Sexual Problems in Men

  • Medical Author:
    Kevin C. Zorn, MD, FRCSC, FACS

    Dr. Kevin Zorn is a dual-board-certified (US and Canada), minimally-invasive uro-oncology, fellowship trained urologist at the University of Chicago. His main focus of clinical and scientific interest is in the surgical treatment of renal and prostate cancer. He is also an expert in performing surgery with the DaVinci Surgical Robotic System to manage localized prostate cancer and small renal masses. Dr. Zorn studied medicine and urology at McGill University in Montréal.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Sexual Problems in Women

Sexual dysfunction is a common concern shared by many women. Problems may occur during any phase of the sexual response cycle (excitement, plateau, orgasm, and resolution) that prevent a woman from experiencing sexual satisfaction. Many women are reluctant or embarrassed to discuss their sexual problems, but it's important to tell your doctor what you are experiencing since most cases of sexual dysfunction can be treated.

Sexual dysfunction can have physical or psychological causes. Physical causes include:

  • diabetes,
  • heart disease,
  • neurological diseases,
  • hormonal imbalances,
  • menopause,
  • chronic diseases such as kidney disease or liver failure,
  • alcoholism,
  • drug abuse, and
  • side effects of medications, including antidepressant drugs.

What are sexual problems in men?

Sexual health is an important part of a man's life, no matter his age, civil status, or sexual orientation. It is also an important part of a couple's foundation and contributes to the quality of life. Sexual problems in men are very common and impact sexual health. Many problems with sexual health can be treated. Therefore, it is important for a man to discuss these issues with a physician.

The definition of sexual dysfunction is the inability to have a satisfactory sexual relationship. This definition depends on each person's own interpretation on what he judges satisfactory. In general, sexual dysfunction can affect the quality of life and, even more importantly, can be the first symptom of another medical or psychological problem. Any sexual complaint should be taken seriously and evaluated.

What is the physiology of sexual function?

Sexual activity involves coordination between various systems of the body. Hormones and neurological pathways must be in sync for sexual desire to be present. Blood vessels, nerves, and penile integrity must all be present for an adequate erection and its maintenance during the sexual relation. Muscles and nerves coordinate ejaculation achieved when the physiological passageway for sperm (from the testicles to the urethra) is present. Orgasm is a complex phenomenon that isn't completely understood but it involves the coordination of muscles and nerves. When sexual dysfunction is present, the physician must evaluate all the possible problems in this chain of events.

How are sexual problems in men diagnosed?

Evaluation of sexual dysfunction starts with a detailed medical, sexual, and psychological history, followed by a thorough physical examination. The second step must not be overlooked because sexual dysfunction can have many causes. Sometimes, the patient's partner can also contribute to the evaluation and could provide useful information as well.

A detailed medical, psychological, and sexual history is acquired during the interview with the physician. Some of the questions that are asked can be intimate and might cause you to feel shy to answer thoroughly. It is imperative to give the proper information, even though it is understandable that it can take time to be comfortable talking about this. Having a good relationship with your physician is always helpful.

Some of the questions the doctor could ask might concern the frequency of sexual relations, your sexual orientation, if the frequency or quality of sexual relations are satisfying, and your number of sexual partners, among others. They will also inquire about nonsexual-related complaints.

A complete physical examination is performed including assessing the pulses in the legs and a thorough examination of the external genitalia (penis, scrotum, and perineum) and their reflexes..

One of the possible tests is a nocturnal tumescence test to evaluate nocturnal erections. Your physician might also ask for tests for penile blood vessel function or some tests of the nervous system to help differentiate between possible causes of sexual dysfunction.

Medically Reviewed by a Doctor on 3/2/2016
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