Patient education: Sex problems in males (The Basics)

What types of sex problems can males have? — Sex problems can happen in people of all genders.

In males, problems might include:

●Being unable to get or keep an erection most times that you have sex. Doctors call this "impotence" or "erectile dysfunction."

●Having little or no interest in sex. Doctors call this "low libido."

●Ejaculating too soon after sex begins, before you are ready to ejaculate. Doctors call this "premature ejaculation."

●Being unable to ejaculate (even though you can get and keep an erection).

What causes sex problems? — You might have trouble getting or keeping an erection if you have a condition that keeps the penis from getting enough blood. Things that reduce blood flow to the penis can include:

●Getting older

●Heart disease

●Diabetes

●High blood pressure

●Smoking

●Drinking alcohol or using drugs

Other things that can cause sex problems include:

●Nerve problems or damage, for example, a spinal cord injury or a condition such as multiple sclerosis

●Depression, stress, or problems with your partner or relationship

●Certain medicines, including medicines used to treat depression or heart disease

Should I see a doctor or nurse? — Yes. Your doctor or nurse can help figure out the cause of your problem. They will talk with you, do an exam, and order blood tests. They might also order another test, such as a test that measures your night-time erections.

Is there anything I can do on my own to improve my sex problem? — Maybe. If you are having relationship problems, you can try to improve your relationship with your partner. For example, you can:

●Talk to your partner about how to make sex better.

●Make an effort to have more fun together by having a regular "date night."

●Read books or websites about sex.

●Go to counseling, either alone or with your partner.

If you are overweight, losing weight might help improve your sex problems. Getting regular exercise can help, too, even if you are not overweight.

How are sex problems treated? — Treatment depends on the cause of the problem and can include:

●Medicines to help you get and keep an erection – Examples of these medicines include sildenafil (sample brand name: Viagra), vardenafil (sample brand name: Levitra), tadalafil (sample brand name: Cialis), and avanafil (sample brand name: Stendra). These medicines can cause side effects, such as low blood pressure. Follow your doctor's instructions closely when taking these medicines. Also, let your doctor know if you are taking any other medicines, because certain combinations can be unsafe. People who take certain medicines should not take medicines to get an erection. Examples include "nitrates" used to treat heart problems, and certain "alpha blockers" used to treat an enlarged prostate gland.

Some medicines for treating sex problems are sold on the internet. However, these are not always safe, and they can even contain harmful ingredients.

●Devices to help you get and keep an erection – Erection devices work in different ways. Some are implanted into the penis to form an erection. Others work a bit like a vacuum and help pull blood into the penis.

●Hormone treatment – Sex problems can happen if your body does not make enough male hormones (testosterone). If your hormone levels are very low, your doctor might treat you with testosterone, which can come in a shot, skin patch, skin gel, capsule, or tablet that sticks to your gums.

●Treatment to improve mood – If you are struggling with depression or anxiety, your doctor might prescribe medicines or counseling.

●Treatments to delay ejaculation – Doctors can prescribe medicines to keep you from ejaculating too quickly. Some of the medicines used to treat depression work very well for this. Some people also use a method called "pause and squeeze." In this method, you stop having sex and press behind the tip of your penis when you feel like you are going to ejaculate. After the feeling goes away, you continue having sex.

●Treatment to help ejaculation problems caused by depression medicines – Sometimes, medicines used to treat depression can make it hard or impossible to ejaculate. Let your doctor know if this happens. They can change your dose or your medicine so the problem gets better.

More on this topic

Patient education: Sex problems in females (The Basics)
Patient education: Sex as you get older (The Basics)
Patient education: Priapism (The Basics)
Patient education: Androgen replacement in men (The Basics)

Patient education: Sexual problems in males (Beyond the Basics)