Sexual dysfunction or a sexual problem is defined as facing problems in any part of the sexual response cycle, which prevents the individual or couple from experiencing sexual gratification. It is most correctly described as sexual dissatisfaction because of this reason and can lead to intimacy problems in your relationship. The sexual response cycle is composed of four phases namely; excitement, plateau, orgasm and resolution.

On average one in every five Australian men suffer from sexual problems like erectile dysfunction or impotence to some degree. In fact 150 million men all over the world suffer from this condition and one million suffer from it in Australia alone.

Despite the prevalence of this problem, most men feel hesitant while disclosing details about it in front of a medical practitioner or therapist. Many are even shy about discussing their condition with their spouse. It must be understood that most sexual problems are treatable therefore discussing them will help you combat them.

Causes of male sexual dysfunction

Most people start facing sexual problems after a traumatising experience in the recent past or as a result of a painful childhood incident.

There are also several physical causes in the body that can trigger sexual dysfunction. The key to receiving treatment is understanding the nature of the cause of this problem. Some physical or psychological causes that lead to sexual dysfunction are as follows:

• Physical: Many medical and physical conditions can lead to sexual dysfunction like diabetes, heart and vasculature abnormalities. Some neurological conditions, alcoholism, drug abuse or liver and kidney failure can also contribute to sexual problems. Many people may also suffer from sexual dissatisfaction as a result of side effects of certain drugs like antidepressants.
• Psychological: Stress and anxiety due to problems at home or excessive workload can significantly contribute to sexual performance problems. Performance anxiety can also make some partners hesitant when initiating sexual contact. Various problems with relationships or marital issues also lay the foundation of problems with sexual performance. In fact most couples may experience problems out of fear because of a traumatising past sexual experience or guilt over an extra marital affair. Many depressed patients also complain of problems in the sexual activity.

Types of sexual problems affecting men:

When an individual knocks on a counsellor's door with a sexual problem, they generally complain of a feeling of dissatisfaction during the act of sexual intercourse. They are not aware of the exact nature of the problem that they are suffering from. Sexual problems are basically divided into ejaculation disorders, erectile dysfunction and inhibited sexual desire (libido).

Ejaculation disorders: Ejaculation disorders may sometimes be caused by a lack of attraction for the partner or a past traumatising sexual experience. Certain religious and cultural taboos may create a sinful image about the act of sexual intercourse and make the individual suffer from ejaculatory problems. These are further divided into:

1.  Premature ejaculation: Ejaculation occurring before the desired moment of penetration. Individuals taking anti-depressants  or suffering from nervous problems like spinal shock may suffer from this problem.

2. Retarded ejaculation: The process of ejaculation is slowed down and it becomes difficult for the male to reach the point of ejaculation.

3. Retrograde ejaculation: This is when the ejaculate moves back into the bladder instead of coming out through the urethral orifice at the time of orgasm. Diabetics who suffer from diabetes neuropathy may suffer from problems of retrograde ejaculation. Medications taken for certain mood disorders may lead to this problem as a side effect.

Erectile Dysfunction (impotence): This is defined as the inability to achieve or maintain an erection for the act of sexual intercourse. Most causes of erectile dysfunction are physical in nature like penile injury, side effects of medication, atherosclerosis, nerve disorders or Peyronie's disease (scar tissue in the penis). However many psychological factors can also lead to erectile dysfunction. These include performance anxiety, stress and depression.

Loss of Libido: This condition involves a decreased interest and desire for any form of sexual activity. Low levels of testosterone have been proved to be associated with this condition. Medical problems like diabetes, hypertension, and certain medication like anti depressants can also lead to a decreased sexual desire. Psychological illnesses like anxiety and depression also significantly contribute to this problem.

Male psychosexual dysfunction

This is defined as the inability to achieve sexual arousal and satisfaction due to some mental or emotional problems and in the absence of any noted physical or medical problems. This problem can have grave consequences on your relationship health and tarnish your self esteem. The following causes can contribute to psychosexual dysfunction:

• Depression
• Anxiety, nervousness or fear
• Traumatic sexual experience like rape, child abuse
• Guilt
• Stress due to work load or financial worries
• Uncertain sexual orientation
• Performance anxiety
• Negative feelings about body image or not feeling attracted to the partner
• Religious or cultural restrictions
• Relationship problems (abusive relationship, conflict with spouse)

The symptoms of psychosexual dysfunction may greatly affect the quality of sexual experience and cause relationship problems. Here are a few common sexual problems faced by men:

• Inability to maintain an erection
• Ejaculation occurring prematurely or not at all
• Absence of arousal upon sexual stimulation or inability to reach an orgasm
• Decreased desire for sexual intercourse

Treatment of male sexual dysfunction

Most causes of psychosexual dysfunction can be effectively treated if the underlying cause is dealt with appropriately. Treatment for underlying anxiety or depression may remove the root cause of this kind of sexual dysfunction. The treatment strategies for sexual dysfunction are as follows:

• Medical treatment: Medicines like Viagra, Cialis or Levitra can help alleviate the symptoms of sexual dysfunction. Besides a rigorous control on illness like diabetes, hypertension and atherosclerosis can also prove to be helpful. Hormone therapy in the form of testosterone replacement therapy can help with certain sexual problems like decreased libido.
• Psychotherapy: Therapy sessions with a trained counsellor or sex therapist can help individuals combat problems like anxiety, depression or guilt which interfere with the quality of their sexual experience.
• Mechanical aids: Penile implants and devices can help people suffering from severe forms of erectile dysfunction.
• Effective communication: Sometimes an open dialogue with your partner about your sexual expectations and issues can help couples overcome the hesitancy that may be hampering the quality of their sexual act. A couples counsellor can help with improving your communication.
• Prevention: Although sexual problems can be treated by various means, it’s important to implement preventive measures. These include following your doctor's guidelines for underlying illnesses, avoiding cigarettes, alcohols and recreational drug use, getting prompt treatment if you experience problems like stress, anxiety or depression and maintaining healthy relationship communication with your sexual partner.

Related articles:

Strategies for Overcoming Depression

Sexual Addiction: What is it and Does it Exist?

Pornography Addiction: An Overview of Symptoms and Treatment

If you or someone you know suffers from a male sexual dsyfunction, Australia Counselling has therapists, counsellors and psychologists that can help. View our sex therapy page to find a list of counsellors or psychologists located in Sydney, Perth, Melbourne, Adelaide, Brisbane, Canberra or regional areas of Australia.

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