Sexual Disorders in Men
Monday, January 4th, 2010
A sexual disorder in men means difficulties in sexual intercourse. Sexual dysfunction includes a variety of disorders that affect sex drive (libido), the ability to achieve or maintain an erection (erectile dysfunction, or impotence), ejaculation, and the ability to achieve orgasm.
Sexual dysfunction may result from either physical or psycho logic factors; many sexual problems result from a combination of both. A physical problem may lead to psycho logic problems (such as anxiety, fear, or stress), which can in turn aggravate the physical problem. Men feel pressured by a partner to perform well sexually and become distressed when they cannot (performance anxiety). Performance anxiety can be troublesome and further worsen a man’s ability to enjoy sexual relations.
Normal Sexual Function
Normal sexual function is a complex interaction involving both the mind (thoughts, memories, and emotions) and the body. The nervous, circulatory, and endocrine (hormonal) systems all interact with the mind to produce a sexual response. A delicate and balanced interplay among all parts of the nervous system controls the sexual response in men.
The most common sexual dysfunctions in men are
? Lack of Desire
? Decreased libido
? Erectile Dysfunction
? Premature Ejaculation
? Retrograde Ejaculation
Desire (also called sex drive or libido) is the wish to engage in sexual activity. It may be triggered by thoughts, words, sights, smell, or touch. Desire leads to the first stage of the sexual response cycle, excitement. Excitement is sexual arousal. During excitement, blood flow to the penis increases, leading to an erection. Also, muscle tension increases throughout the body. In the plateau stage, excitement and muscle tension are maintained or intensified. Orgasm is the peak or climax of sexual excitement. At orgasm, muscle tension throughout the body further increases. The man experiences contractions of the pelvic muscles followed by a release of muscle tension. Semen is usually, but not always, ejaculated from the penis. Although ejaculation and orgasm often occur nearly simultaneously, they are separate events. Ejaculation can occur without orgasm. Also, orgasm can occur in the absence of ejaculation, especially before puberty, or with the use of certain drugs (such as some antidepressants). Most men find orgasm highly pleasurable. In resolution, a man returns to an unaroused state. After orgasm, men cannot have another erection for some time (refractory period), often as short as 20 minutes or less in young men but much longer in older men. The time between erections generally increases as men age.
Decreased Libido
Sex drive (libido) varies greatly among men. Different men find different degrees of libido satisfactory. Libido may be decreased temporarily by conditions such as fatigue or anxiety. Libido also tends to gradually decrease as a man ages. Persistent low libido may cause a man and his sex partner distress.
Occasionally, libido can be low throughout a man’s life. Lifelong low libido can result from traumatic childhood sexual experiences or from suppression of sexual thoughts. Most often, however, low libido develops after years of normal sexual desire. Psycho logic factors, such as depression, anxiety, and relationship problems, are often the cause. Some drugs (such as those used to treat high blood pressure, depression, or anxiety) and decreased levels of testosterone can also lower libido.
A man with decreased libido thinks less about sex. He loses interest in sexual fantasy and masturbation, and also in sexual activity. Even sexual stimulation, by sights, words, or touch, may fail to provoke interest. The man often retains the capacity for sexual function. Some men continue to engage in sexual activity to satisfy their partner.
A blood test can measure the level of testosterone in the blood. However, the diagnosis is usually based on the man’s description of his symptoms. If the cause is psycho logic, various psycho logic therapies including behavioral therapies can help. If the testosterone
Level is low; testosterone can be given, usually as a patch or gel applied to the skin or as an injection. If a drug appears to be the cause, a doctor can often try treating the man with a different drug
Erectile Dysfunction
Every man is occasionally unable to achieve an erection; this is normal. Erectile dysfunction occurs when the problem is frequent or continuous.
Erectile dysfunction can range from mild to severe. A man with mild erectile dysfunction may occasionally achieve a full erection, but more often he achieves an erection that is inadequate for penetration. He may frequently be unable to achieve an erection at all. A man with severe erectile dysfunction is rarely able to achieve an erection.
Erectile dysfunction becomes more common with age but is not part of the normal aging process. About half of men 65 years of age and three fourths of men 80 years of age have erectile dysfunction.
Causes
To achieve an erection, the penis needs both an adequate inflow of blood and a slowing of blood outflow. Disorders that narrow arteries and decrease blood inflow (such as atherosclerosis, diabetes, or a blood clot) or surgery on the blood vessels can cause erectile dysfunction. Also, abnormalities in the veins of the penis can sometimes drain blood back to the body so rapidly that erections cannot be sustained despite adequate blood inflow.
