Male Sexual Dysfunction
In men, sexual dysfunction is typically related to problems with arousal, getting an erection, and/or ejaculating. Sexual dysfunction is complicated and can be caused my many things. Improving diet, exercising more, and identifying underlying factors are all important for treating sexual dysfunction.
Male Sexual Dysfunction falls under theHealthy Aging & Longevitycategory.
Last Updated:October 13, 2024
Men who are experiencing sexual dysfunction may have the following symptoms:
- Lack of interest in sex
- Difficulty becoming aroused
- Difficulty getting or maintaining an erection
- Ejaculating too quickly or too slowly
- low-testosterone
Because many of the symptoms (e.g., satisfaction with time to ejaculation, level of interest in sex) are subjective, sexual dysfunction diagnoses are primarily based on what an individual identifies as problematic. A person’s emotions and previous experience can contribute to sexual dysfunction, so a full history and psychiatric evaluation may be useful. Similarly, lab tests can be used to identify or rule out physiological causes of sexual dysfunction.[2]
Depending on the condition, a variety of medical treatments may be used:[2]
| Condition | Medical Treatments |
|---|---|
| Premature ejaculation | Selective serotonin reuptake inhibitors (SSRIs) Topical anesthetics (e.g., lidocaine) |
| Delayed ejaculation | Cessation of medications that may cause delayed ejaculation (e.g., SSRIs, opioids) |
| Erectile dysfunction | Phosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, vardenafil, tadalafil) |
| Low libido | Testosterone replacement therapy and/or cessation of libido-reducing medications (e.g., SSRIs, opioids) |
Additionally, sexual dysfunction can be secondary to some other issue, such as depression, cardiovascular disease, or hypogonadism (i.e., low testosterone).
A handful of studies have found maca to improve sexual desire in people with and without sexual dysfunction. Additionally, cocoa extract may improve sexual function by supporting vascular health.
A number of other supplements have shown some promise (e.g., fenugreek, yohimbine, tribulus-terrestris, Eurycoma Longifolia Jack), but very little research has been conducted on any of these supplements.
In individuals who are overweight, or have diet-related health conditions like type-2-diabetes, weight loss can markedly improve sexual function.[3]
Regular exercise can improve erectile dysfunction.[3]
Psychotherapy and sex therapy are also effective for treating sexual dysfunction, especially if the dysfunction is caused by a person’s beliefs, previous experiences, or perception of themselves.[2]
Smoking cessation is probably beneficial for erectile dysfunction.[4][5]
If the sexual dysfunction is secondary to another condition, treating that condition may resolve the sexual dysfunction.
“Normal” sexual function requires vascular, neurological, hormonal, and psychological systems to function together. As such, issues with any of these symptoms may produce issues with sexual function.[6]
Sexual dysfunction can be caused by:
- Neurological issues (e.g., damage to the brain, the spinal cord, or the nerves of the penis)
- Vascular issues (e.g., reduced penile blood flow due to cardiovascular disease)
- Endocrine issues (e.g., low testosterone, high prolactin, high/low thyroid hormones)
- Psychosocial issues (e.g., depression, stress, or relationship issues)[7]
- Sleep disturbances
- Medications (e.g., SSRIs, opioids, certain blood pressure medications)
- Recreational drugs
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What was studied?
The effect of supplementation with antioxidants on the severity of erectile dysfunction (ED) assessed with the International Index of Erectile Function (IIEF) and on sexual satisfaction.
Background
Many sex hormones play a role in maintaining sperm health. Select hormones may serve as biomarkers to aid in the assessment and troubleshooting of sperm quality.
Background
Male testosterone levels typically begin to decline around 35–40 years of age. This decline is associated with a variety of chronic age-related conditions. Androgen administration is an increasingly popular method for alleviating such conditions, but the strength of the evidence for its use is tenuous. This review examines the literature on androgen administration to clarify its effectiveness.
