Understanding Male Sexual Problems -- Diagnosis and Treatment
How Do I Know If I Have Sexual Problems?
The most important way for your health care provider to diagnose a sexual problem is to listen carefully to the story you tell, review the list of medications and substances you use (including natural remedies) to track whether your sexual dysfunction is connected with them, and try to determine whether your difficulties are recent or long-standing. It's also important for your health care provider to understand your level of knowledge about your body and about sexuality.
The health care provider will probably encourage talking about relationships, partners, past sexual history, any history of trauma, possible symptoms of depression, and any other stresses or concerns that may be interfering with your ability to respond sexually. Though these topics may seem extraordinarily private, they must be covered to properly evaluate sexual dysfunction and help you have a more satisfying sex life.
Genital itching can be a symptom of many conditions which may include vaginal infections in females or jock itch in males. In either sex, itching may be caused by skin irritation, sexually transmitted diseases, and allergies. In many cases, genital itching that is caused by irritation will clear up on its own if the irritation is removed. Other causes of itching may require more intensive treatment. If you are concerned about genital itching that does not go away, talk to your doctor or another...
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Your health care provider will give you a thorough physical exam, checking for high blood pressure, vascular disease, a neurological disorder, or obvious signs of conditions affecting your penis or testicles. You'll probably be given a blood test to check for diabetes, thyroid disease, and any other hormonal disorders your practitioner may suspect.
Because men normally have multiple erections during sleep, you'll probably be asked about whether you ever awaken with an erection. Sometimes men are asked to undergo a test in a sleep lab to be monitored for erections during sleep. While this information can help tell whether erectile dysfunction may be due to problems with the vascular or nervous systems, it doesn't necessarily indicate whether the erection is sufficient for sexual penetration.
An ultrasound exam that measures the blood flow within the pelvis (a penile Doppler study) can determine whether there is enough blood flow and pressure in the penis to allow for an adequate erection.
A measurement of blood pressure in the penis, called the penile-brachial index, may be helpful in diagnosing penile vascular disorders. A test dose of an erection-inducing agent, such as papaverine, is injected into the penis under a doctor's supervision, followed by monitoring for a subsequent erection. Also, penile blood pressure can be measured during the erection. During this exam, contrast dye may also be injected into an artery so X-rays can reveal any leaks in the vascular system that could account for erectile dysfunction. Surgery to correct the leaks has not been found to be effective.
What Are the Treatments for Sexual Problems?
Any underlying physical conditions will be treated in an effort to improve your sexual functioning. Medication may be given to increase testosterone levels, decrease prolactin, treat thyroid disease, or address high blood pressure. If your sexual dysfunction seems to be due to medications for another condition, your health care provider may prescribe an alternative with fewer sexual side effects. If you smoke, drink alcohol, or use any recreational drugs, you'll be encouraged to stop. If you avoid tobacco, you will provide more oxygen to the vascular tissues of the penis.
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