Physicians of Urological Associates of Bridgeport

Male Sexual HealthMale Sexual Health

Sexual health is a source of concern and worry for many men.

Yet, some people are too shy to talk to their doctors about sex. Others wrongly think that sexual problems are a normal part of aging. No matter what your age, talk to your doctor if you have erection problems, less interest in sex, or other problems that keep you or your partner from enjoying sex. Also, talk to your doctor about your risk of sexually transmitted infections and how to lower your risk. Problems with sexual health are medical problems, and your doctor can help. With treatment, many men and their partners are able to resume a normal, satisfying sex life.

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Sexual Problems

Sexual problems are not uncommon among men, especially as they age. Many men have problems getting or keeping an erection. Some men have problems with ejaculation. Others have lower than normal levels of testosterone, which is the most important male sex hormone. The good news is that treatment often can help sexual problems.

Erection Problems

ED Drugs Not Safe for Everyone

Many men now take a pill to treat erection problems. Current brands include Viagra, Levitra, and Cialis. These drugs work by affecting blood pressure. They are not safe for everyone. Never take Viagra, Levitra, or Cialis if you take heart medicines called nitrates. Doing so could cause a sudden — and dangerous — drop in blood pressure. Also, tell your doctor if you take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. Before taking drugs to treat ED, talk to your doctor about the benefits and risks so you can make an informed choice.

Problems getting or keeping an erection is called erectile dysfunction, or ED. ED used to be called impotence. It’s hard to know how many men have ED. But estimates of U.S. men affected range from 15 million to 30 million. Most of the time, ED has a physical cause. ED may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. Many health problems can lead to ED. ED is also a side effect of many common medicines, including some used to treat depression or high blood pressure. Unhealthy habits like smoking, abusing alcohol, overeating, and leading an inactive lifestyle also can lead to ED. Emotional factors, such as stress or depression, also can cause ED. Having ED can affect self-esteem and cause frustration, anger, and sadness.

The good news is that ED is treatable at any age. Your doctor can offer a number of treatments for ED. For many men, problems with ED are solved by taking a pill. Some men use an external pump and band to help the penis become and stay erect. Others are helped by penis injections or implants. Some men need to try two or three options before they find a treatment that works for them. Even if treatment solves your problems with ED, you still need to take care of other health issues that may have caused you to have ED. This may involve lifestyle changes and other treatments. Counseling also can help men and their partners cope with the emotional affects of ED.

Loss of Sexual Interest

Your interest in sex, also called libido, can vary over the course of your life. Some men have low libidos during times of stress or illness. At times, your interest and desire for sex might not match that of your partner, which is normal in long-term relationships. Still, low libido should not be ignored. It can be a sign of a health problem, such as depression. Some medicines can affect sex drive. Reduced levels of male hormones can cause men to be less interested in sex. This naturally occurs with aging. Although it is normal for men to have less interest in sex as they age, having no interest in sex is not normal. Emotional or relationship problems also can play a large role in a man’s sex drive.

If you have less interest in sex, talking frankly with your doctor is the first step toward restoring sexual health. Treatment usually is aimed at the underlying cause of low libido. A combination of factors often affects sex drive. Treatment could include medicine and counseling.

Low Testosterone

Can Testosterone Help Older Men Feel Young?

Hormone therapy gives the body more testosterone to make up for levels that are too low. It works well at restoring sex drive, building muscle mass, and boosting energy and mood in some men with low testosterone. But we don’t know if hormone therapy is helpful or even safe for all older men with low testosterone. We also don't know what level of testosterone is normal in aging men. And some older men should not take hormone therapy. If you are concerned about testosterone levels, talk to your doctor.

Testosterone is the most important male hormone. It helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone. Lower than normal levels of testosterone can affect a man’s body and mood. Signs of low testosterone in adult men can include:

  • Less interest in sex
  • Erection problems
  • Lowered sperm count
  • Increased breast size
  • Hot flashes
  • Feeling irritable or angry
  • Problems with memory and concentration
  • Depression
  • Muscle mass and hair loss
  • Bone loss
  • Smaller and softer testes

Adult men can have low testosterone levels for a number of reasons. In adult males of all ages, injury, disease, and using certain drugs can cause low testosterone levels. A gradual decline in testosterone level is normal in healthy males as they age. Low testosterone in aging men can cause them to be less interested in sex or have fewer erections. But it is not normal for aging men to have no interest in sex. There could be other reasons for these symptoms.

If you have any symptoms of low testosterone, talk to your doctor. You can get your testosterone level tested with a simple blood test. Get the test in the morning, when testosterone levels peak during the day. If you do have low testosterone, your doctor will want to find out the underlying cause. Finding out the cause for low testosterone can be hard and might involve many tests. You might want to see a specialist, such as an endocrinologist or urologist, who can work with you to treat this problem. Testosterone replacement is an option for some men with low testosterone. But using testosterone therapy in men with borderline low levels is a controversial issue. One reason is that the long-term effects of testosterone replacement are not known. Another reason is that we don’t know what testosterone levels are "normal" as men age. If you have low testosterone, your doctor can help you understand the benefits and risks of treatment so you can make an informed choice.

Male Infertility

Lots of couples have trouble conceiving a child. About 40 percent of the time, the cause of infertility is traced entirely or in part to the man.

The male fertility process involves making mature sperm and getting the sperm to reach and fertilize the egg. For this process to happen, a man must be able to have and sustain an erection, have enough sperm, have enough semen to carry the sperm to the egg, and have sperm that are the right shape and move in the right way. A problem in any part of this process can lead to problems conceiving.

Many factors can affect male fertility. Some include:

  • Age
  • Stress
  • Smoking, drugs, and alcohol
  • Undescended testicles or damage to the testicles
  • Wearing tight underwear
  • Medications
  • Environmental toxins
  • Genetic conditions
  • Other health problems

If your partner has not become pregnant after 1 year of frequent sex without birth control (or after 6 months if your partner is 35 or older), talk to your doctor. A semen analysis can be a good first step for couples facing fertility problems because it is much easier and costs less than tests that look at female fertility. The test looks at a man’s semen and sperm. Many couples with fertility problems go on to have healthy pregnancies and babies. In some cases, the cause for infertility in the man or woman cannot be found or cannot be treated.

Female Sexual Dysfunction

There are many problems that can keep a woman from enjoying sex. They include:

  • Lack of sexual desire
  • Inability to become aroused
  • Lack of orgasm, or sexual climax
  • Painful intercourse

These problems may have physical or psychological causes. Physical causes may include conditions like diabetes, heart disease, nerve disorders or hormone problems. Some drugs can also affect desire and function. Psychological causes may include work-related stress and anxiety. They may also include depression or concerns about marriage or relationship problems. For some women, the problem results from past sexual trauma.

Occasional problems with sexual function are common. If problems last more than a few months or cause distress for you or your partner, you should see your healthcare provider.

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