Male Sexual Dysfunction

Male sexual dysfunction is very common and encompasses loss of desire or libido, inability to achieve and sustain an erection satisfactory for intercourse, and ejaculation disorders and orgasmic difficulties.

There are many potential causes of sexual dysfunction, including use of certain medications and medical conditions such as Peyronie’s disease.

Treatment for sexual dysfunction often addresses an underlying medical condition, such as hypertension, elevated cholesterol, diabetes mellitus, nerve damage, stress, anxiety, and depression.


Male sexual dysfunction is comprised of several problems associated with a man’s sexual performance including:

  • Erectile dysfunction, or the inability to experience an erection during sex
  • Peyronie’s disease, a curvature of the penis during an erection
  • Priapism, or long-lasting erections resulting from underlying disease or trauma, unrelated to sexual desire
    Decreased libido, or lowered interest in sex
  • Premature ejaculation, the release of semen before or shortly after penetration and with minimal sexual stimulation
  • Retrograde ejaculation, or the reverse flow of semen into the bladder during ejaculation.

Erectile Dysfunction (ED)/Impotence
Consistent or recurrent inability to attain and/or maintain a penile erection sufficient for sexual performance.

Ejaculation and Orgasm
Orgasm: A pleasurable feeling (a cerebral event) usually associated with emission and/or ejaculation.

  • Emission: Passage of seminal fluid through the urethra and its expulsion from the urethral meatus.
  • Ejaculation: Recurrent of persistent genital pain induced by non-coital sexual stimulation.
  • Premature Ejaculation (PE): Persistent or recurrent occurrence of ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it (also called early ejaculation or rapid ejaculation).
  • Delayed Ejaculation: Undue delay in reaching ejaculation during sexual activity.
  • Anorgasmia: Inability to achieve an orgasm during conscious sexual activity although nocturnal emission may occur.
  • Anejaculation: Absence of ejaculation during orgasm.
  • Retrograde ejaculation: Backward passage of semen into the bladder after emission, usually due to failure of closure of the bladder neck mechanism, demonstrated by presence of spematozoa in the urine.

Peyronie’s Disease
Involves the scarring of a region of the tunica of the erection chambers and the formation of a hard, nodular plaque which is most commonly on the top part of the penis just under the skin. Peyronie’s Disease may result in a bending of the erection toward the scarred, fibrous plaque. It may also result in painful intercourse (either from the erection itself or the pain felt by the partner), and erectile dysfunction.

Priapism
An involuntary, non-physiologic, usually painful prolonged erection that does not result from sexual desire. The corpus spongiosum and glands are not effected, it is not relieve by ejaculation, and my ironically result in permanent erectile dysfunction. While Its cause is unknown in about one-third of patients, known causes of priapism include:

  • Blunt trauma
  • Nerve impairment
  • Circulatory problems (including clot formation)
  • Alcohol and drug abuse
  • Sickle cell anemia
  • Anesthesia
  • Use of medications, such as synthetic hormones, antidepressants, and anticoagulants.

Hypogonadism
Having a biovailable testosterone concentration below the normal range of bioavailable testosterone concentration for that of healthy, young adult men.

Hypoactive Sexual Desire Disorder
Persistent or recurrent deficiency and/or absence of sexual fanatasies/thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress.