Sexual Dysfunction in Male
Definition
Sexual dysfunction is difficulty experienced by an individual or partners during any stage of a normal sexual activity, including physical pleasure, desire, preference, arousal or orgasm.
The World Health Organization defines sexual dysfunction as a "person’s" inability to participate in a sexual relationship as they would wish". This definition is broad and gives way too many interpretations.
A diagnosis of sexual dysfunction under DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunctions can have a profound impact on an individual’s perceived quality of sexual life.[1][3]
Sexual dysfunction in males encompasses a range of conditions that hinder their ability to enjoy or participate in sexual activity. Common synonyms or related terms include:
- Erectile dysfunction (ED): This refers to the persistent inability to achieve or maintain an erection sufficient for sexual intercourse.
- Impotence: An older term for ED, often carrying a more negative connotation.
- Male sexual disorder: A broader term encompassing various sexual dysfunctions in males.
- Sexual dysfunction: While not specific to males, it can refer to any sexual difficulty experienced by either gender.
- Sexual performance anxiety: A psychological factor that can contribute to or exacerbate sexual dysfunction.
It’s important to note that these terms can have different nuances and may be used interchangeably depending on the context.
Overview
Epidemiology
Causes
Types
Risk Factors
Pathogenesis
Pathophysiology
Clinical Features
Sign & Symptoms
Clinical Examination
Diagnosis
Differential Diagnosis
Complications
Investigations
Treatment
Prevention
Homeopathic Treatment
Diet & Regimen
Do’s and Don'ts
Terminology
References
Also Search As
Overview
Overview of Sexual Dysfunction in Male
Male sexual dysfunction (MSD) affects 10–25% of middle-aged and older people, and female sexual dysfunction occurs with similar frequency.
Demographic changes, the popularity of newer treatments, and greater awareness of sexual dysfunction by patients and society have led to increased diagnosis and associated health care expenditures for the management of this common disorder.
Because many patients are reluctant to initiate discussion of their sex lives, physicians should address this topic directly to elicit a history of sexual dysfunction.
Epidemiology
Epidemiology of Sexual Dysfunction in Male
High Prevalence: Studies suggest a high prevalence of sexual dysfunction among Indian men. For example, a study on men with alcohol dependence syndrome found that 58.3% had one or more sexual dysfunctions (Kumar et al., 2014). Another study in a rural area reported that 81% of men had at least one sexual health disorder (Tiwari et al., 2018).
Common Dysfunctions: The most commonly reported sexual dysfunctions include:
- Premature ejaculation
- Erectile dysfunction
- Low sexual desire
- Inability to reach orgasm
- Dissatisfaction with orgasm
Associated Factors: Several factors have been associated with sexual dysfunction in Indian men, including:
- Age
- Chronic diseases (e.g., diabetes, hypertension)
- Lifestyle factors (e.g., smoking, alcohol use)
- Psychological factors (e.g., stress, anxiety, depression)
It is important to remember: Sexual dysfunction can have a significant impact on a man’s quality of life. If you are experiencing any sexual difficulties, it is important to talk to your doctor. There are many effective treatments available.[4][5]
Causes
Causes of Sexual Dysfunction in Males
Sexual dysfunction in males is a complex issue with a multitude of potential causes. It’s essential to remember that these causes can often intertwine, and successful treatment frequently involves addressing multiple factors.
Organic Causes
- Vascular Disease: Conditions such as atherosclerosis, hypertension, and diabetes can impair blood flow to the penis, hindering erectile function.
- Neurological Disorders: Diseases like Parkinson’s disease, multiple sclerosis, and spinal cord injuries can disrupt nerve signals necessary for sexual function.
- Hormonal Imbalances: Low testosterone levels, thyroid problems, and other hormonal irregularities can diminish libido and sexual response.
- Chronic Illnesses: Kidney or liver failure, heart disease, and respiratory conditions can all impact sexual health.
- Medications: Certain medications, including antidepressants, antihypertensives, and opioids, can have sexual side effects.
Psychogenic Causes
- Stress and Anxiety: Mental health significantly influences sexual performance. Stress, anxiety, and depression can dampen desire and lead to erectile difficulties.
- Relationship Issues: Conflicts, poor communication, and intimacy problems within a relationship can translate into sexual dysfunction.
- Past Trauma: A history of sexual abuse or negative sexual experiences can create psychological barriers to intimacy.
- Performance Anxiety: Worrying about sexual performance can create a self-fulfilling prophecy of dysfunction.
Lifestyle Factors
- Substance Abuse: Excessive alcohol consumption and drug use can impair sexual function.
- Smoking: Smoking damages blood vessels and contributes to erectile dysfunction.
- Obesity: Being Higher Weight is linked to various health conditions that can affect sexual health.
- Lack of Exercise: A sedentary lifestyle can negatively impact overall health, including sexual well-being.
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Types
Types of Sexual Dysfunction in Male
Sexual Dysfunction may Classified in to 4 categories
Sexual Desire Disorder or Hypoactive sexual desire disorder
- Decreased libido is characterized by a lack or absence for some time of sexual desire or libido for sexual activity or of sexual fantasies.
Causes:
- Decrease in the production of testosterone in men
- Ageing
- Fatigue
- Medications (such as the SSRIs) or psychiatric conditions, such as depression and anxiety.
Sexual Arousal Disorder
Sexual arousal disorders were previously known as impotence in men, though these have now been replaced with less judgmental terms.
Impotence is now known as erectile dysfunction.
For people of all genders, these conditions can manifest themselves as an aversion to and avoidance of sexual contact with a partner.
In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.
There may be physiological origins to these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease can also contribute, as well as the nature of the relationship between the partners.
Additionally, the condition post-orgasm illness syndrome (POIS) may cause symptoms when aroused, including adrenergic-type presentation; rapid breathing, paresthesia, palpitations, headaches, aphasia, nausea, itchy eyes, fever, muscle pain and weakness and fatigue.
Duration
From the onset of arousal, symptoms can persist for up to a week in patients.
The etiology of this condition is un known, however it is believed to be a pathology of either the immune system or autonomic nervous systems.
It is defined as a rare disease by the NIH but the prevalence is unknown. It is not thought to be psychiatric in nature, but it may present as anxiety relating to coital activities and thus may be incorrectly diagnosed as such. There is no known cure or treatment.[1][3]
Erectile dysfunction
Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis.
Causes:
- Damage to the Nervi erigentes which prevents or delays erection, or
- Diabetes
- Cardiovascular disease, which simply decreases blood flow to the tissue in the penis, many of which are medically treatable.
- Psychological or physical. Psychological erectile dysfunction can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.
- Erectile dysfunction from vascular disease is seen mainly amongst older individuals who have atherosclerosis.
- Vascular disease is common in individuals who have diabetes, peripheral vascular disease, hypertension and those who smoke. Anytime blood flow to the penis is impaired, erectile dysfunction is the end result.
Other causes
- Drugs Individuals who take drugs that lower blood pressure or antipsychotics, antidepressants, sedatives, narcotics, antacids or alcohol can have problems with sexual function and loss of libido.
- Hormone deficiency is a relatively rare cause of erectile dysfunction.
- In individuals with testicular failure, as in Klinefelter syndrome, or those who have had radiation therapy, chemotherapy or childhood exposure to mumps virus, the testes may fail and not produce testosterone. Other hormonal causes of erectile failure include brain tumors, hyperthyroidism, hypothyroidism or disorders of the adrenal gland.
Orgasm Disorder
Anorgasmia
Anorgasmia is classified as persistent delays or absence of orgasm following a normal sexual excitement phase in at least 75% of sexual encounters. The disorder can have physical, psychological, or pharmacological origins. SSRI antidepressants are a common pharmaceutical culprit, as they can delay orgasm or eliminate it entirely. A common physiological culprit of anorgasmia is menopause; one in three women report problems obtaining an orgasm during sexual stimulation following menopause.
Premature ejaculation is when ejaculation occurs before the partner achieves orgasm, or a mutually satisfactory length of time has passed during intercourse. There is no correct length of time for intercourse to last, but generally, premature ejaculation is thought to occur when ejaculation occurs in under two minutes from the time of the insertion of the penis. For a diagnosis, the patient must have a chronic history of premature ejaculation, poor ejaculatory control, and the problem must cause feelings of dissatisfaction as well as distress the patient, the partner or both.
- Historically attributed to psychological causes, new theories suggest that premature ejaculation may have an underlying neurobiological cause which may lead to rapid ejaculation.
- Post-orgasmic Disorder
Post-orgasmic disorders cause symptoms shortly after orgasm or ejaculation. Post-coital tristesse (PCT) is a feeling of melancholy and anxiety after sexual intercourse that lasts for up to two hours. Sexual headaches occur in the skull and neck during sexual activity, including masturbation, arousal or orgasm.
Other factors
- In men, post orgasmic illness syndrome (POIS) causes severe muscle pain throughout the body and other symptoms immediately following ejaculation. The symptoms last for up to a week.
- POIS may involve adrenergic symptoms: rapid breathing, paresthesia, palpitations, headaches, aphasia, nausea, itchy eyes, fever, muscle pain and weakness and fatigue.
- The etiology of this condition is unknown; but it may present as anxiety relating to coital activities and thus may be incorrectly diagnosed as such. There is no known cure or treatment.
- Dhat syndrome is another condition which occurs in men. It is a culture-bound syndrome which causes anxious and dysphoric mood after sex, but is distinct from the low-mood and concentration problems (acute aphasia) seen in post orgasm illness syndrome.[1][3]
Sexual pain Disorder
- In men, structural abnormalities of the penis like Peyronie’s disease can make sexual intercourse difficult and/or painful. The disease is characterized by thick fibrous bands in the penis that lead to excessive curvature during erection.
- It has an incidence estimated at 0.4–3% or more, is most common in men 40–70, and is of uncertain cause.
- Risk factors include genetics, minor trauma (including that occurring during cystoscopy or transurethral resection of the prostate), chronic systemic vascular diseases, smoking, and alcohol consumption.
- Priapism is a painful erection that occurs for several hours and occurs in the absence of sexual stimulation. This condition develops when blood gets trapped in the penis and is unable to drain.
- If the condition is not promptly treated, it can lead to severe scarring and permanent loss of erectile function. The disorder is most common in young men and children. Individuals with sickle-cell disease and those who use certain medications can often develop this disorder.
Causes:
- Anxiety Disorder
- Panic disorder
- Aging
- Prostatic Trouble
- Injury to spinal cord
Risk Factors
Risk Factors of Sexual Dysfunction in Males
Sexual dysfunction in males is a prevalent concern, often associated with various risk factors that increase an individual’s susceptibility. Understanding these risk factors can aid in prevention and early intervention.
Medical Risk Factors of Sexual Dysfunction in Male
- Chronic Diseases: Diabetes, cardiovascular disease, hypertension, and neurological disorders significantly elevate the risk of sexual dysfunction.
- Hormonal Imbalances: Low testosterone levels, thyroid disorders, and other hormonal fluctuations can impair sexual function.
- Surgeries or Injuries: Procedures involving the pelvis, spinal cord, or genitals can potentially lead to sexual dysfunction.
- Medications: Certain medications, such as antidepressants, antihypertensives, and antipsychotics, can have sexual side effects.
Psychological Risk Factors of Sexual Dysfunction in Male
- Mental Health Conditions: Depression, anxiety, and stress are strongly linked to sexual difficulties.
- Past Trauma: A history of sexual abuse or negative sexual experiences can contribute to dysfunction.
- Relationship Problems: Poor communication, conflicts, and lack of intimacy within a relationship can manifest as sexual issues.
- Performance Anxiety: Excessive worry about sexual performance can exacerbate dysfunction.
Lifestyle Risk Factors of Sexual Dysfunction in Male
- Substance Abuse: Excessive alcohol consumption, drug use, and smoking significantly impact sexual health.
- Obesity: Being Higher weight is associated with various health conditions that can contribute to sexual dysfunction.
- Sedentary Lifestyle: Lack of physical activity can negatively affect overall health, including sexual function.
Other Risk Factors of Sexual Dysfunction in Male
- Age: Advancing age is associated with an increased risk of sexual dysfunction, although it’s not an inevitable consequence of aging.
- Socioeconomic Status: Lower socioeconomic status can be linked to increased risk due to limited access to healthcare and other factors.[7]
Pathogenesis
Pathogenesis of Sexual Dysfunction in Males
Sexual dysfunction in males encompasses a variety of conditions that disrupt the normal physiological and psychological processes involved in sexual response. Understanding the underlying mechanisms, or pathogenesis, of these dysfunctions is crucial for effective diagnosis and treatment.
Key Pathophysiological Mechanisms of Sexual Dysfunction in Male
Vascular Dysfunction: Impaired blood flow to the penis, often due to atherosclerosis, hypertension, or diabetes, is a major contributor to erectile dysfunction. Reduced arterial inflow and increased venous outflow hinder the ability to achieve and maintain an erection.
Neurological Impairment: Damage to nerves responsible for transmitting signals between the brain, spinal cord, and genitals can disrupt sexual function. Conditions like Parkinson’s disease, multiple sclerosis, and spinal cord injuries can lead to erectile difficulties, ejaculatory problems, and decreased sensation.
Hormonal Imbalance: Androgens, primarily testosterone, play a crucial role in libido and sexual response. Low testosterone levels, whether due to aging, testicular dysfunction, or other factors, can lead to decreased sexual desire, erectile difficulties, and impaired ejaculation.
Psychogenic Factors: Stress, anxiety, depression, and relationship issues can negatively impact sexual function. These psychological factors can disrupt the delicate balance of neurotransmitters and hormones involved in sexual arousal and response.
Medication Side Effects: Certain medications, particularly those affecting the cardiovascular, nervous, or endocrine systems, can have adverse sexual side effects. Antidepressants, antihypertensives, and antipsychotics are common culprits.
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Pathophysiology
Pathophysiology of Sexual Dysfunction in Males
Sexual dysfunction in males involves a disruption of the intricate physiological processes that govern sexual arousal, desire, and response. Understanding the underlying pathophysiology is crucial for effective management and treatment.
Vascular Impairment:
- Erectile Dysfunction (ED): Atherosclerosis, hypertension, and diabetes can lead to reduced blood flow to the penis, hindering the ability to achieve and sustain an erection. This involves impaired relaxation of smooth muscle in the penile arteries and increased venous outflow.
- Other Dysfunctions: Vascular insufficiency can also contribute to decreased penile sensation and impaired ejaculation.
Neurological Dysfunction:
- Central Nervous System: Conditions affecting the brain or spinal cord (e.g., stroke, multiple sclerosis, Parkinson’s disease) can disrupt nerve signals essential for sexual function, leading to ED, delayed ejaculation, or premature ejaculation.
- Peripheral Nervous System: Damage to peripheral nerves (e.g., from diabetes, pelvic surgery) can impact erectile function, ejaculation, and orgasm.
Endocrine Abnormalities:
- Hypogonadism: Low testosterone levels can decrease libido, impair erectile function, and affect overall sexual well-being.
- Other Hormonal Imbalances: Thyroid disorders, hyperprolactinemia, and adrenal dysfunction can also contribute to sexual difficulties.
Psychogenic Factors:
- Stress, Anxiety, and Depression: These emotional states can negatively impact libido, arousal, and sexual performance.
- Relationship Issues: Conflicts, poor communication, and lack of intimacy can lead to sexual dissatisfaction and dysfunction.
- Past Trauma: A history of sexual abuse or negative sexual experiences can create psychological barriers to healthy sexual function.
Medication Side Effects:
- Various Medications: Antidepressants, antihypertensives, antipsychotics, and other drugs can interfere with sexual function through various mechanisms.[1]
Clinical Features
Clinical Features of Sexual Dysfunction in Males
Sexual dysfunction in males encompasses a range of disorders that can significantly impact an individual’s quality of life. Recognizing the clinical features of these conditions is crucial for timely diagnosis and appropriate management.
Erectile Dysfunction (ED):
- Inability to achieve or maintain an erection sufficient for satisfactory sexual performance.
- May be associated with decreased libido, anxiety, and relationship difficulties.
Premature Ejaculation (PE):
- Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration.
- Often accompanied by feelings of distress, frustration, and avoidance of sexual intimacy.
Delayed Ejaculation (DE):
- Marked delay in ejaculation or inability to ejaculate despite adequate sexual stimulation.
- Can lead to frustration, anxiety, and decreased sexual satisfaction for both partners.
Male Hypoactive Sexual Desire Disorder (MHSDD):
- Persistently or recurrently deficient or absent sexual/erotic thoughts or fantasies and desire for sexual activity.
- May be associated with relationship problems, hormonal imbalances, or psychological factors.
Other Sexual Dysfunctions:
- Substance/Medication-Induced Sexual Dysfunction: Sexual difficulties caused by substance use or medication side effects.
- Pain-Related Sexual Dysfunction: Pain during sexual activity (dyspareunia) or penetration (vaginismus), often associated with physical or psychological causes.[7]
Sign & Symptoms
Sign & Symptoms of Sexual Dysfunction in Male
The sexual dysfunction in males can manifest through a variety of signs and symptoms, often impacting both physical and emotional well-being. Recognizing these indicators is crucial for seeking timely help and addressing any underlying concerns.
Common Signs & Symptoms:
Erectile Dysfunction (ED):
- Difficulty getting or keeping an erection firm enough for sexual intercourse.
- Reduced sexual desire or libido.
- Anxiety or stress related to sexual performance.
Premature Ejaculation (PE):
- Ejaculation occurring sooner than desired, often within one minute of penetration.
- Difficulty controlling or delaying ejaculation.
- Feelings of frustration, embarrassment, or anxiety about sexual performance.
Delayed Ejaculation (DE):
- Significant delay or inability to ejaculate despite adequate sexual stimulation.
- Reduced sexual satisfaction or frustration for both partners.
Male Hypoactive Sexual Desire Disorder (MHSDD):
- Persistent or recurrent lack of interest in sexual activity or fantasies.
- Reduced frequency or absence of sexual thoughts or desires.
- Difficulty initiating or responding to sexual advances from a partner.
Other Sexual Dysfunctions:
- Loss of Libido: Decreased interest in sexual activity or fantasies.
- Painful Intercourse (Dyspareunia): Pain during sexual activity, often related to physical or psychological causes.
- Difficulty Achieving Orgasm (Anorgasmia): Inability to reach orgasm despite adequate sexual stimulation.[9]
Clinical Examination
Clinical Examination of Sexual Dysfunction in Males
A comprehensive clinical examination is crucial in evaluating sexual dysfunction in males. This assessment involves a detailed medical history, physical examination, and potentially specialized tests to identify the underlying causes and guide appropriate treatment.
Medical History:
- Detailed Sexual History: Open and non-judgmental discussion about the patient’s sexual concerns, including the nature, duration, and severity of the dysfunction.
- Past Medical History: Exploration of any pre-existing medical conditions (e.g., diabetes, cardiovascular disease, neurological disorders) or surgeries that could contribute to sexual difficulties.
- Medication Review: Assessment of current medications, as certain drugs can have sexual side effects.
- Psychosocial History: Evaluation of potential psychological factors, such as stress, anxiety, depression, or relationship problems.
Physical Examination:
- General Physical: Assessment of overall health, including vital signs, body mass index, and signs of systemic diseases.
- Genitourinary Examination: Inspection of the external genitalia for any abnormalities, palpation of the testes and prostate, and assessment of penile sensation and reflexes.
- Vascular Examination: Evaluation of peripheral pulses and blood pressure to assess vascular health, which can impact erectile function.
- Neurological Examination: Assessment of neurological function, including reflexes, sensation, and muscle strength, particularly in the lower extremities.
Specialized Tests (if indicated):
- Laboratory Tests: Blood tests to assess hormone levels (e.g., testosterone, thyroid hormones, prolactin), blood glucose, and lipid profile.
- Nocturnal Penile Tumescence (NPT) Test: Monitoring erections during sleep to differentiate between organic and psychogenic causes of ED.
- Vascular Studies: Doppler ultrasound or penile angiography to assess blood flow to the penis.
- Neurophysiological Tests: Nerve conduction studies or electromyography to evaluate nerve function.[10]
Diagnosis
Diagnosis
- Detail history of patient regarding Surgical history, Chronic illness, other metabolic diseases such as DM, Hypertension, Hyperthyroid, Hypothyroid, etc.
- Physical Examination
- Systemic Examination
- Any sign of Anaemia, Blood Pressure, Cardiovascular Diseases, Thyroid examination, Neurological Examination.
Genital Examination
- Bulbo cavernous reflex
- Size of penis, scrotum, Testis.
Differential Diagnosis
Differential Diagnosis of Sexual Dysfunction in Males
Accurate diagnosis of sexual dysfunction in males necessitates a meticulous evaluation of various potential causes, as these conditions can often overlap or coexist. Considering a broad differential diagnosis is essential for effective management and treatment.
Organic Causes:
- Vascular Disorders: Atherosclerosis, hypertension, diabetes, peripheral vascular disease.
- Neurological Disorders: Stroke, Parkinson’s disease, multiple sclerosis, spinal cord injury, peripheral neuropathy.
- Endocrine Disorders: Hypogonadism, hyperprolactinemia, thyroid dysfunction, adrenal insufficiency.
- Genitourinary Conditions: Peyronie’s disease, priapism, prostate cancer, urethral stricture.
- Medications: Antidepressants, antihypertensives, antipsychotics, opioids, and others.
- Substance Abuse: Alcohol, tobacco, illicit drugs.
Psychogenic Causes:
- Mood Disorders: Depression, anxiety, generalized anxiety disorder.
- Stress-Related Disorders: Acute stress disorder, post-traumatic stress disorder (PTSD).
- Relationship Issues: Conflicts, communication problems, lack of intimacy.
- Performance Anxiety: Fear of failure, spectatoring.
- Past Trauma: History of sexual abuse or negative sexual experiences.
Mixed Causes:
- Combination of Organic and Psychogenic Factors: Many cases of sexual dysfunction involve an interplay of physical and psychological factors.[11]
Complications
Complications of Sexual Dysfunctions in Males
Sexual dysfunctions in males can lead to a range of complications that extend beyond the physical realm, affecting emotional well-being, relationships, and overall quality of life. Recognizing and addressing these potential complications is crucial for comprehensive management.
Psychological Distress:
- Anxiety and Depression: Sexual difficulties can trigger or exacerbate anxiety and depression, creating a cycle that further impacts sexual function.
- Low Self-Esteem: Feelings of inadequacy, shame, and embarrassment can erode self-esteem and confidence.
- Relationship Problems: Sexual dysfunction can strain intimate relationships, leading to communication breakdowns, decreased intimacy, and even separation or divorce.
Fertility Issues:
- Difficulty Conceiving: Erectile dysfunction, delayed ejaculation, or other dysfunctions can hinder conception efforts.
Reduced Quality of Life:
- Decreased Sexual Satisfaction: Unsatisfactory sexual experiences can lead to frustration, disappointment, and a decline in overall well-being.
- Avoidance of Intimacy: Fear of failure or discomfort can lead individuals to avoid sexual activity altogether, impacting both personal and relationship satisfaction.[12]
Investigations
Investigation of Sexual Dysfunction in Male
- Serum Prolactin
- Serum Testosterone
- Gonadotropins
- CBC
- Blood sugar level
- Lipid Profile
- Thyroid profile
- PSA [Prostate Specific Antigen]
Treatment
Treatment
- Therapies currently employed for the treatment of ED include oral PDE-5 inhibitor therapy, injection therapies, testosterone therapy, penile devices, and psychological therapy.
- In addition, limited data suggest that treatments for underlying risk factors and comorbidities—for example, weight loss, exercise, stress reduction, and smoking cessation—may improve erectile function.
- Decisions regarding therapy should take into account the preferences and expectations of patients and their partners. [3]
ORAL AGENTS
- Sildenafil, tadalafil, vardenafil, and avanafil are the only approved and effective oral agents for the treatment of ED.
- These four medications have markedly improved the management of ED because they are effective for the treatment of a broad range of causes, including psychogenic, diabetic, vasculogenic, postradical prostatectomy (nerve-sparing procedures), and spinal cord injury.
- Several oral medications like Viagra, Cialis and Levitra have become available to help people with erectile dysfunction and have become first line therapy. These medications provide an easy, safe, and effective treatment solution for approximately 60% of men. In the rest, the medications may not work because of wrong diagnosis or chronic history.
ANDROGEN THERAPY
- Testosterone replacement is used to treat both primary and secondary causes of hypogonadism.
VACUUM CONSTRICTION DEVICES
- Vacuum constriction devices (VCDs) are a well-established non-invasive therapy.
- They are a reasonable treatment alternative for select patients who cannot take sildenafil or do not desire other interventions.
- VCDs draw venous blood into the penis and use a constriction Ring to restrict venous return and maintain tumescence.
- Adverse ejaculation. Additionally, many patients complain that the devices are cumbersome and that the induced erections have a non-physiologic appearance and feel.
INTRAURETHRAL ALPROSTADIL
INTRACAVERNOSAL SELF-INJECTION
SURGERY
- Surgical implantation of a semirigid or inflatable penile prosthesis.
Prevention
Prevention of Sexual Dysfunctions in Males
While sexual dysfunction in males can be caused by a complex interplay of factors, adopting proactive measures can significantly reduce the risk and promote long-term sexual health.
Maintain a Healthy Lifestyle:
- Regular Exercise: Engaging in regular physical activity improves cardiovascular health, boosts testosterone levels, and enhances overall well-being, contributing to healthy sexual function.
- Balanced Diet: A nutritious diet rich in fruits, vegetables, whole grains, and lean protein supports overall health and helps prevent chronic diseases that can impact sexual function.
- Weight Management: Maintaining a healthy weight reduces the risk of obesity-related complications that can contribute to sexual dysfunction.
- Limit Alcohol and Avoid Smoking: Excessive alcohol consumption and smoking can impair blood flow and nerve function, increasing the risk of erectile dysfunction and other sexual difficulties.
Manage Stress and Mental Health:
- Stress Reduction Techniques: Practicing relaxation techniques such as meditation, yoga, or deep breathing exercises can help manage stress and anxiety, which can negatively impact sexual function.
- Seek Professional Help: If experiencing depression, anxiety, or other mental health concerns, seeking therapy or counseling can provide support and improve overall well-being, including sexual health.
Prioritize Open Communication:
- Communicate with Your Partner: Open and honest communication with your partner about sexual needs, preferences, and concerns can foster intimacy and prevent misunderstandings that might lead to sexual difficulties.
- Seek Professional Guidance: If experiencing persistent sexual concerns, consulting a healthcare professional or sex therapist can provide guidance and treatment options.
Manage Chronic Conditions:
- Control Diabetes and Hypertension: Effectively managing these conditions through medication, lifestyle changes, and regular medical checkups can help prevent complications that can lead to sexual dysfunction.
- Address Other Medical Conditions: If you have any other chronic conditions, work closely with your healthcare provider to manage them effectively and minimize their impact on sexual health.
Practice Safe Sex:
- Use Condoms: Consistent condom use protects against sexually transmitted infections (STIs), which can sometimes lead to sexual complications.[13]
Homeopathic Treatment
Homeopathic Treatment of Sexual Dysfunction in Male
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.
which includes
- The medical history of the patient,
- Physical and mental constitution,
- Family history,
- Presenting symptoms,
- Underlying pathology,
- Possible causative factors etc.
A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.
What Homoeopathic doctors do?
A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.
The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.
The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.
Homeopathic Medicines for Sexual Dysfunction in Male:
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.
Medicines:
Agaricus
- It is a best acting medicine in MSD.
- Furthermore, External itching of sexual organs.
- Frequent continued erections; additionally great desire for an embrace, with slight ability and insufficient seminal emission, every embrace followed by great debility and languor.
- Profuse night-sweats also sometimes burning itching of skin, complaints after sexual debauchees.
- Lastly, In women itching and irritation of pudendum, with strong desire for sexual intercourse; great selfishness, forgetfulness and indifference; very strong bearing-down feeling.
Agnus Castus
- Diminished sexual instinct, after an embrace he feels easy and light.
- In detail, Complete prostration and impotence.
- Semen watery also deficient; penis so relaxed that voluptuous fancies excite no erections.
- Testes cold, swollen, hard also painful.
- Impotence, with gleet, especially with those who frequently had gleet; additionally pollutions from irritable weakness with prostatorrhoea; prostatic juice passes with hard stool.
- Premature old age in young person from abuse of sexual functions, with melancholy, apathy, mental distraction, self-contempt, general debility, also Spermatorrhoea of old sinners, though impotent,
Anacardium
- Basically Sexual debility; nervous prostration following sexual emissions.
- Moreover, Weakness of memory and general temporary feebleness of brain- force; hypochondriasis, sullen mood, dread of labor.
- Difficult digestion; weakness of stomach, relieved by eating, but all the symptoms return in a few hours.
- Frequent urging to stool without being able to accomplish anything; discharge of prostatic fluid with the stool, also after emission of urine.
Argentum Metallicum
- Effects of onanism; seminal emissions; almost every night, without erection.
- Atrophy of penis.
Argentum nitricum
- Erections, but they fail when coition is attempted; embrace is painful, as if urethra were put upon a stretch and is sensitive at orifice.
- Want of sexual desire, the genital organs having shriveled; frequent nightly emissions, sometimes with lascivious dreams.
