A Visual Guide to Erectile Dysfunction and Other Male Sexual Dysfunction

Impaired sexual functioning defines a series of conditions collectively termed male sexual dysfunction. Most people are familiar with Erectile Dysfunction (ED) and premature ejaculation (PE). However, some may also suffer from Peyronie’s Disease (PD).

A Man could have ED in the Following Two Scenarios: 

• • When his sexual desire reduces 

• • When he has trouble getting or maintaining an erection sufficient for sexual satisfaction. 

The Appearance of Signs or Symptoms of PD may be Sudden or Gradual. These include: 

• • Scar tissue (called plaque, which builds up under the skin of the penis as flat lumps or hard tissue), 

• • A significant bend to the penis (which could be upward, downward, or sideways), erection problems (though ED could be the precursor to PD symptoms),

• • Shortening of the penis

• • Penile pain (which could also be without an erection) and other penile deformities

The curvature and penile shortening may worsen over time. However, the condition stabilizes within three months to a year. The pain takes about a year or two to reduce, but the curvature, penile shortening, and scar tissue remain. However, in some cases, the curvature and pain associated with PD reduce without treatment.

Those who suffer from PE cannot delay ejaculation beyond the three-minute mark after penetrating. However, it could occur even when they masturbate. It could be lifelong. In other words, it takes place nearly all the time, starting with the first sexual encounter. Similarly, it can be acquired. That means it develops after having previous sexual encounters without problems with ejaculation. Though many men believe they have PE Symptoms, they do not meet the criteria for a diagnosis.

Age is not just a number in the case of this category of afflictions; its prevalence increases as one grows older. One form of erectile issue or another afflicts about half of the men aged between 40 and 70. The number of septuagenarians with sexual performance troubles is four times that of men in their twenties.

But age is also not the only risk factor for these conditions. The men with the following also are also at risk of developing them. 

• • Diabetics

• • Those with anxiety

• • Cancer

• • Depression

• • Disturbed central serotonin neurotransmission/5-HT postsynaptic receptor functioning

• • Hypertension

• • Penile trauma

• • Stroke.

To diagnose male sexual dysfunction, doctors will look at the case history in depth. Additionally, they will conduct a thorough physical examination. The patient may have to fill out a questionnaire for that. His responses will facilitate the doctor’s diagnosis. If a patient or his partner establishes an impairment in sexual functioning, the primary care provider will diagnose this.

A physician will treat this ailment based on its etiology. The first line of erectile insufficiency treatment is a phosphodiesterase (PDE-5) inhibitor or mental health care if the patient suffers from psychogenic ED. If the male sexual dysfunction case is more complicated, the patient may have to take an injection, undergo surgery, or seek shockwave therapy. As for those suffering from PE, PCPs recommend behavioral therapy or selective serotonin reuptake inhibitors as first-line treatments.

Though sexual dysfunction can affect women, this piece focuses on male sexual dysfunction. It can occur at the desire, arousal, or climax stage of the normal sexual response cycle. But it could be due to the pain a person with the condition has to bear.

The physiological and psychological components of human sexual function make it complex. Male sexual dysfunction has multiple standalone causes as far as risk factors and treatments are concerned. People may have low sexual desire (a lack of interest in having or thinking about sex, alone or with a partner). Erectile issues may be consistent or recurrent, but they are not uncommon. Most men hesitate to report sexual failure to their physicians. Hence, the latter must ask about sexual health and function for them to be able to diagnose it properly.

Most of the available literature is about ED and PE because they are the most common male sexual dysfunctions. However, it is difficult to compare them because the bases are the way they are defined, like: 

• • The population studied

• • The patients’ ages

• • Medical histories

• • Socioeconomic conditions 

• • cultural backgrounds. 

Reportedly, between 15 and 25% of people of varying ages and from different geographical locations showed a decrease in interest in or desire for sex, and most were 60 years old or older. The prevalence rates of orgasmic dysfunction (OD) ranged between 11.8 and 19.4 percent. For all regions of the world, the prevalence rate ranged from five to eight percent, but in East and Southeast Asia, it was between 10 and 15%. As far as dyspareunia is concerned, there is not much literature. As per a global survey, the prevalence rate of painful ejaculation was about 16.8%.

Male sexual dysfunction can either be a primary disease process or a secondary one. The first time a person complains of sexual dysfunction symptoms, the healthcare professional must rule out underlying conditions or medications that result in secondary sexual dysfunction.