Background
Sleep affects virtually all aspects of health, and average sleep quality has decreased over time, partially due to the increasing presence of technology in the bedroom and demanding lifestyles. This review analyzed the literature on how sleep can affect men’s health.
Background
Many supplements have been touted as aphrodisiacs or overall sexual enhancers, but proof is needed. The present study tested a combination of ingredients.
In individuals who are overweight, or have diet-related health conditions like type-2-diabetes, weight loss can markedly improve sexual function.[3]
Yes. Although a little alcohol might decrease one’s inhibitions and thus increase your libido, too much alcohol acutely (drunkenness) or chronically (alcoholism) can lead to sexual disorders, loss of libido, less intense orgasms, and some degree of erectile dysfunction and a probable reduction in testosterone production in men.
Regular exercise can improve erectile dysfunction.[3]
Psychotherapy and sex therapy are also effective for treating sexual dysfunction, especially if the dysfunction is caused by a person’s beliefs, previous experiences, or perception of themselves.[2]
Smoking cessation is probably beneficial for erectile dysfunction.[4][5]
If the sexual dysfunction is secondary to another condition, treating that condition may resolve the sexual dysfunction.
Like all things, the dose matters! A moderate amount of exercise can increase levels of hormones in the body including testosterone, cortisol, prolactin, and oxytocin — all of which play a role in your sex drive. Exercise also improves blood flow and reduces risk factors for diseases that are associated with sexual dysfunction including cardiovascular disease, obesity, and diabetes. A weekly exercise duration of 160 minutes has been shown to improve symptoms of erectile dysfunction that were related to improved cardiovascular and metabolic health.[10] Performing pelvic floor (i.e., Kegel) exercises may also strengthen lower pelvic muscles and improve erectile function and satisfaction. On the other hand, extreme levels of exercise may cause libido to fall drastically.
cannabis use is frequently associated with feelings of euphoria that may enhance mood, increase sexual desire, and boost arousal — leading to a better sexual experience. Unfortunately, there is a lack of research on the effects of cannabis on sexual function. Some studies suggest that erectile-dysfunction is higher in cannabis users compared to nonusers.[11] There is also contradictory evidence that cannabis may enhance erectile function or diminish erectile function,[12] and that cannabis may be associated with increased reports of an inability to reach orgasm, reach orgasm too quickly, or reach orgasm too slowly.[13]
“Normal” sexual function requires vascular, neurological, hormonal, and psychological systems to function together. As such, issues with any of these symptoms may produce issues with sexual function.[6]
Sexual dysfunction can be caused by:
- Neurological issues (e.g., damage to the brain, the spinal cord, or the nerves of the penis)
- Vascular issues (e.g., reduced penile blood flow due to cardiovascular disease)
- Endocrine issues (e.g., low testosterone, high prolactin, high/low thyroid hormones)
- Psychosocial issues (e.g., depression, stress, or relationship issues)[7]
- Sleep disturbances
- Medications (e.g., SSRIs, opioids, certain blood pressure medications)
- Recreational drugs
erectile-dysfunction can be caused by physical factors (such as impaired blood flow to the penis) or psychological factors. Psychological erectile dysfunction can often be caused by personal, professional, or emotional stressors, as well as the pressure to perform sexually (or even obtain an erection in the first place). Fortunately, stress management techniques, when added to traditional erectile dysfunction treatment, can improve symptoms of stress and erectile dysfunction.[8]
