Sexual Health and Fertility in Men
Because problems with your sexual health and fertility can directly affect
your quality of life and your intimate relationships, they often bring a great
level of concern and worry to many men. If you have a problem with your sexual
health or fertility, remember that you are not alone, and that if you talk with
your health care provider, there is a good chance you can get treatment that
works.
Impotence and Loss of Libido
It might be helpful to know that
many men, especially as they age, have problems with impotence
(erectile dysfunction) or
loss of libido (reduced or lost interest in sex). Some men also have problems
with ejaculation, while others actually have a condition with which their
testicles fail to make the normal amount of testosterone.
About nine percent of American men are thought to have impotence, and it is
more common as men age. For example, impotence affects about 10 percent of men
in their sixties, 25 percent of men in their seventies, 40 percent of men in
their eighties, and more than half of those in their nineties. Many things can
cause impotence, including having atherosclerosis (hardening of the arteries),
high blood pressure, diabetes, depression and other emotional or psychological
illnesses, pelvic surgery, kidney failure, multiple sclerosis, stroke, some
types of epilepsy, and alcoholism. Some men who take medicines for heart disease
or drugs that can affect the central nervous system, such as hormonal medicines
or heroin and cocaine also are at risk for impotence.
Loss of libido (reduced or lost interest in sex) also can occur at different
points in a man's life. It can happen for many reasons, including stress in our
daily lives, from illnesses, medications, psychiatric problems, and reduced
levels of male sex hormones. Also, uneven sexual desire, at times, between you
and your partner are normal and inevitable in long-term relationships. It is how
you handle these challenges that makes the difference.
The good news is that there are ways you can overcome both impotence and loss
of libido with new drugs and therapies, or with counseling. If you have a
problem with either of these, talk with your health care provider about
treatments that could help you. Don't be embarrassed. Being honest and getting
help now can help you relax and enjoy an even better relationship with your
partner.
Infertility
It is not uncommon for couples to have trouble becoming pregnant
or experience infertility. Infertility is defined as not being able to become
pregnant despite trying for one year, in women under age 35, or despite trying
for six months in women 35 and over. Pregnancy is the result of a chain of
events. As described in our Fertility Awareness section, a woman must release an
egg from one of her ovaries (ovulation). The egg must travel through a fallopian
tube toward her uterus. Your sperm must join with (fertilize) the egg along the
way. The fertilized egg must then become attached to the inside of the uterus.
While this may seem simple, in fact there are many things can prevent pregnancy.
Reasons for infertility in men include:
- Age. Although your body
decreases some sperm production after age 25, unlike women, you might remain
fertile into your 60s and 70s. But as you age, you might begin to have
problems with your sperm that make it harder for them to fertilize an egg.
These can include problems with the shape and movement of your sperm, sperm
gene defects, or producing no sperm, or too few sperm.
- Lifestyle. Behaviors such
as smoking cigarettes or marijuana, heavy alcohol use, and taking illegal
drugs can temporarily reduce sperm quality.
- Environmental exposures.
Researchers are looking at whether exposure to environmental toxins, such as
pesticides and lead, also may be to blame for some cases of infertility.
- Health problems. For men, having a health problem, such as a sexually
transmitted disease (STD), diabetes, genetic disease (such as cystic fibrosis),
the mumps virus after puberty, surgery
on or infection in the prostate gland, or a severe testicle injury or problem,
can cause infertility. Some men who are infertile have suffered from a
condition called a varicocele - a network of veins in the scrotum that are
bluish, long, "worm-like" and enlarged. They can cause pain and discomfort,
but seem to become smaller or disappear when the man lies down. Although these
can be treated, they might damage the testes.
- Medications. Some medicines that men take for ulcers or psoriasis can cause
infertility. Some blood pressure lowering drugs (such as diuretics, beta
blockers, and central agonists) also can cause impotence.
If you or your partner has a problem with sexual function, libido or
fertility, don't delay seeing your health care provider for help. There is a
good chance that you can get treatment for your problems.
Source: National Institutes of Health (www.nih.gov)
Last Editorial Review: 11/16/2004