Aurum Metallicum
- Testes mere pendent shreds, either frequent nightly emissions or nightly erections without emission, or nightly erections and pollutions, without subsequent weakness.
- Discharge specifically of prostatic fluid from a relaxed penis, with settled suicidal melancholia in MSD.
- Lastly, Sterility from lowered vitality of the parts with great mental depression.
Baryta Carb
- Diminution of sexual desire also great weakness of the genital organs in persons addicted to the excessive use of stimulating drinks.
- Numbness of genitals; erections while riding, with impotence in MSD.
- Cloudy urine with yellow sediment; heaviness in small of back and loins.
- Small retracted testicles with pulsations between shoulders.
- Hypertrophy especially of prostate; sweat about scrotum.
Belladonna
- Increased sexual desire, with great inclination to masturbation.
- Nocturnal emission of semen, during relaxation of penis.
- Sexual desire decreased, weakness and relaxation of genitals; nymphomania, especially during pregnancy.
Berberis
- Suppressed sexual desire; during coition too weak also too short thrill, ejection too soon.
- Coldness and numb feeling in prepuce and glans; scrotum shrunken, cold, with pressure in testicles; too speedy ejaculation of semen, the desire is weak also soon passes away.
- Swelling and stitching-tearing pains in spermatic cords, pain extending down into testicles and especially to the epididymis.
- All in all, Suppressed sexual desire in women, with long-delayed thrill and often cutting and stitching in the parts during coition; vagina painful to touch.
Bufo Rana
- Longs for solitude, to give himself up to his vice; quick ejaculation, without thrill, with spasms and painful uneasiness of the limbs.
- Frequent nocturnal emissions, followed by debility; slow emission, or entirely absent; aversion to coitus; impotency.
- Imbecility with loss of all decency; masturbation or coitus causes convulsions, simulating those of epilepsy, usually followed by profound sleep; inclination to touch the genitals.
Calcarea Carb
- Bad effects of early masturbation, night- sweats follow every emission, or after marriage, every coitus is followed by weakness of mind and body.
- Increased sexual desire provokes emission, but unusual weakness follows indulgence, and ejaculation is tardy; burning and stinging while semen discharges during coition pressing pain in head and back.
- Lassitude and weakness in lower extremities; sweats easily.
Calcarea Phos
- Erections while riding in a carriage, without sexual desire; shooting through perineum into penis.
- Voluptuous feeling, as if all female genitals were filling up with blood, she feels all parts pulsating, with increased sexual desire; nymphomania just before menses and in young married people.
Cannabis Indica
- Satyriasis, erections while riding, walking, and also while sitting still, not caused by amorous thoughts.
- Violent painful erections; sexual desire increased in both sexes.
Cantharis
- Seminal emissions at night, followed by a disagreeable burning heat all over body.
- Great anxiety, heaviness, inability to sleep for the rest of the night; nightly emissions followed by shivering lasting for an hour or two and sleeplessness for that night.
- Partial blindness for an hour or two after an emission.
- Great despondency, inability to apply himself to work and thus life becomes a burden.
- Frightful satyriasis, violent painful priapism, discharge of blood instead of semen.
- Over sensitiveness of all female parts; pruritus, with strong sexual desire; itching in vagina; pernicious consequences of masturbation.
Carbo Veg
- Onanism during sleep; frequent pollutions without any sensation.
- Continual erections at night, without any voluptuous sensations of fancies.
- Seminal discharge too soon during coitus, followed by roaring in head; prostatic discharge while straining at stool.
Coffea
- Excessive sensitiveness about genitals especially vulva, with voluptuous itching; would like to rub or scratch, but parts are too sensitive.
- Male sexual organs much excited without seminal emission and with dry heat of body.
- Nocturnal emissions followed by great languor and irritability.
Conium
- Premature dementia, atrophy of testicles.
- Bad effects from suppressed sexual desire or from excessive indulgence.
- Painful seminal emission instead of the normal pleasurable thrill.
- Sexual desire without erection or with an insufficient one, pollutions, with subsequent excitement of the sexual desire, even when merely dallying with women.
- Discharge of prostatic juice during every motion, without lascivious thoughts.
Hyoscyamus
- In both sexes sexual desire excessive, lascivious, exposes pudenda.
- Excited sexual desire without excitement of the fancy; masturbation with smutty talk.
- Specifically indicated medicine for Sexual dysfunction.
Lachesis
- Onanism, with epilepsy.
- Nocturnal emission, with a thrill of delight.
- Excessive sexual desire, with constant erection at night; emissions, with profuse night-sweats; emissions, with cheerful disposition and feeling of ease on waking, succeeded by an increased mental concentration; semen has a pungent smell.
Lycopodium
- Mental, nervous and bodily weakness due to Sexual dysfunction.
- Impotence; penis small, cold and relaxed; erections feeble.
- Falls asleep during an embrace, excessive and exhausting pollutions; desponding, grieving, extremely sensitive.
- Weakness of memory; pale, wretched complexion.
- Weak digestion; the old man’s balm, strong desire, but cannot get up an erection.
Natrum Mur
- Deficient nutrition and dirty, flaccid, torpid skin.
- Genital organs smell badly and strongly; feeling of weakness in sexual organs,
- Sexual instinct dormant, with irrational emission during an embrace.
- Frequent nocturnal emissions in spite of frequent embraces; after sexual excesses physical weakness, even paralysis.
- Scrotum relaxed flabby, emission of prostatic fluid without erection when thinking of sexual things.
Nux Vomica
- Bad effects from early masturbation.
- Headache, backache, difficulty in walking due to Sexual dysfunction .
- Frequent involuntary emissions at night, especially towards morning.
- Bad effects from sexual excesses and abuse of liquors; easily excited desire, but during an embrace the penis becomes relaxed; increase of smegma.
Picric Acid
- It is best indicated medicine in MSD.
- Violent, strong, and long-lasting erections, with fear it would rupture the penis, followed by profuse seminal emissions.
- Great sexual desire; violent erections all night, preventing sleep.