While low testosterone is linked to symptoms of sexual dysfunction, having low testosterone does not always lead to low libido or erectile dysfunction, since these conditions can also have several other causes. Men can also experience sexual dysfunction with high or normal levels of testosterone. Because testosterone levels decline with age and are associated with sexual dysfunction symptoms, the two are often incorrectly causally linked. In men with low testosterone, testosterone replacement therapy has been shown to have only mild effects on erectile function and sexual satisfaction but large effects on libido.[9]
- ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
- ^Cleveland ClinicSexual Dysfunction
- ^Bhanu P Gupta, M Hassan Murad, Marisa M Clifton, Larry Prokop, Ajay Nehra, Stephen L KopeckyThe effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysisArch Intern Med.(2011 Nov 14)
- ^Chunlei Wu, Haiying Zhang, Yong Gao, Aihua Tan, Xiaobo Yang, Zheng Lu, Youjie Zhang, Ming Liao, Mengjie Wang, Zengnan MoThe association of smoking and erectile dysfunction: results from the Fangchenggang Area Male Health and Examination Survey (FAMHES)J Androl.(Jan-Feb 2012)
- ^Gholamreza Pourmand, Mohammad Reza Alidaee, Sohrab Rasuli, Ameneh Maleki, Abdolrasoul MehrsaiDo cigarette smokers with erectile dysfunction benefit from stopping?: a prospective studyBJU Int.(2004 Dec)
- ^Dirk Rösing, Klaus-Jürgen Klebingat, Hermann J Berberich, Hartmut A G Bosinski, Kurt Loewit, Klaus M BeierMale sexual dysfunction: diagnosis and treatment from a sexological and interdisciplinary perspectiveDtsch Arztebl Int.(2009 Dec)
- ^Qian Liu, Youpeng Zhang, Jin Wang, Sen Li, Yongbiao Cheng, Jialun Guo, Yong Tang, Hanqing Zeng, Zhaohui ZhuErectile Dysfunction and Depression: A Systematic Review and Meta-AnalysisJ Sex Med.(2018 Aug)
- ^Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri CStress management and erectile dysfunction: a pilot comparative study.Andrologia.(2014-Aug)
- ^Boloña ER, Uraga MV, Haddad RM, Tracz MJ, Sideras K, Kennedy CC, Caples SM, Erwin PJ, Montori VMTestosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials.Mayo Clin Proc.(2007-Jan)
- ^Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson KPhysical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies.Sex Med.(2018-Jun)
- ^Damiano Pizzol, Jacopo Demurtas, Brendon Stubbs, Pinar Soysal, Corina Mason, Ahmet Turan Isik, Marco Solmi, Lee Smith, Nicola VeroneseRelationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-AnalysisAm J Mens Health.(Nov-Dec 2019)
- ^Shamloul R, Bella AJImpact of cannabis use on male sexual health.J Sex Med.(2011-Apr)
- ^Smith AM, Ferris JA, Simpson JM, Shelley J, Pitts MK, Richters JCannabis use and sexual health.J Sex Med.(2010-Feb)
- Testosterone - Roaiah MF, El Khayat YI, GamalEl Din SF, Abd El Salam MAPilot Study on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Erectile Function in Aging Males With Partial Androgen Deficiency (PADAM)J Sex Marital Ther.(2016 May 18)
- Testosterone - G Cavallini, S Caracciolo, G Vitali, F Modenini, G BiagiottiCarnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male agingUrology.(2004 Apr)
- Erections - V Gentile, P Vicini, G Prigiotti, A Koverech, F Di SilverioPreliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetesCurr Med Res Opin.(2004 Sep)
- Erections - Giorgio Cavallini, Fabio Modenini, Giovanni Vitali, Aleardo KoverechAcetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomyUrology.(2005 Nov)
- Sperm Quality - Khaw SC, Wong ZZ, Anderson R, Martins da Silva Sl-carnitine and l-acetylcarnitine supplementation for idiopathic male infertility.Reprod Fertil.(2020-Jul)