The following are the underlying conditions:

• • Cardiovascular disease

• • Chronic kidney disease

• • Diabetes mellitus

• • Endocrinopathies

• • Hypertension

• • Hyperlipidemia

• • Neurological disorders

• • Obstructive sleep apnea (OSA)

• • Peripheral artery disease

• • Psychological factors

• • Testosterone deficiency

• • Thyroid disease

Many Categories of Medication can result in Male Sexual Dysfunction. These include:

• • Antiandrogens

• • Antidepressants

• • Antihypertensives

• • Anti-Parkinsonian medication

• • Diuretics

• • Opioids

• • Sympathetic blockers

Read more: Do Chewable ED Medications Really Work?

The following lab tests can help identify the underlying conditions that result in male Sexual dysfunction symptoms:

• • Blood urea nitrogen

• • Complete blood count

• • Creatinine

• • Hemoglobin A1C

• • Hormone levels

• • Lipid panel

• • Thyroid panel

• • Vital signs

The American Urological Association (AUA) has a Grade C recommendation to measure morning serum testosterone for people suffering from erectile failure symptoms. The findings of physical exams may also include gynecomastia. This is an increase in breast gland tissue in men or underdeveloped pubic hair. 

If one is deficient in testosterone or other endocrinopathies, he could have these issues. Men should undergo a genital exam to assess the size of their testicles, the presence of penile lesions/abnormalities, or previous surgery. Treating specific conditions or discontinuing offending agents may alleviate male sexual dysfunction symptoms.

It may be an uncomfortable topic to discuss with a physician, but erectile problems are common. It affects about 30 million people in the US. More than half of American men aged 40 and older have some degree of inability to achieve or maintain an erection.

People should adopt the following Lifestyle Changes for ED Prevention:

• • A Harvard study found that walking 30 minutes a day can reduce the risk of erectile problems by 41%.

• • Any exercise, including swimming or tennis, will reduce and reverse erectile insufficiency. Blood flow is a prerequisite for a strong erection, and physical activity enhances it. Those who do weight-bearing exercises have a large quantity of natural testosterone. They will boost the strength of the erection and a man’s sexual drive.

• • Riding a bike is some people’s favorite form of exercise. But the bike’s seat could also contribute to difficulty getting or keeping an erection. To reduce the condition, one should buy a saddle that reduces the pressure on the perineum.

• • Losing weight/reducing the size of one’s waist could help reduce the risk of erectile issues. Among the Lifestyle Changes for ED Prevention, this is perhaps the best.

• • Kegel’s exercises are not gender-specific. Men also need a strong pelvic floor. And they are easy to perform.

• • According to a study on male aging, the following foods decreases the risk of male sexual dysfunction

• • A diet rich in fish

• • Fruits

• • Vegetables

• • Whole grains

• • Reduction in consumption of processed food

• • Eating less red meat

• • Use of less refined grains.

• • Alcohol consumption in moderation (just one or two drinks a day) reduces risk of erectile failure. Excessive drinking can result in premature ejaculation because it damages the muscle cells in the penis.

• • Smoking also damages the blood vessels, making it difficult for them to deliver blood to the body, including the penis. One should also avoid second-hand smoke.

• • If a man does not get deep, restful sleep, it could affect his sexual performance. If he suffers from sleep apnea, using a CPAP could improve erectile function.

• • One must manage diabetes and control his blood sugar for enhanced sexual performance. Male sexual dysfunction can be caused in diabetics due to the following: 

• • Continuous spikes in the latter

• • Damage in the blood vessels

• • Erectile tissue malfunction 

• • Nerve degeneration

• • Hypertension/high blood pressure could hamper the blood flow to the penis. The medications people took to manage those conditions earlier had sexual side effects. But the newer ones do not. They merit a discussion with the doctor.

• • Studies by the National Institute of Health (NIH) and in Finland concurred that men who had sex once a week were twice as likely to suffer from erectile challenges and other male sexual dysfunction. However, the condition should not deter people from having sex.

• • Depression and low self-esteem may affect a man’s sexual health and prevent him from getting or keeping an erection. A depressed person must seek help immediately.         

While some of these reduce the risk of an inability to get or keep the penis up, others reverse the condition.

ED and cardiovascular health issues are related. They are also common – in the United States alone, they affect about 18 million men over 20. However, that number could be under-reported: it might be over 30 million.

Though older men are at a higher risk of suffering from the condition, getting or keeping an erection is not linked to one’s age alone. Though many men will suffer from erection issues at some stage, that should not dishearten them. The reason for this is that, usually, the condition’s cause is identifiable. Moreover, it may even go away with treatment.

Learn more: Top 5 Medicines to Enhance Sex Drive in Men