- Great weakness and heaviness of lower limbs; impotence.
- Penis relaxed and shrunken; coldness of genitals.
Platina
- Satyriasis, sexual desire excessive, with violent erections, especially at night.
- Nymphomania, worse especially in the lying-in state.
- Either Tingling or titillation from the genitals up into the abdomen.
- Painful sensitiveness and continual pressure in the region of the mons veneris also genital organs.
- Besides this, Masturbation in young boys who have been seduced into it, embrace with little pleasure and very brief.
- All in all, Constant erections at night without seminal emissions, or often without amorous dreams.
Sarsaparilla
- Painful seminal emissions specifically at night; painful emissions, excited even in daytime without sexual feeling.
- Lascivious dreams with erections wake him up, with headache, prostration and vertigo.
- In detail, Inclination to coitus, with restless sleep and frequent emissions, spermatic cords swollen.
- Sexual excitement makes them ache and sensitive; besides this bloody pollutions; offensive odor about genitals.
Selenium
- Seminal weakness, with erethism also nervous exhaustion.
- Voluntary or involuntary seminal emissions are followed by irritability, mental confusion, headache.
- Almost paralytic weakness of spine.
- Involuntary escape of prostatic fluid, dribbling of semen during sleep and after stool also urination.
- Aggravation during the relaxation; impotence, lewd thoughts, but physically unable; erections slow, insufficient.
Diet & Regimen
Diet & Regimen of Sexual Dysfunction in Male
- Getting regular exercise
- Eating a varied and nutritious diet
- Maintaining a healthy weight
- Limiting alcohol consumption and avoiding tobacco use
- Sharing intimate times with a partner that do not involve sex
- Flavonoids increase blood flow and the concentration of nitric oxide in the blood, both of which play a role in getting and maintaining an erection.
- There are many types of flavonoids, but sources include Trusted Source:
- Cocoa and dark chocolate
- Fruits and vegetables
- Nuts and grains
- Tea
- Wine
Do’s and Don'ts
Do’s and Don’ts of Sexual Dysfunctions in Males
Navigating sexual dysfunction can be challenging, but understanding the key do’s and don’ts empowers individuals to seek help, support their partners, and manage their condition effectively.
Do’s of Sexual Dysfunction in Male :
Seek Professional Help: If you experience persistent or recurring sexual difficulties, consult a healthcare professional or sex therapist. They can diagnose the underlying cause, offer treatment options, and provide valuable support.
Communicate Openly with Your Partner: Honest and open communication with your partner about your concerns, fears, and desires is crucial. It fosters understanding, strengthens intimacy, and encourages mutual support.
Prioritize a Healthy Lifestyle: Maintain a balanced diet, engage in regular exercise, get adequate sleep, and manage stress levels. These lifestyle factors contribute to overall well-being, including sexual health.
Explore Treatment Options: Depending on the cause of your dysfunction, various treatment options may be available, such as medication, therapy, counseling, or lifestyle changes. Discuss these options with your healthcare provider to find the best approach for you.
Be Patient and Understanding: Addressing sexual dysfunction takes time and effort. Be patient with yourself and your partner, and maintain a positive outlook throughout the process.
Don’ts of Sexual Dysfunction in Male :
Ignore the Problem: Ignoring sexual dysfunction can worsen the condition and strain relationships. Don’t hesitate to seek help early on.
Self-Diagnose or Self-Treat: Avoid self-diagnosing or self-treating sexual dysfunction. Consult a qualified healthcare professional for proper evaluation and guidance.
Feel Ashamed or Embarrassed: Sexual dysfunction is a common issue, and there’s no need to feel ashamed or embarrassed. Seeking help is a sign of strength and self-care.
Blame Yourself or Your Partner: Avoid assigning blame for sexual difficulties. Instead, focus on working together as a team to address the issue.
Give Up: Don’t lose hope. With proper treatment and support, many individuals experiencing sexual dysfunction can overcome their challenges and enjoy a fulfilling sexual life.
Terminology
Terminologies
Sexual Dysfunction: A broad term referring to any persistent or recurrent problem that interferes with a person’s ability to desire, become aroused, or experience orgasm during sexual activity.
Erectile Dysfunction (ED): The inability to achieve or maintain an erection sufficient for satisfactory sexual performance.
Premature Ejaculation (PE): The persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. It is often accompanied by feelings of distress, frustration, and/or the avoidance of sexual intimacy.
Delayed Ejaculation (DE): A marked delay in ejaculation or inability to ejaculate despite adequate sexual stimulation.
Male Hypoactive Sexual Desire Disorder (MHSDD): A persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person’s life.
Other Terminologies
Libido: A person’s overall sexual drive or desire for sexual activity.
Arousal: The physical and psychological changes that occur in the body in response to sexual stimulation, leading to increased blood flow to the genitals and other physiological changes.
Orgasm: The peak of sexual pleasure, characterized by rhythmic contractions of the pelvic muscles and a release of sexual tension.
Ejaculation: The expulsion of semen from the penis during orgasm.
Dyspareunia: Painful sexual intercourse.
Anorgasmia: The inability to achieve orgasm despite adequate sexual stimulation.
Psychogenic: Relating to or arising from the mind or emotions.
Organic: Relating to or arising from a physical or physiological cause.
Vascular: Relating to blood vessels and blood flow.
Neurological: Relating to the nervous system and its functions.
Endocrine: Relating to hormones and the glands that produce them.
Terminologies related to homoeopathy
For Erectile Dysfunction (ED):
- Agnus castus: Indicated for low libido, decreased sexual power, and impotence, especially in cases associated with sadness or depression.
- Caladium: Useful when there is a lack of erection with a strong sexual desire, or when erections are weak and incomplete.
- Lycopodium: Often prescribed for men with performance anxiety, premature ejaculation, and lack of confidence.
- Nuphar luteum: Indicated for cases of impotence with complete absence of sexual desire.
- Selenium: Considered for ED associated with fatigue, weakness, and premature ejaculation.
For Premature Ejaculation (PE):
- Caladium: Helpful when PE is accompanied by a weak erection or lack of sexual excitement.