- Testosterone - Ambiye VR, Langade D, Dongre S, Aptikar P, Kulkarni M, Dongre AClinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot StudyEvid Based Complement Alternat Med.(2013)
- Erections - Mamidi P, Thakar ABEfficacy of Ashwagandha (Withania somnifera Dunal. Linn.) in the management of psychogenic erectile dysfunctionAyu.(2011 Jul)
- Testosterone - Guay AT, Spark RF, Jacobson J, Murray FT, Geisser MEYohimbine treatment of organic erectile dysfunction in a dose-escalation trialInt J Impot Res.(2002 Feb)
- Erections - Ernst E, Pittler MHYohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trialsJ Urol.(1998 Feb)
- Testosterone - Gonzales GF, Córdova A, Vega K, Chung A, Villena A, Góñez CEffect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy menJ Endocrinol.(2003 Jan)
- Libido - Stone M, Ibarra A, Roller M, Zangara A, Stevenson EA pilot investigation into the effect of maca supplementation on physical activity and sexual desire in sportsmenJ Ethnopharmacol.(2009 Dec 10)
- Testosterone - Morales A, Black A, Emerson L, Barkin J, Kuzmarov I, Day AAndrogens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiencyAging Male.(2009 Dec)
- Testosterone - Conaglen HM, Suttie JM, Conaglen JVEffect of deer velvet on sexual function in men and their partners: a double-blind, placebo-controlled studyArch Sex Behav.(2003 Jun)
- Testosterone - Biswas TK, Pandit S, Mondal S, Biswas SK, Jana U, Ghosh T, Tripathi PC, Debnath PK, Auddy RG, Auddy BClinical evaluation of spermatogenic activity of processed Shilajit in oligospermiaAndrologia.(2010 Feb)
- Testosterone - de Andrade E, de Mesquita AA, Claro Jde A, de Andrade PM, Ortiz V, Paranhos M, Srougi MStudy of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunctionAsian J Androl.(2007 Mar)
- Erections - Hong B, Ji YH, Hong JH, Nam KY, Ahn TYA double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary reportJ Urol.(2002 Nov)
- Erections - Choi HK, Seong DH, Rha KHClinical efficacy of Korean red ginseng for erectile dysfunctionInt J Impot Res.(1995 Sep)
- Testosterone - Steels E, Rao A, Vitetta LPhysiological Aspects of Male Libido Enhanced by Standardized Trigonella foenum-graecum Extract and Mineral FormulationPhytother Res.(2011 Feb 10)
- Erections - W Cherdshewasart, N NimsakulClinical trial of Butea superba, an alternative herbal treatment for erectile dysfunctionAsian J Androl.(2003 Sep)
- Erections - Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LS, Holmberg ARThe use of Butea superba (Roxb.) compared to sildenafil for treating erectile dysfunctionBJU Int.(2010 Jan)
- Erections - R Stanislavov, V NikolovaTreatment of erectile dysfunction with pycnogenol and L-arginineJ Sex Marital Ther.(May-Jun 2003)
- Erections - Hossein Mohammadzadeh-Moghadam, Seyed Mohammad Nazari, Ali Shamsa, Mohammad Kamalinejad, Habibollah Esmaeeli, Amir Abbas Asadpour, Abdoljavad KhajaviEffects of a Topical Saffron (Crocus sativus L) Gel on Erectile Dysfunction in Diabetics: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled TrialJ Evid Based Complementary Altern Med.(2015 Oct)
- Erections - Safarinejad MR, Shafiei N, Safarinejad SAn open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatmentInt J Impot Res.(2010 Jul-Aug)
- Quality of Life - Suter A, Saller R, Riedi E, Heinrich MImproving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trialPhytother Res.(2013 Feb)
- Libido - Wheatley DTriple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugsHum Psychopharmacol.(2004 Dec)
- Libido - Harte CB, Meston CMAcute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled trialJ Sex Med.(2008 Jan)
- Penile Girth - Horita H, Sato Y, Adachi H, Suzuki N, Kato R, Hisasue S, Suzuki K, Tsukamoto TEffects of levodopa on nocturnal penile tumescence: a preliminary studyJ Androl.(1998 Sep-Oct)