Men's Sexual Problems: Not Her Fault

It is estimated that approximately 1 in 10 men have a problem related to having sex, such as premature ejaculation or erectile dysfunction (reference). Sexual problems can affect any man of any sexual orientation or gender identity including straight, gay, bisexual, queer, or transgender.

Erectile Dysfunction

Erectile dysfunction (ED) occurs when a man cannot get and/or keep an erection that allows him to participate in sexual activity. This may be caused by physical and/or psychological problems and can occur at any time during a man’s life. ED can also be caused by a number of medications, smoking tobacco (?), and the use of alcohol and/or drugs.

Ejaculation Problems

The three main ejaculation problems that occur for men are:

1. Premature ejaculation

2. Delayed ejaculation

3. Retrograde ejaculation

Each one of these three main ejaculation problems will be discussed in detail below, including causes of the issue and treatment options.

1. Premature Ejaculation

Premature ejaculation occurs when a man ejaculates (comes) sooner than he wants. This is a problem only when it bothers him or his partner(s). Premature ejaculation may be caused by physical or psychological issues but is certainly affected by performance anxiety and stress experienced during sexual encounters.

Physical causes of premature ejaculation include:

• Thyroid problems

• Prostate problems

• Drug use

• Penile hyper-sensitivity

Psychological causes of premature ejaculation include::

• Stress

• Depression

• Sexual performance concerns

• Relationship concerns

• Sexual trauma (physical or emotional)

Treatment options for erectile dysfunction include:

• Masturbation before sex

• Change in sexual positions

• Condom selection

• Numbing gel for head of the penis (Topical anaesthetics)

• Couples therapy

• Antidepressants (SSRIs)

• Phosphodiesterase-5 Inhibitors (Viagra®️, Cialis®️)?

2. Delayed ejaculation

Delayed ejaculation occurs if there is a delay in the ability to ejaculate and/or an inability to ejaculate at all.

Physical causes of delayed ejaculation include:

• Previous surgery to the bladder or prostate

• Diabetes or multiple sclerosis

• Spinal cord injury

• Age?

• Medications (especially antidepressants, antipsychotics and pain meds)

• Drugs or alcohol

Treatment options for delayed ejaculation include:

• Correcting the underlying problems

• Counselling

3. Retrograde Ejaculation

This is when semen that is ejaculated goes backwards into the bladder instead of coming out the penis. This is usually a result of prostate surgery. This may be annoying but is usually not a problem unless trying to conceive a child. If this is the case, artificial insemination or In-vitro fertilization may be required.