Male Sexual Problems: More Than Just Erectile Dysfunction

Male Sexual Problems

You may be familiar with the term erectile dysfunction. But there are many other types of male sexual dysfunction.

Trouble achieving or keeping an erection can be a symptom of erectile dysfunction (ED). About 52 percent of men ages 40 to 70 have ED at some time. But there are other types of sexual dysfunctions in men besides ED. Here are some of these conditions.


Hypogonadism may be due to low testosterone levels. It is common in aging males because levels start to drop 1 percent per year around age 40. Symptoms include:

  • Low libido
  • Poor erectile quality
  • Few erections
  • Difficulty achieving orgasm
  • Low-intensity orgasms
  • Less sexual feeling in penis
  • Less ejaculate
  • Depression
  • Lower energy, muscle mass, strength, bone density
  • Fatigue
  • Impaired awareness, reasoning, judgment
  • Sleep problems

Hypoactive sexual desire disorder (HSDD)

HSDD involves a lack of sexual fantasies and desire. This often causes relationship problems. These symptoms can be due to low hormone levels or from drugs used to treat depression, high blood pressure, cancer or convulsions. HSDD may be diagnosed when the symptoms can’t be explained by drug side effects or other conditions. About 5 percent of men have HSDD. It can exist along with ED and other sexual disorders. It may also stem from problems within the relationship.

Ejaculatory disorders

The most prevalent of these disorders is premature ejaculation.

It is the most common sexual disorder in men ages 18 to 59, and can lead to infertility. It may be diagnosed when ejaculation commonly occurs very soon after sexual contact (often within one or two minutes). This can cause distress to the man and affect his relationships.

Absence of orgasm

The absence of orgasm is most often caused by psychological issues or by certain medications. But it can also be caused by decreased penile sensation due to nerve problems. It occurs more often in diabetics with nerve damage.

Peyronie’s disease

A penis that curves or shortens oddly during an erection may be a sign of Peyronie’s disease. It is caused by scar tissue on the penile shaft that restricts expansion. Painful erections, tenderness and ED may result.

This disease occurs in only about 1 percent of men, usually between the ages 45 and 60. Although there may be a genetic link, risk factors include:

  • Repeat trauma from intense sexual intercourse, accidents or surgery
  • Trauma from an erect penis buckling
  • Having intercourse almost daily

See your doctor if you have symptoms of Peyronie’s disease. This condition evolves slowly and may resolve on its own. Doctors will often wait one year before considering surgery to resolve scar tissue.


This may involve pain in the penis, testicles or perineum (area in the groin between the penis and the rectum). Pain may occur during intercourse, or during or just after ejaculation. This condition may be related to other medical problems such as prostate inflammation. You should report any pain or discomfort to your doctor to find the cause.


The causes for sexual dysfunction can be physical or psychological – or a combination of both.

If the inability to have a firm erection occurs only once in a while, then a physical or medication issue is less likely. Persistently low libido may mean hypogonadism, depression or a medication issue. Not being able to maintain erections is often due to poor penile blood flow.

Sexual dysfunction may also be tied to:

  • Relationship problems
  • Stroke
  • Plaque buildup in arteries
  • High blood pressure
  • Problems with:
    • Smoking
    • Obesity
    • Kidneys
    • Depression
    • Anxiety
    • Alcohol

Talk to a doctor if you are having sexual problems. You will be given a thorough exam and asked questions to help find the root of your condition. Once the cause is found, your doctor can talk to you about treatments. Sometimes, simply changing a medication or getting counseling may help.

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