A sexual problem, or sexual dysfunction, refers to a problem during anyphase of the sexual response cycle that prevents the man or couple fromexperiencing satisfaction from the activity. The sexual response cycle has fourphases: excitement, plateau, orgasm, and resolution.

While research suggests that sexual dysfunction is common (43% of women and31% of men report some degree of difficulty), it is a topic that many peopleare hesitant to discuss. Fortunately, most cases of sexual dysfunction aretreatable, so it is important to share your concerns with your partner anddoctor.

What Causes Male Sexual Problems?

Sexual dysfunction can be a result of a physical or psychologicalproblem.

• Physical causes: Many physical and/or medical conditions can cause problemswith sexual function. These conditions include diabetes, heart and vascular(blood vessel) disease, neurological disorders, hormonal imbalances, chronicdiseases such as kidney or liver failure, and alcoholism and drug abuse. Inaddition, the side effects of certain medications, including someantidepressant drugs, can affect sexual desire and function.
• Psychological causes: These include work-related stress and anxiety,concern about sexual performance, marital or relationship problems, depression,feelings of guilt, and the effects of a past sexual trauma.

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Who Is Affected by Sexual Problems?

Both men and women are affected by sexual problems. Sexual problems occur inadults of all ages. Among those commonly affected are those in the geriatricpopulation, which may be related to a decline in health associated withaging.

How Do Sexual Problems Affect Men?

The most common sexual problems in men are ejaculation disorders, erectiledysfunction and inhibited sexual desire.

What Are Ejaculation Disorders?

There are different types of ejaculation disorders in men, including:

• Premature ejaculation: This refers to ejaculation that occurs before orsoon after penetration.
• Inhibited or retarded ejaculation: This is when ejaculation is slow tooccur.
• Retrograde ejaculation: This occurs when, at orgasm, the ejaculate isforced back into the bladder rather than through the urethra and out the end ofthe penis.

In some cases, premature and inhibited ejaculation are caused bypsychological factors, including a strict religious background that causes theperson to view sex as sinful, a lack of attraction for a partner, and pasttraumatic events. Premature ejaculation, the most common form of sexualdysfunction in men, often is due to nervousness over how well he will performduring sex. Certain drugs, including some anti-depressants, may affectejaculation, as can nerve damage to the spinal cord or back.

Retrograde ejaculation is common in males with diabetes who suffer fromdiabetic neuropathy (nerve damage). This is due to problems with the nerves inthe bladder and the bladder neck that allow the ejaculate to flow backward. Inother men, retrograde ejaculation occurs after operations on the bladder neckor prostate, or after certain abdominal operations. In addition, certainmedications, particularly those used to treat mood disorders, may causeproblems with ejaculation.