Sexual Problems in ManIntroduction 
A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.
While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor.
What Causes Sexual Problems?Sexual dysfunction can be a result of a physical or psychological problem.
Physical causes: Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.
Who is Affected by Sexual Problems?Both men and women are affected by sexual problems. They can occur in adults of all ages. Among those commonly affected are seniors, which may be related to a decline in health associated with aging.
How do Sexual Problems Affect Men?The most common sexual problems in men are ejaculation disorders, erectile dysfunction, and inhibited sexual desire.
What Are Ejaculation Disorders?There are different types of ejaculation disorders, including:
- 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 is forced back into the bladder rather than through the urethra and out the end of the penis.
In some cases, premature and inhibited ejaculation are caused by a lack of attraction for a partner, past traumatic events, and psychological factors, including a strict religious background that causes the person to view sex as sinful. Premature ejaculation, the most common form of sexual dysfunction in men, often is due to nervousness over how well he will perform during sex. Certain drugs, including some antidepressants, may affect ejaculation, as can nerve damage to the spinal cord or back.
Retrograde ejaculation is common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backward and into the bladder. In other men, retrograde ejaculation occurs after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation. This generally does not require treatment unless it impairs fertility.
Sexual Problems in WomenWhat are sexual problems?
A sexual problem means that sex is not satisfying or positive for you. In women, common sexual problems include feeling little or no interest in sex, having problems getting aroused, or having trouble with with orgasm. For some women, pain during intercourse is a problem.
Most women have a sexual problem at one time or another. For some women, the problem is ongoing. But your symptoms are only a sexual problem if they bother you or cause problems in your relationship.
There is no "normal" level of sexual response, because it is different for every woman. You may also find that what is normal at one stage of your life changes at another stage or age. For example, it's common for an exhausted mother of a baby to have little interest in sex. And it's common for both women and men to have less intense sex drives as they age. This is linked in part to hormone changes in the body.
What are some causes of sexual problems in women?Female sexuality is complex. At its core is a need for closeness and intimacy. Women also have physical needs. When there is a problem in either the emotional or physical part of your life, you can have sexual problems.
Some common causes include:
- Emotional causes, such as stress, relationship problems, depression or anxiety, a memory of sexual trauma, and unhappiness with your body.
- Physical causes, such as hormone problems, pain from an injury or other problem, and certain conditions such as diabetes or arthritis.
- Aging, which can cause changes in the vagina, such as dryness and stiffening.
- Certain medicines that can cause sexual problems. These include medicines for depression, blood pressure, and diabetes.
What are the symptoms?Sexual problems can include:
- Having less desire for sex.
- Having trouble feeling aroused.
- Not being able to have an orgasm.
- Having pain during intercourse.
How are sexual problems in women diagnosed?Women often recognize a sexual problem when they notice a change in desire or sexual satisfaction. When this happens, it helps to look at what is and isn't working in the body and in life. For example:
- Are you ill, or do you take a medicine that can lower your sexual desire or response?Are you stressed or often very tired?
- Do you have a caring, respectful connection with a partner?
- Do you and your partner have the time and privacy to relax together?
- Do you have painful memories about sex or intimacy?
Your doctor can help you decide what to do. He or she will ask questions, do a physical exam, and talk to you about possible causes.
Some women find it hard to talk to their doctor about sexual problems at first. Sometimes it helps to write out what you want to say beforehand. For example, you could say something like "For the past few months, I haven't enjoyed sex as much as I used to." Or you could say "Ever since I started taking that medicine, I haven't felt like having sex."
How are they treated?Treatment for sexual problems depends on what is causing the problem. There may be one or more issues causing the problems. Many sexual problems can be worked out after you know the cause or causes.
Sex involves emotional, physical, and relationship issues. Successful treatment requires a high level of comfort between you and your doctor. Ideally, you and your partner will also be able to talk openly about sexual concerns. Treatment may include treating health problems, getting communication counseling, and learning about things you can practice at home. For example, you might take a warm bath to relax, have plenty of foreplay before sex, or try different positions during sex.
Sources: medicinenet.com/webmd.com
