Male sexual dysfunction
Male sexual dysfunction is a problem with 1 of the 4 main components of male sexual function (libido, erection, ejaculation, orgasm) that interferes with interest in or ability to engage in sexual intercourse. Many drugs and numerous physical and psychological disorders affect sexual function.
Libido:
Libido is the conscious component of sexual function. Decreased libido manifests as a lack of sexual interest or a decrease in the frequency and intensity of sexual thoughts, either spontaneous or in response to erotic stimuli. Libido is sensitive to testosterone levels as well as to general nutrition, health, and drugs. Conditions particularly likely to decrease libido include hypogonadism, uraemia, and depression.
Erection:
Erection occurs as the result of a complex neuropsychological process. The increased inflow and veno-occlusion together produce penile rigidity. Many factors affect the ability to have an erection.
Ejaculation:
Ejaculation is controlled by the sympathetic nervous system. In addition, the neck of the bladder closes, preventing retrograde ejaculation of semen into the bladder. SSRIs may delay or inhibit ejaculation.
Premature ejaculation:
Is ejaculation occurring sooner than desired by the man or his partner. It is usually caused by sexual inexperience, anxiety, and other psychological factors instead of disease. It can be treated successfully with sex therapy and SSRIs.
Ejaculatory insufficiency:
Is reduced or absent semen volume that may result from retrograde ejaculation (prostatic fluid flowing backward into the bladder) or interruption of sympathetic stimulation. Retrograde ejaculation is common in men with diabetes and can also be caused by surgery on the neck of the bladder or transurethral resection of the prostate. Diminishes ejaculatory volume
Orgasm:
Is the highly pleasurable sensation that occurs in the brain generally simultaneously with ejaculation. Anorgasmia may be a physical phenomenon due to decreased penile sensation (e.g., from neuropathy) or a neuropsychological phenomenon due to psychiatric disorders or psychoactive drugs.
Ejaculatory disturbances
Premature ejaculation
Premature ejaculation is an extremely common condition. Kinsey, in his landmark report, had stated that it affects as many as 75% of all men. In today's context, premature ejaculation (PE) becomes especially relevant because of the increasing emphasis on female sexual gratification. Today's woman will not take anything lying down unless it is good enough (pun intended, of course). However, premature ejaculation seems to be nature's original design. The Karma Sutra has classified PE as one among many normal ejaculatory patterns.
- Ejaculate the semen before penetration
- Not able to satisfy the partner
- Desire in sex with lack of eructation and early semen ejaculation
- Some person ejaculates the semen even when seeing or talking with ladies
Delayed (Retarded) ejaculation
Delayed or retarded ejaculation is a condition which is, in many ways the exact opposite of premature ejaculation. It is defined as a persistent difficulty in achieving ejaculation despite the presence of adequate sexual desire, erection and stimulation. On the face of it, this might seem to be a good condition to suffer from because it carries connotations of great staying power. This may be true sometimes, especially if the female partner also requires a long time to reach orgasm. Often, however, it is more a cause for worry than for rejoicing. The male often goes on for a half hour or more with little sexual pleasure, and constantly worries about when he is going to finish. The female partner usually has already attained orgasm and waits eagerly for the man to finish. She stops lubricating shortly after she has attained orgasm and the remainder of the sex act is a painful formality. Situations such as these can lead to a lot of relationship problems between the partners.
- Delayed ejaculation even after your partner gets full satisfaction
- Worry about the ejaculation (he worry’s when semen will come)
- Your partner got irritated because of continues friction even after her climax
- She got averse the sex because of your sexual activity (delayed ejaculation produce vaginal dryness and burning sensation after and during sex)
Retrograde ejaculation
Retrograde ejaculation (which can also present as Anejaculation - vide infra), as its name implies, is a condition where the seminal fluid is ejaculated backward (retrograde) into the urinary bladder instead of forward (ante grade), as is the norm. This usually occurs because the neck of the urinary bladder, which normally closes to block such retrograde flow, is unable to do so. Such inability usually results from neurological or physical damage to the bladder neck, which in turn can result from a variety of clinical conditions.
Patients with retrograde ejaculation usually achieve orgasm normally and feel the sensation of having ejaculated. However, little or no seminal fluid emerges from the penis. Instead, the patient often notices that the post-ejaculatory urine, i.e. the urine passed after sexual intercourse, is cloudy with semen.
Anejaculation
Anejaculation is a condition characterized by the absence of ejaculation.
The causes can be psychological and physical.
Psychological Anejaculation is usually anorgasmic i.e. unaccompanied by orgasm.
Situational Anejaculation means that a man can ejaculate in some situations but not in others. For instance, a man may be able to ejaculate and attain orgasm with one partner but not with another. This usually occurs when there is a psychological conflict or a relationship difficulty with one partner. Or he may be able to ejaculate quite normally during masturbation but not during intercourse. It can also occur in stressful situations, as when a man is asked to collect a sample of semen in the laboratory for infertility treatment.
Total Anejaculation, the man is never able to ejaculate when awake. Deep-rooted psychological conflicts are usually the cause. Such men, however, usually have normal nocturnal (night) sleep emissions.
Treatment
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Counselling and sex therapy
Counselling and sex therapy are sometimes effective in helping patients with sexual problems, especially when caused by psychogenic reasons. Sex therapy promotes education and relief of symptoms of sexual dysfunction. Marital and personal counselling is targeted on interpersonal and relationship issues which contribute to resolving a couple's or an individual's psychological and emotional dysfunction.
Mail us to get sex counselling consult.ur.dr@gmail.com
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