Male Sexual Problems Other Than Erectile Dysfunction

Erectile dysfunction (ED), or impotence, is what most people think of when they hear the term "male sexual problem." However, other forms of sexual dysfunction can affect men. These include:

Hypoactive sexual desire disorder: Men with this disorder have a persistent lack of sexual desire or appetite, absence of sexual fantasies and complete lack of interest in and avoidance of sexual contact with a partner. The National Institutes of Health estimates 15 million to 30 million American men do suffer from erectile dysfunction and need drugs to have sexual intercourse. It may be caused by boredom or unhappiness in a long-standing relationship or result from traumatic events in childhood or adolescence. Depression also may play a role. Possible physical causes include drug side effects and hormonal deficiencies. Sometimes, boosting abnormally low testosterone levels may help.

Male orgasmic disorders: Also called ejaculatory disorders, they include inhibited ejaculation (orgasm does not occur) and premature ejaculation (when ejaculation occurs before, during or soon after penetration and before the man desires). Inhibited orgasm is usually caused by a psychological disorder such as depression or anxiety, or use of substances like alcohol or drugs. The man's emotional state and feelings such as guilt, boredom or resentment also may play a role. The cause of premature ejaculation is unclear but is thought to result from a combination of psychological and physical factors. Both problems are typically treated with therapy that teaches the man and his partner techniques for either producing or slowing down orgasm. In some cases, premature ejaculation can be treated with small doses of an SSRI, an antidepressant such as Prozac®, Paxil® or Zoloft®, taken either daily, or one to two hours before a sexual encounter.

Peyronie's disease: Thought to affect about 1 percent of men usually between the ages of 40 and 60, Peyronie's disease is characterized by the formation of a hard, fibrous layer called plaque under the skin on one side of the penis. This disorder usually starts out as inflammation, leading to a hardened scar that causes the penis to bend sharply when erect. If hardening occurs on both sides, indentations and shortening may result. The scarring or hardening can make erections painful and intercourse difficult or impossible. The bent or misshapen appearance of the penis can lead to emotional distress, which in turn worsens any sexual difficulties. Doctors are not sure what causes Peyronie's disease. But in many cases, the condition resolves itself. A physician will usually monitor the man closely for about a year, watching the plaque development and checking erectile function. Medications that might help to alleviate plaque buildup include topical vitamin A, collagenase ointment, B-complex vitamins or calcium channel blockers. If these treatments don't work and the condition doesn't go away on its own, surgery may be necessary. Surgeons have developed various techniques for removing the plaque without affecting penile function.

Dyspareunia: Men who experience dyspareunia, or pain during intercourse, usually have an underlying problem such as prostatitis (inflammation of the prostate gland) or some kind of nerve damage.