Sexual Dysfunctions (SD) effect many men. There are potentially many different dysfunctions and diagnosis. There can be many contributing causes (etiologies) leading to SD. Some potential causes of SD may be due to: medication, anxiety, depression, alcohol use/abuse, poor heart health/circulation, diabetes, hypertension, stage of development in life, hormonal imbalance, and relational problems, to name a few. Problems in SD may have an impact in any of the phases of the sexual response cycle being: Desire, arousal, orgasm, and/or resolution.
For example, a man may be lacking in the desire for sex, meaning that he is not interested in the act or in having sexual contact with their partner or may lose interest in all aspects that may be sexual. Perhaps the problem is in the arousal phase, where they may actually want to have sexual relations, but physically just can’t attain or maintain an erection. The problem/dysfunction may be in the orgasm phase where the person may be able to want to have sex, achieve an erection, but orgasms/ejaculates too quickly or not at all. Classification and diagnosis of specific disorders is always an important first step in treating any SD. Some specific male sexual disorders as classified in the: Diagnostic and Statistic Manual of Mental Disorders 5 are: Erectile Disorder, Male Hypoactive Sexual Desire Disorder, Premature (early) Ejaculation, Delayed Ejaculation, and Substance/Medication-induced Sexual Dysfunction to name a few.
Sexologists’ focus on treatment is to figure out what the mental aspect to problem is and what can be done to reduce distress and improve the quality of life of the patient.They may work with a physician to buttress the psychological aspect of treatment. Every case is different and calls for different approaches to hopefully render viable solutions for the patient.
Since the advent of Viagra, Cialis, Levitra and other erectile dysfunction medications, many men just pop a pill prior to seeking out sexual activity and doing so may get the physical job done, but often the underlying psychological causes and their relation to physical health problems responsible for the SD are not thought about, much less talked about.
We live in an instant gratification society where we ignore many of the problems with our health and usually let them stack up until dams burst. There’s always a proactive way towards your mental and physical health. If you are suffering from a SD you should consult with your physician to rule out any potential physical root causes to the problem(s) in order for you to treat it appropriately. Ask your doctor the right questions to get the right answers. If you are on medication check to see what the side effects are. If you haven’t gotten a prostate check in a while, do so. If you don’t talk to your doctor about your sex life then perhaps its time you do.
As we get older we have to be much more aware as to what we consume and what interactions our bodies have with the foods we eat and the substances we take. Everything has an effect on the body including things as seemingly innocuous as caffeine intake. The physical part aside let’s talk a little bit about the psychological/emotional effects of SD; which is the part Sexologists treat. Anxiety and SD can and usually do go hand in hand. Not to mention feelings of inadequacy and diminished feelings surrounding one’s “manhood” all leading to potentials in developing depressive symptoms as well. As they say in the world of psychotherapy: "anxiety and depression are close cousins".
Societal expectations set up men to take pride in being able to perform in the bedroom and when that is in question it is easy to fall into the slippery slope of self-doubt, fear and self-loathing. As a psychotherapist I like to take the sex research pioneers Masters and Johnson’s approach in the treatment of SD in that not unlike any other relationship problem, it can be treated as a problem within the couple not just the individual. What does this mean? It means that all physical and emotional problems do not exist in a vacuum or solely with the individual “who has a problem”. All aspects of a person’s life are to be accounted for. There can and usually are other stress aspects in an individual’s life that may be harming their sex life. These stressors are important to talk about because of their impact on overall sexual health.
When addressing an issue the good news is that it potentially leads to evaluating and exploring the attitudes of yourself and of your partner's in relation to your sexuality and its expression in the relationship. This can open up important channels of communication. All too often, we fail to talk about the gorilla(s) in the room causing a lot of pain, which all too often leads to no resolution at best and ill resolution at worst.
As a man this is important to talk about again and again, because of the undue pressure that men place on themselves to perform in not just the bedroom, but in all aspects of life as stated. As men size up each other on the playing fields of life, be it in the board room, bed room or any field of play the stress to perform and perform well can become a major stress and distraction. Men are competitors and have that competitive spirit, which can be healthy, but these attitudes can also have a down side due to the lack of asking for help when it may be needed.
I often get the question as to what are some examples of the psychological aspects and treatment typical in the face of a sexual dysfunction? A concrete treatment example for SD is called Sensate Focus as developed by Masters and Johnson. In Sensate Focus, there are exercises assigned with the task of changing the mindset of the individual regarding sex, their role and the importance of their performance. Sensate Focus basically shifts the mind off performance and essentially puts the energy/focus into pleasing the other (partner). This mind shift and the implementation of the phases of Sensate Focus in the bedroom has had promising results in changing the dynamics that have developed and potentially cause/perpetuate sexual problems for couples.
This is just a grossly brief example of a set of techniques and system that are available for men who may be having problems with sexual performance that many may not even be aware exists. A good resource to read that may help with issues/concerns surrounding performance is a book by Dr. Ian Kerner titled: She Comes First: The Thinking Man’s Guide to Pleasuring a Woman linked HERE. This book is highly informative on female genitalia and helps men with learning how to focus on pleasuring women. Of course, there is also the title: He Comes Next: The Thinking Woman’s Guide to Pleasuring a Man, which addresses fulfilling a male’s pleasure from a female partner’s perspective. Mind that my intended tone in this article is not in my intention to promoting pro hetero normative and hetero relational expectation, as the same can be applied to same gender relationships; but it is what it is for my purpose in imparting information here.
That being said, not knowing what help may be out there is why it is important to seek professional help because the person helping you through these issues can be an objective observer to help you through progress and potentially get you through the stumbling blocks along the path towards health. Obviously, the professional can only assign tasks with your permission as to what you are comfortable to do, but it is up to you to implement what information you go over in therapy sessions on your own time in your own privacy. There are no guarantees in the process of psychotherapy, but the aim is to hopefully get the patient to start seeing the changes in their sex life that they want and deserve to see.
Know that if you are shy or embarrassed in expressing the need for help with these issues you are not alone. Many men still hang onto the idea that it is less manly or taboo to talk about their physical, mental, and/or emotional needs. We as a culture/society need to keep changing that and be unapologetic or unashamed when we need to ask for assistance in any area of our life especially with regards to our sexual health. That is what baffles me, we don’t mind asking for help setting up a retirement fund/investment, but when it comes to asking for simple directions we stubbornly refuse. If you are unhappy sexually and aren’t feeling fulfilled, do yourself a favor and talk to a professional about it because your health is worth it. Asking for help usually is the most difficult part of the process, once you seek it, the doing usually comes naturally.