Conditions That Affect Male Sexual Function

An Overview of Conditions Affecting Male Sexual Function

According to the National Institute of Health, male sexual desire disorder affects around three percent of the population, and erectile dysfunction affects as many as five percent of adult men. Also, three percent of males have hypoactive sexual desire, and approximately four percent of men suffer with ejaculatory disorders. A man must have normal spermatogenesis to impregnate a woman. Also, he must be able to transmit the sperm into the woman's vagina. Without a normal erection or problems with spermatogenesis, this cannot occur. Male sexual functioning disorders include ejaculation disorders, undescended or mispositioned testicles, benign prostatic hyperplasia, inguinal hernia, and erectile dysfunction. Any sexual function problem that prevents sexual activity or the sexual response cycle can alter fertility. Fortunately, most causes of male sexual dysfunction are treatable.

Ejaculation Disorders

There are three types of ejaculation disorders: premature ejaculation, inhibited ejaculation, and retrograde ejaculation. Premature ejaculation occurs before or soon after vaginal penetration. With inhibited ejaculation, the ejaculatory process is slow to occur. Retrograde ejaculation occurs when the ejaculate is forced back into the bladder rather than exiting via the urethra and end of the penis.

Incidence, Prevalence, and Causes

Some cases of premature and inhibited ejaculation are caused by a lack of attraction to the sex partner, or from psychological factors. Premature ejaculation is the most common type of sexual dysfunction in men, and it is due to nervousness and performance anxiety. Also, many medications and drugs affect ejaculation, such as antidepressants, alcohol, and opiates. Retrograde ejaculation is common in men who suffer from diabetic neuropathy, where there is substantial nerve damage.

Signs and Symptoms

Ejaculation disorders are diagnosed based on subjective complaint. When the man experiences difficulties with ejaculation, the doctor can identify the type of sexual dysfunction based on the patient's description of the problem.

Treatment

For premature ejaculation, treatment involves self-help techniques and couples therapy. Certain techniques used include use of a thick condom to decrease sensation, masturbating an hour before sexual activity, and taking deep breaths during intercourse. Also, certain medications can help with delaying ejaculation, such as selective serotonin reuptake inhibitors (SSRIs). With inhibited ejaculation, the physical causes must be treated.

Undescended or Mispositioned Testicles

Undescended or mispositioned testicles are two of the most common congenital testicular conditions that affect male sexual function. The testes normally descend into the scrotum from the abdomen before birth, but sometimes this does not occur. If the testicles are malpositioned, they could sit in the inguinal canal, pelvis, abdomen, or high scrotum.

Incidence, Prevalence, and Causes

Undescended or mispositioned testicles occur in approximately four percent of all full-term infants, and it is more common for premature infants. Many cases of this condition resolve by the first year of life, but many times the condition is not recognized, resulting in infertility due to endocrine understimulation and high body temperature. Also, men with undescended or mispositioned testicles are at a greater risk for developing testicular cancer.

Signs and Symptoms

There are no real signs or symptoms of malpositioned and undescended testicles for male infants and toddlers. Older men do experience infertility, however. The diagnosis of this condition is made by clinical inspection of a qualified physician and by testicular ultrasound.

Treatment

The treatment for mispositioned and undescended testicles involves surgery. This is usually done when the infant is around one year old. Some cases of rectractile testes descend without surgery.

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is the condition where the prostate gland enlarges. This disorder can cause trouble with urination and frequent lower urinary tract infections. In addition to compromised urethral outlet function, many men also have difficulty with structural functioning.

Incidence, Prevalence, and Causes

Health experts estimate that as many as 50 percent of all men in their 50s have BPH, and by the age of 80, as many as 90 percent will develop this condition. Androgens are male sex hormones that are needed for normal growth and function of the prostate gland. While they do not directly cause BPH, an imbalance between two forms of androgens contributes to prostatic enlargement. Also, a defect in substances that regulate the prostate gland can produce inflammation, further worsening the condition. Risk factors for BPH include physical inactivity, use of over-the-counter cold medications, diet pills, obesity, and smoking.

Signs and Symptoms

Men with benign prostatic hypertrophy have troublesome symptoms, including a decline in urine stream force, nighttime urination, feelings that the bladder is not emptying, and urinary retention. BPH is diagnosed by a digital rectal examination. Several laboratory tests to assess the prostate include the serum prostate specific antigen (PSA), urinalysis, urine culture, chemistry panels, and BUN and creatinine levels. To accurately diagnose this condition, the doctor may order voiding tests, such as an urodynamic study or uroflowmetry test.

Treatment

BPH is often difficult to treat. In order to slow the growth of the prostate gland and relax the prostate muscles, alpha 1-adrenergic blockers are used. These include medications such as doxazosin (Cardura), tamsulosin (Flomax), and terazosin (Hytrin). Additionally certain 5-alpha reductase inhibitors are used to inhibit the conversion of testosterone to DHT (Avodart, for example).

Inguinal Hernia

Abdominal hernias are protrusions of the abdominal contents through the abdomen wall. Over half of these hernias are indirect inguinal hernias, which present in the inguinal canal. The majority of these hernias is congenital and only become symptomatic when trauma or chronic cough occurs.

Incidence, Prevalence, and Causes

A direct inguinal hernia is one that does not pass through the inguinal canal, yet enters the canal. An indirect inguinal hernia enters the canal and remains there or descends farther into the scrotum. In the U.S. alone, over 700,000 inguinal hernia repairs are done each year. Health experts estimate that 25 percent of men have an inguinal hernia during their lifetime.

Signs and Symptoms

The symptoms and signs of an inguinal hernia include groin tenderness, bowel obstruction, a visible bulge, and pain. The doctor can tell if someone has an inguinal hernia by inspecting the inguinal canal via the scrotum. To confirm this condition, ultrasound is often necessary.

Treatment

Many men with inguinal hernias require surgery, which is done by laproscopic method or conventional measures. This surgery is especially necessary when there is a risk for necrosis (tissue death).

Erectile Dysfunction

Erectile dysfunction (ED) is defined as the inability to achieve and/or maintain and erection that is sufficient for sexual activity. ED occurs from a complex multifactorial cause, involving physical, environmental, social, and psychological factors.

Incidence, Prevalence, and Causes

The known physical causes of ED include advancing age, diminished testosterone levels, cardiovascular disorders, and endocrine conditions. Common psychological causes include fatigue, depression, low self-esteem, performance anxiety, and stress.Risk factors for this condition include heart disease, hypertension, diabetes, cigarette smoking, spinal cord injuries, stroke, congenital defects, and renal failure. This disorder is quite common, affecting as many as 15 million men over the age of 18 years.

Signs and Symptoms

To diagnose ED, the doctor must conduct a detailed history and physical examination. The main symptom is inability to obtain an erection or maintain one. Laboratory tests to assess this condition include thyroid, hormone, and prolactin levels. To determine vascular problems, a dynamic infusion cavernosometry test is done.

Treatment

In order for the doctor to treat this condition, the underlying cause must first be identified. Psychological issues must be addressed with medications, counseling, and behavioral modification. If serum testosterone levels are low, supplementation is often necessary. Alternative therapies include penile prosthesis, surgery, vacuum erection devices, and injections.

Pregnant or planning a family? Mobile Mom is here to help. We have the tools you need from the friends you trust. Calculate when you’re most fertile, see if you might be pregnant, or get the support you need from other moms with apps by Mobile Mom.