From Viagra commercials to spam emails to late-night comedy routines, potential problems in male sexual function are all around us. It can be hard to find the facts amidst the noise — especially if you’re embarrassed to talk about it.
The truth is, 31 percent of men report having experienced some type of sexual dysfunction. The good news is there’s a solution for just about every form of male sexual problem. Keeping yourself and your intimate relationships healthy can help you feel more like the man you want to be in bed.
Erectile dysfunction (ED) occurs when you cannot get or keep an erection firm enough for sexual intercourse. Although the occurrence of ED increases with age, it isn’t an inevitable consequence of aging. ED has many possible causes:
- emotional or psychological stress
- relationship problems
- physical factors that impact circulation, like high blood pressure or diabetes
- lifestyle habits like smoking, excessive alcohol consumption, or lack of exercise
Most men experience ED from time to time, but solutions exist! First, talk to your doctor about possible physical causes. Also discuss whether any medications or supplements you’re taking could be adding to the problem. Seek help from a licensed therapist if anxiety, depression, or relationship troubles might be the source of ED.
There are also a number of lifestyle changes that can help ED, such as:
- quitting smoking
- cutting down on drinking
- losing weight
- exercising more
There are also prescription solutions. There are several different prescription medications aimed to treat ED before it starts. These medications work for 80 percent of people who take them, according to the American Urological Association. There’s also a vacuum pump, a medical device that stimulates your penis before you have sex. If these treatments don’t work, your doctor may recommend a penile implant.
No one feels sexy all the time. But you may be suffering from male hypoactive sexual desire disorder (low libido) if you rarely have an interest in sex.
The idea of how much libido is “enough” varies in different cultures, so how do you know if your libido is low? The main reason to seek help is if your lack of desire disappoints you or your partner. Low libido can be caused by a number of physical, psychological, and emotional factors, from low testosterone to anxiety to poor communication.
Visit your doctor if you’re experiencing low libido. Your doctor will take a patient history, physical exam, and order any appropriate lab tests to help determine if there’s a physical problem causing the low libido.
A number of physical conditions and illnesses could be the underlying cause of low libido:
- low levels of the thyroid or testosterone hormones
- circulatory problems
Certain medications like some antidepressants can slow sex drive. Many men have some reduction in libido as they age.
Difficulties in your relationship may be making you feel less attracted to your partner if physical causes are ruled out. Consider attending individual or couple’s therapy if a psychological or emotional condition such as depression, anxiety, or stress might be responsible.
Premature ejaculation happens when you have an orgasm during sex earlier than you or your partner would like. This happens to almost every man at some point in his sexual life.
There are many causes for premature ejaculation. It’s not uncommon for sexually inexperienced men to become excited and reach orgasm very quickly. If you’ve had an active sex life for some years, you still might ejaculate too quickly because of a psychological concern about sex, like feeling guilty or awkward.
Premature ejaculation can have physical sources as well. For example, studies have shown a connection between premature ejaculation and hyperthyroidism. There could also be a problem with your urethra, or, more rarely, a problem in the reflex that controls ejaculation.
You might be put on a medication, if testosterone or thyroid hormones levels are determined as the cause for your premature ejaculation. And, of course, if you find out you have an infection, you’ll want to treat it as quickly as possible.
If your prematurity is not physical, start by trying a couple of different “do-it-yourself” techniques to delay orgasm:
- attend to your partner’s pleasure if you feel like you’re going to orgasm to slow you down
- try thinking of something other than sex as you get closer to orgasm
- use topical anesthetics like lidocaine to numb your penis enough to keep you from ejaculating too soon
- use a condom, which also reduces sensitivity
If these methods don’t work, your doctor may prescribe an antidepressant or selective serotonin reuptake inhibitor (SSRI).
Retrograde ejaculation occurs when semen travels back into the bladder instead of exiting through the urethra. This can be referred to as a dry orgasm, which is the ejaculation of little or no semen. Although it may sound dangerous to your health, and even painful, it’s not. However, retrograde ejaculation can lead to infertility, and it certainly could worry you, which would make sex less fun.
In a normal orgasm, your bladder closes itself off from the urethra, and semen passes by the bladder and out the penis. In retrograde ejaculation, the neck of the bladder doesn’t close, so semen is able to go there. You might notice that your urine is cloudy if you have a problem with retrograde ejaculation.
The bladder neck muscle doesn’t tighten correctly with retrograde ejaculation. This can be because the neck is weakened because of nerve damage caused by a medical condition, surgery, or because there’s an obstruction, though that’s rare. Diabetic neuropathy of the bladder, characterized by nerve damage that prevents bladder reflexes from working properly, can cause retrograde ejaculation. Prostate and urethra surgery can also cause retrograde ejaculation. The side effects of certain medications may also cause the problem, including medication for:
- high blood pressure
- prostate enlargement
- some mood disorders
Treatment for retrograde ejaculation depends on the cause. Retrograde ejaculation caused by nerve damage may be treated with mediation. Permanent physical changes that have caused retrograde ejaculation, for instance those related to surgery, most likely cannot be improved by medication.
If you’re taking medication that you think might be causing retrograde ejaculation, ask your doctor if you can change prescriptions to something that doesn’t interfere with orgasm. In the unlikely circumstance that the path of your semen is blocked, you and your doctor might consider surgery.
It is important to remember that you can have a completely satisfying sex life if you experience retrograde ejaculation. The main reason to seek help for retrograde ejaculation is if it’s impacting fertility.
We are surrounded by sexual images, which can give a narrow idea of what it means to be a man. You might be worried about sexual performance if you feel you don’t fit a certain male ideal. Those worries can then add to problems in bed. Try to focus on what feels right for you and your partner.
Talk to your doctor if you think you have a medical problem that’s keeping you from the sex life you want. If your own thoughts and feelings about sex are getting in the way of intimate satisfaction, seek help from a therapist.
The most important takeaway is that there are solutions to problems in the bedroom. With a little effort, knowledge, and the support of your doctor and partner, you can lead the sex life you want.