- Graphites: Indicated for men with a history of skin problems or unhealthy lifestyle habits.
- Kali bromatum: Used for PE associated with nervous exhaustion, weakness, and mental fatigue.
- Nux vomica: Considered when PE is linked to overindulgence in stimulants, alcohol, or a sedentary lifestyle.
- Staphysagria: Useful when PE is associated with suppressed anger or resentment.
References
References use for Article Sexual Dysfunction in Male
- Harrison-s_Principles_of_Internal_Medicine-_19th_Edition-_2_Volume_Set
- Homoeopathic Therapeutics By Lilienthal
- https://en.wikipedia.org/wiki/Sexual_dysfunction
- Kumar, B. N. A., Mallanna, S., Raj, G. S., & Prasannakumar, D. R. (2014). Prevalence, typology and clinical correlates of sexual dysfunction among men with alcohol dependence syndrome. Indian Journal of Medical Research and Pharmaceutical Sciences, 4(3), 79-85.
- Tiwari, S. C., Pandey, A., Singh, J. V., Pandey, N., & Pandey, A. R. (2018). Prevalence and correlates of sexual health disorders among adult men in a rural area of North India: An observational study. Journal of Family Medicine and Primary Care, 7(3), 515-521.
- Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th Edition, Benjamin J. Sadock, Virginia A. Sadock, Pedro Ruiz, 2015, Wolters Kluwer.
- The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th Edition, American Psychiatric Association, 2013, American Psychiatric Publishing.
- Campbell-Walsh Urology, 11th Edition, Alan J. Wein, Louis R. Kavoussi, Andrew C. Novick, Alan W. Partin, Craig A. Peters, 2015, Elsevier.
- The Merck Manual of Diagnosis and Therapy, 20th Edition, Robert S. Porter, Justin L. Kaplan, 2018, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
- Smith’s General Urology, 18th Edition, Emil A. Tanagho, Jack W. McAninch, 2013, McGraw Hill Professional.
- The 5-Minute Clinical Consult, 26th Edition, Frank J. Domino, Robert A. Baldor, Jeremy Golding, Nancy P. Southall, 2023, Wolters Kluwer.
- The Oxford Textbook of Sexual Health, 3rd Edition, David L. Rowland, Mark A. Barratt, 2019, Oxford University Press.
- The New Male Sexuality, Revised Edition, Bernie Zilbergeld, 2000, Bantam Books.
Also Search As
Sexual Dysfunction in males also search as
Online search engines:
- Use specific keywords: Combine relevant terms like "homeopathy," "sexual dysfunction," "males," and specific conditions (e.g., "erectile dysfunction," "premature ejaculation").
- Refine searches: Use advanced search options to specify the type of content you are looking for (e.g., scholarly articles, blog posts, case studies).
- Explore homeopathic websites: Many homeopathic organizations and practitioners have websites with educational resources, including articles on sexual dysfunction.
Homeopathic journals and publications:
- Browse reputable journals: Look for peer-reviewed homeopathic journals that publish research articles and case studies on sexual dysfunction in males.
- Search online databases: Access online databases specializing in homeopathic literature to find relevant articles.
libraries:
- Visit local libraries: Some libraries, especially those affiliated with homeopathic institutions, may have collections of homeopathic books and journals.
- Consult with librarians: Ask librarians for assistance in finding relevant resources on sexual dysfunction in males.
Homeopathic practitioners:
- Consult with a homeopath: A qualified homeopath can provide information about available articles and resources related to sexual dysfunction.
Additional tips:
- Use credible sources: Focus on information from reputable homeopathic organizations, practitioners, and journals.
- Look for recent publications: Homeopathic research is ongoing, so prioritize articles published in recent years.
- Consider different perspectives: Explore articles that discuss various homeopathic approaches to sexual dysfunction.
Frequently Asked Questions (FAQ)
What is Sexual Dysfunction in Male?
Definition
Sexual dysfunction is difficulty experienced by an individual or partners during any stage of a normal sexual activity, including physical pleasure, desire, preference, arousal or orgasm.
Which Foods can help to cure Sexual Dysfunction in Male?
- Cocoa and dark chocolate
- Fruits and vegetables
- Nuts and grains
- Tea
- Wine
Is sexual dysfunction in males a normal part of aging?
While the risk of sexual dysfunction increases with age, it’s not an inevitable part of aging.Many older men continue to enjoy a healthy and fulfilling sex life.
What are the 5 types of Sexual Dysfunction in Male?
Types
- Hypoactive sexual desire disorder
- Sexual Arousal Disorder
- Erectile dysfunction
- Orgasm Disorder
- Sexual pain Disorder
Is homeopathy safe for treating sexual dysfunction?
Homeopathic remedies are generally considered safe when prescribed by a qualified practitioner. However, it’s essential to disclose any existing medications or health conditions to avoid potential interactions.
How can I improve my sexual health?
Maintaining a healthy lifestyle, managing stress, communicating openly with your partner, and seeking professional help when needed can significantly improve your sexual health.
What are the reasons of Sexual Dysfunction in Male?
- Decrease in the production of testosterone in men
- Ageing
- Fatigue
- Medications
- Psychiatric conditions (depression and anxiety)
Can homeopathy help with erectile dysfunction
Yes, homeopathy offers various remedies like Agnus castus and Lycopodium, traditionally used to address erectile dysfunction by targeting its underlying physical and emotional causes.
Give the symptoms of Sexual Dysfunction in Male?
Symptoms
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
What are the treatment options for sexual dysfunction in males?
Treatment
Treatment varies depending on the specific dysfunction and underlying cause.Options include medication, therapy, lifestyle changes, or a combination of these approaches.
Homeopathic Medicines used by Homeopathic Doctors in treatment of Sexual Dysfunction in Male?
Homoeopathic medicines for sexual dysfunction in males
- Agaricus
- Agnus Castus
- Aurum Metallicum
- Baryta Carb
- Bufo Rana
- Cannabis Indica
- Hyoscyamas
