Sexual dysfunction in men is defined as a persistent inability to conduct satisfactory sexual intercourse. Sexual disorders in males are divided into disorders of sexual dysfunction, sexual orientation, and sexual behavior. Several factors play a role in the normal sexual functioning, including vascular events, intracavernosal nitric oxide system, and androgens and impairment in any of these factors could lead to the development of any sexual disorder. Sexual dysfunction can take different forms in men and a person can be said to have sexual dysfunction under the following conditions:
1. If a person ejaculates before he or his partner desires
2. Does not ejaculates when required
3. Unable to have sufficient erection during sexual intercourse
4. Lack or absence of sexual desire
Premature ejaculation is one of the most common sexual dysfunction in men and occurs when a man persistently ejaculates much sooner than he or his partner desires. Distress is one of the most common results of this sexual disorder and sexual relationship between the couple is often affected by premature ejaculation. Numerous studies suggest that people who suffer from premature ejaculation are at greater than normal risk of developing kidney failure. Premature ejaculation is of two types:
- Lifelong Premature Ejaculation - This type of premature ejaculation means a disorder which existed from the time when a person first became sexually active.
- Acquired Premature Ejaculation - This type of premature ejaculation means that a disorder develops overtime after a person had a normal sexual life, without any symptoms of premature ejaculation.
There are many factors that can lead to the development of premature ejaculation and the reasons to its development can be biological, chemical or emotional. Also, it can be a result of any problem with the brain signal that rules the sexual excitement. There are treatments available to treat this sexual dysfunction such as psychological therapy, behavioral therapy, and medical therapy.
Erectile dysfunction is also known as impotence and it is defined as an inability to sustain an erection during sexual intercourse. After premature ejaculation, it is the most common sexual dysfunctioning in men and almost all men at some point of their life experience some degree of sexual difficulty but when it becomes persistent, it is considered to be sexual dysfunctioning. Erectile dysfunction can be divided into primary and secondary impotence:
- Primary impotence is not very common and its causes are associated with the low androgen levels, genetic defects, and severe psychopathology.
- Secondary impotence is much more common and it is usually caused by disorders such as diabetes, arteriosclerosis, neurological disorders, psychological issues, blood pressure medications, and antidepressants.
Penile erection is a hemodynamic process that is initiated by the relaxation of smooth muscles in the corpus cavernosum. At the time of sexual stimulation, nitric oxide is released from the nerve endings to the corpus cavernosum which is the main erectile tissue. Nitric oxide leads to the activation of the enzyme guanylate cyclase which further results in the increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the main erectile tissue. cGMP allows an inflow of blood and hence, an erection is achieved.
Men who suffer from erectile dysfunction are mostly recommended phosphodiesterase type 5 inhibitors to treat this sexual dysfunction and mostly recommended medicines include Viagra, Cialis, and Levitra. These drugs inhibit phosphodiesterase type 5 and block the degradation of cyclic guanosine monophosphate (cGMP).
Disorders of desires are highly associated with sexual dysfunctions and disorder of desires can either be deficient or compulsive.
- Hypoactive Sexual Desire - It is defined as a disorder which is characterized by a lack or absence of sexual desires or fantasies during the sexual activity. This type of sexual disorder negatively impacts the lives of both the partners and increases distress in their life. Symptoms of hypoactive sexual desires include lack of motivation to involve in any physical activity due to decreased desire, lack of sexual desire in response to erotic cues or stimulation, anxiety and major distress that further includes, sadness, frustration, and worry.
- Compulsive sexual behavior - This sexual disorder or desires is defined as sex addiction, hypersexuality, and problematic sexual behavior. It is characterized by repetitive and intense sexual fantasies and behavior that bring stress to an individual and often results in psychosocial impairment.