Male sexuality

Male sexuality counselling

Male Sexuality

Healthy male sexuality is characterized by satisfaction with sexual function including desire, confidence, frequency, erection and completion.

One in three men report some type of sexual dysfunction, most commonly erectile and ejaculatory dysfunction.

What is erectile dysfunction?

Erectile dysfunction is characterized by persistent difficulty in achieving or maintaining a firm enough erection for satisfactory sexual penetration or non-penetrative sexual activity. Erectile dysfunction was previously known as “impotence” before it was better understood by the medical community.

What causes erectile dysfunction?

Erectile dysfunction can be caused by medical and/or psychological and relational factors.

Medical causes are the most common cause of persistent erectile dysfunction, accounting for 90% of cases. Medical causes are most often due to an underlying health condition affecting hormones, circulation or nerve supply to the penis. These conditions may include cardiovascular disease such atherosclerosis, diabetes or hypertension, or neurological diseases such as multiple sclerosis or Parkinson’s. It is important to investigate for these physiological causes of erectile dysfunction with blood tests and a physical exam.

- Procedures for the treatment of prostate hypertrophy and cancer also commonly cause erectile dysfunction.

- Several prescription medications, recreational drugs, including smoking and alcohol can cause erectile dysfunction.

- Psychological causes are much less common. Relationship problems, stress, anxiety, or depression may affect desire or suppress the nervous and hormonal triggers of penile blood flow.

Treatment for Erectile Dysfunction

- The most common treatment for erectile dysfunction is PDE-5 inhibitors, including the well known drug sildenafil (Viagra).

- Lifestyle interventions that help to promote healthy circulation such as exercise and diet are integral to treatment success.

- Other options include mechanical devices that help achieve an erection or surgical consultation for a penile implant.

- Therapy can also play an important role in understanding how erectile function is impacting your sexual and relational health and wellbeing, and what psychological factors may be playing a role.

Ejaculation Dysfunction

Although difficulty with delayed ejaculation is possible, concern for premature ejaculation is more common, characterized by consistent climax and ejaculation sooner than wanted after penetration, causing significant distress. Premature ejaculation is more common than erectile dysfunction, and rarely caused by a medical disorder. Most cases have a psychological cause.

Treatment for Premature Ejaculation

Antidepressant medication and numbing creams can be helpful for delaying ejaculation.

Therapy, however, plays the most important role in exploring the effect of anxiety, guilt, depression, trauma and/or relationship stress on ejaculatory satisfaction. There are also several cognitive behavioural techniques that can be learned in therapy. Premature ejaculation responds very well to therapy.

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