mood.
Reduced sexual desire may also be caused by
depression, anxiety, or relationship difficulties. Diabetes, high blood
pressure, and certain medications like antidepressants may also contribute to a
low libido.
How is male sexual dysfunction
diagnosed?
- Blood
tests to check your testosterone levels, blood sugar (for diabetes), and
cholesterol
- Blood
pressure check
- Rectal
exam to check your prostate
- Examination
of your penis and testicles
Other tests can show if you have problems with the
nerve impulses or blood flow to the penis.
Your doctor may also ask questions about your
symptoms and your medical and sexual history. Though these questions may seem
very personal, do not be embarrassed. It is important to answer honestly so the
best treatment can be recommended. You may be sent to a different type of
doctor (urologist, endocrinologist or sex therapist, for example) who can help
you.
How is male sexual dysfunction treated?
Many cases of sexual dysfunction can be corrected
by treating the mental or physical problems that cause it. Treatments include:
- Medications
– drugs that help improve sexual function by increasing blood flow to the penis.
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- Hormone
therapy – low
levels of testosterone raised by hormone replacement therapies that
include injections, patches, or gels.
- Psychological
therapy – a psychological counselor to help you address feelings of
anxiety, depression, fear, or guilt that may affect sexual function.
- Mechanical
aids – vacuum
devices and penile
implants that can
help some men with erectile dysfunction.
Can male sexual dysfunction be
prevented?
While male sexual dysfunction cannot be prevented, dealing
with the causes of the dysfunction can help you better understand and cope with
the problem when it happens. To help maintain good sexual function:
- Follow
your doctor’s treatment plan for any of your medical/health conditions.
- Limit
your alcohol intake.
- Quit
smoking.
- Get
treatment if needed for any emotional or psychological problems such as
stress, depression, and anxiety.
- Communicate
better and more often with your partner.
What is female sexual dysfunction (FSD)?
Many women have a low sex drive or trouble having
an orgasm. Some women are not bothered by this, but others are. A
woman has female sexual dysfunction, also called FSD, when she is upset or
unhappy about her sexual health.
There are several types of sexual dysfunction:
·
Low sexual desire
·
Trouble becoming aroused
·
Trouble having an orgasm
·
Pain during sex
A woman might have more than one of these issues,
which are often related to each other. Sexual dysfunction can be lifelong
or temporary. It can happen all the time, only with a certain partner, or
only at certain times, such as after pregnancy.
A healthy sex life depends on a complex mix of many
factors. The same is true for a troubled sex life. Health issues, certain
prescription medicines, changes in hormone levels, partner or family issues,
and psychological concerns can all contribute to FSD.
DID YOU KNOW?
Studies
show that about 33 percent of American women have low sex drive. Of
those, about one in three women are upset about having low sex drive.
That’s about 10 percent of all women in the U.S.
What treatments are available for FSD?
Choice of treatment depends on the cause of your
problems. Often, a combination of treatments works best. If you
have a medical condition that is causing your FSD, talk with your doctor about
what can be done.
Talking and Counseling
Consider talking with your partner about what’s
going on. Sometimes a better line of communication is all that is needed.
If necessary, you may want to get counseling, by yourself or with your
partner. Sex therapy, usually a later step in the process, also can be
helpful.
Lifestyle Changes
Some women find that losing weight, eating a
healthy diet, exercising, stopping smoking, and getting enough sleep helps
increase their sense of well-being and interest in sex.
Try finding ways to be comfortable with your own
sexuality. This may involve thinking about your attitudes toward sex when
you were growing up, finding ways to improve your self-esteem, and accepting
your body as it is.
Medicines
If certain medicines are causing problems, your
doctor might be able to change your prescription. Other medicines also
can help.
Estrogen
Estrogen can help with vaginal dryness and painful
intercourse. Two types of prescription estrogen are available: local
(vaginal) and whole-body (systemic).
·
Local estrogen comes in very low
doses and is inserted into the vagina as a cream or tablet. It also comes
in a vaginal ring. Local treatment doesn’t have the health risks of whole-body
estrogen because only small amounts of estrogen reach the bloodstream.
·
Whole-body estrogen, also called
hormone therapy, is taken as a pill, skin patch, gel, or spray. Because
it affects the whole body, it has some health risks, such as stroke and blood
clots. These events are rare in healthy women using hormone therapy close to
menopause. Women who have not had a hysterectomy also need to take progestin,
another female hormone, to prevent uterine cancer.
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