Men's Sexual Health

How Sexual Health Affects the Fertility of Men

Problems with a man's sexual health can directly impact fertility, as well as quality of life and intimate relationships. Any problem that affects the male reproductive system or alters fertility can lead to low self-esteem and depression. Infertility is common among both men and women, with as many as 10 percent of couples experiencing difficulties with conception. Common causes of male infertility include age, lifestyle, environmental exposures, health problems, and medications. As a man ages, sperm production declines, and some men have problems with sperm shape and movement. Behaviors like smoking cigarettes, heavy alcohol use, or taking illicit drugs can reduce sperm count and quality. Fertility experts found that many environmental toxins cause infertility, such as pesticides and lead. Numerous health problems affect fertility, such as diabetes, genetic diseases, sexually transmitted infections (STIs), and bacterial or viral infections. Additionally, men who have varicoceles have high rates of infertility, and many medications are associated with infertility.

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The Male Reproductive System

The male reproductive system performs many functions. These include producing, maintaining, and transporting sperm; discharging sperm into the female reproductive tract during intercourse; and, producing and secreting male sex hormones. Unlike the female reproductive system, the man's system is located on the outer aspect of the body. These structures include the penis, scrotum, and testicles. Semen is a fluid substance that contains the reproductive cells known as sperm. Semen is ejaculated through the end of the penis during intercourse.

The entire male reproductive system relies on hormones, which are chemicals that regulate cellular and organ activity. The main hormones that are involved with the male reproductive system are testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH). FSH is needed for spermatogenesis (sperm production), whereas LH is required for the production of testosterone (the hormone that forms sperm). Testosterone assists with the development of the male sexual characteristics, including muscle mass, strength, fat distribution, facial hair growth, sex drive, bone mass, and voice change.

Male Reproductive Structures

The male reproductive tract is a complex system of organs and structures. These include:

  • Penis. This is the male sex organ that has three parts: the root, the body, and the glans. The root attaches to the wall of the abdomen, the body (or shaft) is the central portion, and the glans is the cone-shaped head or end of the penis. The penis is covered with a thin layer of loose skin called the foreskin that is often removed during circumcision. The meatus is the opening of the urethra, the tube that transports urine and semen out of the penis.
  • Scrotum. The scrotum is the loose pouch-like sac of skin that hangs below the penis. This structure contains blood vessels, nerves, and the testicles, which are called testes. For sperm formation, the testes must remain at a cool temperature. Special muscles in the wall of the scrotum contract and relax to move the testicles either closer or farther from the body to adjust temperature.
  • Testicles. The testes are oval organs that are about the size of large olives. They are secured at the end of the spermatic cord inside the scrotum. These two organs are responsible for manufacturing testosterone and generating sperm.
  • Urethra. The urethra is a tube that transports urine and sperm out of the body. When the penis is erect, the flow of urine is blocked, and only semen can be ejaculated from the urethra.
  • Epididymis. The epididymis is a coiled tube that lies on the back of each testis. This reproductive structure stores and transports sperm that are produced by the testis. The epididymis also brings the sperm to maturing.
  • Vas Deferens. The vas deferens is a long, muscular tube inside the pelvic cavity. This tube transports mature sperm from the epididymis to the urethra, where it exits the body via the meatus.
  • Seminal Vesicles. The seminal vesicles are sac-like pouches that produce a sugary fluid, which gives sperm energy. These pouches attach to the vas deferens near the base of the bladder.
  • Ejaculatory Ducts. The ejaculatory ducts are formed by the fusion of the seminal vesicles and the vas deferens. These structures empty into the urethra.
  • Prostate Gland. The prostate gland is a walnut-sized organ that lies below the bladder and in front of the rectum. This gland secretes fluid that nourishes sperm, and semen runs through the center of the prostate when it is ejaculated.

Male Sexual Problems

A sexual problem is often called sexual dysfunction. This refers to any problem that occurs during a phase of the sexual response cycle that prevents a man from experiencing satisfaction from sexual activity. The four sexual response cycles are excitement, plateau, orgasm, and resolution. As many as 33 percent of men report some degree of sexual dysfunction, but most of these cases are treatable.

Causes of Sexual Dysfunction in Men

  • Physical causes: These include conditions such as heart and vascular disease, neurological disorders, diabetes, hormonal imbalances, kidney failure, liver disease, and alcoholism.
  • Psychological causes: These include antidepressant drugs that affect sexual function and desire, relationship problems, feelings of guilt, depression, anxiety, and sexual trauma.

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