Remember, your doctor or healthcare provider is the single best source of information regarding you and your health. Please consult your doctor if you have any questions about your health, your symptoms, or your medication.
The term sexual dysfunction includes a variety of different conditions besides erectile dysfunction (ED). For information on ED please refer to the modules on ED. In this module we will discuss other forms of sexual dysfunction.
What is premature ejaculation?
Before we talk about what causes erectile dysfunction, let’s first take a look at how you get an erection.
This is when ejaculation occurs shortly after erection, sometimes even before penetration. It occurs more often in younger men and is the most common form of sexual dysfunction. Men often do not seek treatment for this condition. In order to make a diagnosis of Premature Ejaculation three criteria must be met:
There is persistent or recurring ejaculation following minimal stimulation and it occurs shortly after erection. It occurs before, on or shortly after penetration and before the man desires
It causes distress or relationship problems
It is not a result of substance abuse or withdrawal Treatment of premature ejaculation usually starts with behavior therapy that uses techniques to help you prevent ejaculation. This is usually very successful initially, but success seems to decrease over time. There are medicines that can help, too. If you think you have this condition, you should talk to your health care professional about treatment options.
What is retrograde ejaculation?
This is when the ejaculate flows back into the bladder rather than forward out of the penis. This is harmless and the fluid will be expelled the next time the man urinates. This is common in men who have had prostate surgery. It may occur in men with diabetes. There are some medicines that can cause retrograde ejaculation, too, so it is always a good idea to talk to your health care professional about your medicines and their potential side effects.
There are some medicines that can help with retrograde ejaculation that are taken about 1-2 hours before sexual activity. If you think you have this condition, you should talk to your health care professional about treatment options.
What is anejaculation?
This is a condition where there is no flow of ejaculate. It occurs in some men with spinal cord injury and in men following radical prostatectomy. Sometimes ejaculation can be induced by using a vibrator, but if you think you have this condition, it is best to talk to your health care professional.
What is anorgasim?
This is the inability to have an orgasm and is usually psychological, but it can sometimes be caused by certain physical conditions. Some men with diabetes can have problems with orgasm and some medicines can cause problems with having an orgasm. Sometimes the use of a vibrator can help, but many men seek psychotherapy. If you think you have this condition, talk to your health care team.
What is priapism?
Priapism is an erection that does not go away, lasting for more than 6 hours. If your erection lasts for less than 6 hours, but longer than you want it to, it is called prolonged erection. This condition is often painful. This is caused by too much blood flow into the penis and too little blood flow out of the penis. This can occur following injury. It can also be a side effect of injection therapy for erectile dysfunction.
If this condition occurs, it is best to seek medical care as soon as possible. The earlier you seek treatment the better the chance of successful treatment. The treatment is an injection into the penis to stop the flow of blood into the penis. In rare cases, surgery is required.
What is decreased libido?
Libido is sexual desire or your interest in sex. Men who have loss of libido, don’t have problems with erectile dysfunction, just with their sex drive. The male libido is stimulated by hormones, so one of the most common causes of low sex drive or desire is low testosterone. Sometimes this occurs with aging, but it can also be caused by significant depression.
Treatment for decreased libido is testosterone supplementation. The benefit of testosterone therapy is to improve testosterone levels and restore your sex drive. There are other benefits that people talk about, like preventing osteoporosis and improving bone mass, increasing muscle strength and decreasing your cardiac risk. It is always best to talk to your health care professional about testosterone and its benefits and risks. The risk of testosterone therapy is that it may increase the growth rate of prostate cancer. It does not cause prostate cancer, but could increase the rate at which it grows.
What is peyronie’s disease?
Peyronie’s disease is a benign condition of the penis that tends to affect middle-aged men. The exact cause is unknown, but plaque (hard tissue) forms along covering of the tubes inside the penis. This plaque is not elastic like other tissues, so when a man gets an erection the penis curves to one side. This can also cause erection problems and is sometimes painful. This most commonly occurs on the top surface of the penis and can be felt when the penis is being examined.
For some men this problem stays the same for a long time and there is no problem with sexual performance. For some men, this gets worse, can be painful and cause erection difficulties. If you think you have this condition, talk to your health care professional. Your doctor will take a history and do a physical examination.
In many cases, no treatment is needed. Men who need treatment often start with Vitamin E, which can decrease the chemicals that cause tissue damage. There are other types of therapy for this condition and your health care professional can explain all of them to you. In some cases, surgery is needed.