Sexual Problems

Sexual problems are not unusual among men. Many men have problems getting or keeping an erection. Some men have problems with ejaculation. The good news is that treatment often can help sexual problems.

Premature ejaculation

A lot of men sometimes ejaculate sooner than they would like. Estimates vary, but around 1 out of 3 men experience premature ejaculation at some time. Usually, premature ejaculation does not need treatment. But if you often ejaculate prematurely — like before starting intercourse or just a minute or two after starting — you can get help.

Premature ejaculation has several possible causes, including:

• Emotional issues like guilt or anxiety
• Low levels of certain brain chemicals
• Being very aroused or stimulated
• Infection of the prostate  

Talk to your doctor if you are concerned. There are several treatments for premature ejaculation. You first might try techniques like stopping sexual stimulation briefly and then restarting it. You also could try using topical creams or condoms to lessen excitement. The U.S. Food and Drug Administration has not approved any medications for premature ejaculation, but your doctor may prescribe antidepressants because a possible side effect is delaying ejaculation.

Open communication with your partner can help with any stress between you. And it can help you figure out ways that you can both achieve satisfaction. Working with a therapist or counselor, either by yourself or as a couple, can be very effective.

Erection problems

Some men have problems getting or keeping an erection. (An erection is when blood fills up the penis, making it firmer and larger.) This problem is called erectile dysfunction, or ED, and sometimes is called impotence. ED is fairly common. In fact, between 15 million and 30 million U.S. men are affected by it. ED can be very upsetting. It can affect self-esteem and cause frustration, anger, and sadness. But there are effective treatments for ED. And counseling can help you and your partner cope with any emotional effects of ED.

Causes of ED include:

• Clogged blood vessels, high blood pressure, and high cholesterol
• Nerve damage from diabetes
• Certain medicines, including some used to treat depression or high blood pressure
• Low testosterone
• Unhealthy habits like smoking, drinking too much alcohol, overeating, and not exercising
• Emotional factors, such as stress or depression

As men get older, ED becomes more common. By age 65, almost 25 percent of men have this problem at least one out of every four times they have sex. But ED is treatable at any age. Your doctor can offer a number of ways to treat ED. If treatment solves your ED, though, you still need to take care of any health issues that may have caused it.

Some men need to try two or three options before they find an ED treatment that works for them. Medication is one popular way to treat ED. Drugs like Viagra increase blood flow to the penis, which helps make an erection possible. Injections to the penis and medicine you put into the tip of your penis also can increase blood flow to it.

Other treatments for ED include a vacuum cylinder and pump you put on your penis to pull blood into it or inflatable rods that are put into the penis through surgery.

You may have heard of herbal products or dietary supplements that claim to treat ED or improve sexual performance. You should beware of these products even if they claim to be "natural." They can contain dangerous ingredients, including prescription medications that are not identified on the product's label.

Loss of sexual interest

Your interest in sex, also called libido, can vary over the course of your life. Some men may lose interest in sex during times of stress or illness. Also, your interest might not match that of your partner at times, which is normal in long-term relationships.

Reduced interest in sex can have a number of causes, including:

• A health problem
• Certain medications
• Reduced levels of male hormones
• Emotional or relationship problems

As men get older, ED becomes more common. By age 65, almost 25 percent of men have this problem at least one out of every four times they have sex. But ED is treatable at any age. Your doctor can offer a number of ways to treat ED. If treatment solves your ED, though, you still need to take care of any health issues that may have caused it.

Some men need to try two or three options before they find an ED treatment that works for them. Medication is one popular way to treat ED. Drugs like Viagra increase blood flow to the penis, which helps make an erection possible. Injections to the penis and medicine you put into the tip of your penis also can increase blood flow to it.

Other treatments for ED include a vacuum cylinder and pump you put on your penis to pull blood into it or inflatable rods that are put into the penis through surgery.

You may have heard of herbal products or dietary supplements that claim to treat ED or improve sexual performance. You should beware of these products even if they claim to be "natural." They can contain dangerous ingredients, including prescription medications that are not identified on the product's label.

Loss of sexual interest

Your interest in sex, also called libido, can vary over the course of your life. Some men may lose interest in sex during times of stress or illne

educed interest in sex can have a number of causes, including:

• A health problem
• Certain medications
• Reduced levels of male hormones
• Emotional or relationship problems

As men age, it is natural to be less interested in sex. But for a healthy man, having no interest in sex is not normal. If you have less interest in sex, talk frankly with your doctor. Treatment can help. It could include medicine, counseling, or both.

Low testosterone

Testosterone is the most important male hormone. It helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone. Lower than normal levels of testosterone can affect a man's body and mood. Signs of low testosterone in adult men can include:

• Less interest in sex
• Erection problems
• Increased breast size
• Hot flashes
• Problems with memory and concentration
• Mood problems, like irritability and depression
• Smaller and softer testicles
• Loss of muscle strength and weakened bones

Low testosterone levels can have a number of causes, including injury, disease, and certain medications. A gradual decline in testosterone is normal in men as they get older. This is sometimes called again male syndrome (or andropause) and can cause erection problems and less sex drive. But it is not normal for healthy older men to have no interest in sex. There could be other reasons for these changes.

If you have symptoms of low testosterone, talk to your doctor. You can get your testosterone level checked with a simple blood test. If you do have low testosterone, your doctor will want to find out the underlying cause. Finding the cause can involve many tests. You might want to see a specialist, such as an endocrinologist or urologist.

Some men with low testosterone take testosterone replacement therapy, which they get through a skin patch or other method. But testosterone therapy is not right for everyone, and its use is controversial. One reason is that testosterone therapy has certain risks. Another reason is that experts don't know exactly what testosterone levels are "normal" as men age. If you have low testosterone, your doctor can help you understand the benefits and risks of treatment so you can decide what's right for you.