Many men struggle with problems during sex. Doctors call this sexual dysfunction. Your health, stress, relationship concerns, and other issues can lead to these problems.
About 31% of men, and 43% of women, have some sort of difficulty during sex. But many types of sexual problems can be treated or otherwise improved. Thanks to ongoing research, doctors understand more about them than ever before.
Common Sexual Problems
You can have problems at different points during sex. Men may experience:
- Lack of sexual desire
- Inability to get or keep an erection
- Orgasms that happen too slowly or too quickly
- Inability to have orgasms
Other possible issues are:
- Deformities of your penis. One type is Peyronie’s disease, in which a buildup of collagen or scar tissue causes the penis to bend.
- Retrograde ejaculation, when semen is forced back into your bladder instead of out of your penis. This may happen in men with nerve damage from diabetes, or after bladder or prostate surgery.
Sex and Aging
Some changes in your desire for sex and sexual performance are common as you age. You may need more foreplay before sex, or more stimulation to get and keep an erection. It also may take longer to get an erection after an orgasm.
But drastic changes can be a sign of a bigger problem. Talk to your doctor if this happens.
Your overall health and any medical conditions you have also affect your sex life. Conditions that can affect your sexual ability or desire for sex include:
- Heart and vascular (blood vessel) disease
- Hormone imbalances
- Nervous system disorders like multiple sclerosis and Parkinson's disease
- High blood pressure
- High cholesterol
Sudden changes in your sex drive or ability to have sex can be a sign you have a medical condition. Tell your doctor if you notice them.
Medications, such as depression and high blood pressure drugs, can also affect sex. If you notice problems after you start a new medicine, ask your doctor how to manage the side effects or if they can switch your prescription.
Smoking, drinking a lot of alcohol, and other unhealthy habits also may hurt your sexual function. On the flip side, regular exercise, weight loss, and stress management could improve your sex life.
Mental and Emotional Issues
Stress, anxiety, depression, and other mental and emotional issues can have a big effect on your sex life. Just worrying about how you'll perform during sex can keep you from enjoying sexual intimacy. So can guilt about sex, fear of pregnancy, or memories of a traumatic sexual experience.
Concerns with your relationship can lead to sex problems, too. Anger at your partner, boredom with the relationship, and other ongoing issues can all affect you sexually.
You might feel nervous or shy about talking to your doctor about your sexual problems. But opening up about your concerns is the first step to getting help.
Your doctor will ask questions about what's happening. They may do a physical exam and order other tests (such as a blood test) to figure out whether an underlying health concern is the cause of your sexual difficulties.
If a medical condition such as heart disease, diabetes, obesity, or depression is affecting your sex life, your doctor may need to address it first.
Your doctor might suggest changing unhealthy habits, such as smoking or drinking too much alcohol, and encourage you to exercise. These things can improve your overall health as well as your ability to have sex.
Other treatment options include:
- Counseling to help you manage stress, anxiety, fear, or guilt, or to address depression or other mental health concerns
- Medications for erection problems that you take as a pill, such as Cialis, Levitra, Stendra, or Viagra
- Medicines for erection problems that you get as a shot, like alprostadil
- Testosterone replacement therapy and other hormone treatments for imbalances
- Medical devices, such as vacuum erection devices, that help you get an erection
- Penis implant surgery
- Surgery to correct penis deformities
- Penile traction therapy, in which you wear a device on your penis to correct deformities