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:

●"Erectile dysfunction" – This is being unable to get or keep an erection most times you have sex.

●"Low sex drive" or "low libido" – These mean having little or no interest in sex.

●"Premature ejaculation" – This is ejaculating too soon after sex begins, before you are ready to ejaculate.

●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:

●The body not making enough of the hormone testosterone

●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 those 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 one to measure 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 have excess body weight, 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. Possible treatments include:

●Medicines to help you get and keep an erection – Examples 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. If you are taking any other medicines, ask your doctor if it is safe for you to take medicines to help with your erections, too. Some combinations of medicines are unsafe. For example, if you take "nitrates" to treat heart problems or certain "alpha blockers" to treat an enlarged prostate gland, you might not be able to take medicines for erections.

●Other treatments to help you get and keep an erection – These work in different ways. Examples include:

•A pump that uses suction to help pull blood into the penis

•A shot given into the base of the penis to cause an erection

•Surgery to put an implant into the penis that forms an erection

●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. It comes in different forms, including a shot or a gel put on the skin.

●Treatment to improve mood – If you are struggling with depression or anxiety, your doctor might prescribe medicines or counseling. Sometimes, it can help to go to therapy with your partner.

●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." For this, 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. Tell your doctor if this happens. They can change your dose or your medicine so the problem gets better.

Can supplements help with sex problems? — 

You might have seen ads for companies selling products to help with erections or improve your sex life. They are often sold as "supplements" or "natural products." In most countries, including the US, these products are not regulated by government agencies the way standard medicines are. They often include drugs and hormones that can be harmful.

More on this topic

Patient education: Sex problems in females (The Basics)
Patient education: Sex as you get older (The Basics)
Patient education: Low testosterone in males (The Basics)
Patient education: Androgen replacement in men (The Basics)
Patient education: Medicines for depression (The Basics)

Patient education: Sexual problems in males (Beyond the Basics)
Patient education: Sexual problems in females (Beyond the Basics)
Patient education: Depression treatment options for adults (Beyond the Basics)