Neurological damage is another possible cause of erectile dysfunction. Damage to the nerves leading to or from the penis produce erectile dysfunction. Such damage could result from surgery (most commonly prostate surgery), spinal disease, diabetes, multiple sclerosis, peripheral nerve disorders, stroke, alcohol, and drugs.
Occasionally, hormonal disturbances (such as abnormally low levels of testosterone) cause erectile dysfunction. Also, factors that decrease a man’s energy level (such as illness, fatigue, and stress) can make erections difficult.
Many drugs can interfere with the ability to achieve an erection, especially among older men. Drugs that commonly cause erectile dysfunction include antihypertensives, antidepressants, some sedatives, cimetidine, digoxin, lithium, and antipsychotics.
Psycho logic issues (such as depression, performance anxiety, guilt, fear of intimacy, and ambivalence about sexual orientation) can impair the ability to achieve erections. Psycho logic causes are more common in younger men. Any new stressful situation, such as a change of sex partners or problems with relationships or at work, can also contribute.
Symptoms
Sex drive (libido) often decreases in men with erectile dysfunction, although some men do maintain a normal libido. Regardless of whether libido changes, men with erectile dysfunction have difficulty engaging in intercourse either because the erect penis is not sufficiently hard, long, or elevated for penetration or because the erection cannot be sustained. Some men stop having erections during sleep or upon awakening. Others may attain strong erections sometimes but be unable to attain or maintain erections other times.
When testosterone levels are low, the result is more likely to be a drop in libido than erectile dysfunction. Low testosterone levels can cause gradual development of many symptoms, including enlargement of the breasts (gynecomastia, raised pitch of the voice, shrinking of the testes (testicles), and loss of pubic hair. Low testosterone may also cause thinning of the bones, loss of energy, and loss of muscle mass.
Diagnosis
Measurement of blood pressure in the legs may reveal a problem with the arteries in the pelvis and groin that supply blood to the penis. Examination of the man’s rectum may reveal a problem with the nerve supply of the penis.
A blood sample is taken to measure the level of testosterone. Certain blood tests can help identify diseases that may lead to temporary or permanent erectile dysfunction. For example, blood tests can reveal evidence of diabetes (which can lead to permanent erectile dysfunction) or infection (which can lead to temporary erectile dysfunction).
If a problem with the arteries or veins is suspected, specialized tests may be performed. Ultrasound examination can reveal narrowing or blockage within the arteries of the penis.
Treatment
Some men and their partners may choose not to pursue treatment for erectile dysfunction. Physical contact without an erection may satisfy their needs for intimacy and fulfillment.
Sometimes, discontinuing use of a particular drug can improve erections.
For men who choose to pursue treatment, there are many choices.
Ayurvedic Treatment: Many Ayurvedic drugs are used to treat erectile dysfunction. Most drugs given to treat erectile dysfunction increase blood flow to the penis. Most of these drugs are given by mouth, but some drugs can be applied locally on the penis.
Premature Ejaculation
Premature ejaculation is ejaculation that occurs too early, usually before, upon, or shortly after penetration.
Many males, especially adolescents, ejaculate sooner than they or their partners would like. Premature ejaculation is not just ejaculation that occurs before a man wants it to but rather ejaculation that occurs very soon often within a minute or two after penetration.
Many experts believe that premature ejaculation almost always results from anxiety or other psycho logic causes. Others think that unusually sensitive penile skin may be a cause. Premature ejaculation is rarely caused by a disease, although inflammation of the prostate gland or a nervous system disorder can cause the condition.
Premature ejaculation can distress a man and his partner. If the man ejaculates too early, the partner may be left unsatisfied sexually and may become resentful.
Ayurvedic Treatment methods that can help a man delay ejaculation includes a variety os sedatives which reduce the mental anxiety and pressure of performance.
Retrograde Ejaculation
Retrograde ejaculation is a condition in which semen is ejaculated backward into the bladder rather than out through the penis.
In retrograde ejaculation, the part of the bladder that normally closes during ejaculation (the bladder neck) remains open, causing the ejaculatory fluid to travel backward into the bladder. Common causes of retrograde ejaculation include diabetes, spinal cord injuries, certain drugs, and some surgical operations (including major abdominal or pelvic surgery one of the most common causes is transurethral resection of the prostate).
Men with retrograde ejaculation can still have orgasms. However, retrograde ejaculation decreases the amount of fluid ejaculated out of the penis; sometimes, no fluid comes out. The condition can cause infertility but is otherwise not harmful.
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