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Sexual Dysfunction

Erectile Dysfunction means ‘lack of power’. It is being unable to have or keep an erection during sex.

Includes premature (early) ejaculation, retarded ejaculation (taking too long to ejaculate) and erectile dysfunction, as well as other problems.

  • It’s a common and distressing problem affecting 10-30% of men on a regular basis.
  • Many men have erectile dysfunction (ED) for psychological reasons such as fear, stress, guilt or feelings of inadequacy.
  • Sometimes it is caused by health conditions or their treatments. Health conditions that increase the risk of ED include heart disease, high blood pressure, diabetes, obesity, prostate problems, depression and mental illness among others.
  • Many drugs can cause erectile dysfunction or other sexual dysfunctions. Read the leaflet in the package for details.
  • DO NOT stop taking prescribed medication if you think it is causing ED. Talk to your doctor and make a plan together about how to deal with it. Your doctor might be able to offer alternative medication that does not cause ED.
  • There is lots of help out there for men suffering from these problems. If you are worried speak to your doctor and they will refer you to a local service in Halton and St Helens. Most men sort the problem out if they seek help.

Treatment of ED is with Psychosexual Therapy, drugs and devices, or a combination of these.

Psychological problems account for 60% of cases of impotence. Psychosexual therapy is a form of counselling that is very useful for men with ED of psychological or mixed cause.

Psychological problems are usually based on fear, guilt or feelings of inadequacy. The more a man worries about not getting an erection, the more the erection is likely to fail. Relaxation training and professional psychosexual counselling are vital.

Drugs can be used with or without psychosexual therapy. They are mainly used for treatment of ED from medical or mixed causes. Drugs can be taken by mouth or given directly into the penis. Due to their expense the NHS only provides drugs and devices for ED to men with certain medical conditions. All others have to pay a costly private prescription fee. Your doctor can explain this.

There are various vacuum devices available on prescription that can produce reliable erections sustainable for sex. For more details, speak to your doctor.

A caring and sympathetic partner is important. He or she is an invaluable support during the investigation and treatment of ED. A partner who mocks or ridicules (or even feels overly sorry for) a man’s performance is making the problem worse and may even have contributed to it in the first place.

Premature Ejaculation

Premature ejaculation is the most common male sexual dysfunction. There are three different ways of defining it:

  • If the man comes before he wants to or before his partner wants him to
  • If ejaculation occurs before the penis penetrates the vagina
  • If the man cannot stop himself ejaculating for at least one minute after penetrating his partner.

Most men experience premature ejaculation several times during their lives most commonly when losing their virginity. It also occurs in over 50% of males when making love to a new partner for the first time. Premature ejaculation is particularly common among teenagers and tends to become less of a problem for men in their twenties and thirties and beyond.

If a man can stop ejaculating for anything over one minute after penetration, this is normal. It may not sound very long, but our primitive male ancestors were originally designed to thrust only five or six times before reaching orgasm!

Premature ejaculation is often due to anxiety especially if a new partner is involved. This can result in eagerness and over-excitement. The other main cause is anxiety about performance ­ whether you will be ‘good enough’ for your partner or will fail to satisfy. No man wants to feel his performance is not up to scratch.

Other causes of premature ejaculation are the man feeling that his partner is not really interested in sex, or if either partner has difficulty in showing or responding to affection. It can also occur from first sexual activity or it can start in response to a negative experience.

Sometimes the opposite problem of retarded ejaculation occurs (see below), especially if the male is trying to postpone his orgasm to make sure his partner is satisfied.

The easiest way to make premature ejaculation less of a problem is to bring your partner to the point of orgasm during foreplay. Then, when your partner is about to come, penetration can occur or you can wait until after your partner’s orgasm before entering. Premature ejaculation can be treated with drugs or psychosexual therapy. Drugs are generally only effective for cases of lifelong premature ejaculation. Drug treatment of premature ejaculation is not licensed in the UK.

Delayed Ejaculation (or does not ejaculate)

Delayed ejaculation is the inability, or delayed ability of a man to ejaculate, despite having prolonged intercourse, adequate stimulation, and an intense desire to do so. This is an occasional occurrence in most men, especially when tired, but some males have never achieved ejaculation during sexual intercourse. Most affected men are able to ejaculate during masturbation.

Retrogade ejaculation occurs when a man has the sensation of orgasm but the semen is emptied into the bladder instead of outside the body.

Medical conditions such as diabetes, an enlarged prostate gland, previous prostate operation or certain drugs (e.g. water tablets, antidepressants, treatment for high blood pressure) are sometimes the cause or a contributing factor.

Click here for further information on Erectile Dysfunction problems

Commonly retarded ejaculation is caused by psychological inhibitions such as in the case of:

  • Newlyweds sleeping next door to their parents
  • Discovering a partner is unfaithful
  • A recent condom break when pregnancy would have been disastrous
  • Having recently been interrupted during sex, such as by your children.

Make sure your surroundings are compatible with unstressful sex that is, quiet, with no risk of interruption or being overheard, warm and comfortable. If problems persist you can be referred for psychosexual therapy, which will involve a structured program with a specialist. Always go to your GP first and they will refer you as appropriate.

Click here for guidance on how to explain to your GP that you are experiencing some problems: Explaining sexual problems to your GP

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