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Male sexual dysfunction is one of the most common health problems affecting
men and is more common with increasing age. Male sexual dysfunction can be
caused by physical or psychological problems. The June 23/30, 2004, issue
of JAMA includes an article about the various types
of male sexual dysfunction and treatments for them.
Main types of male sexual dysfunction
Low libido (sexual interest)
Erectile dysfunction (ED, difficulty
achieving or maintaining an erection)
Premature ejaculation (reaching orgasm [sexual climax] too quickly)
Delayed or inhibited orgasm
Physical abnormalities of the penis
Causes of male sexual dysfunction
Problems in the relationship with the sexual partner can lead
to sexual dysfunction.
Lowered levels of the male hormone testosterone (a condition known as hypogonadism) can cause
low libido or ED.
Certain drugs, such as antidepressants and blood pressure medications,
can cause sexual dysfunction.
Erectile function can be impaired by a stroke or by nerve damage
from diabetes or surgery.
Disorders affecting blood vessels, such as atherosclerosis (hardening of the arteries) and high blood pressure,
are risk factors for ED.
Other possible causes of sexual dysfunction include smoking, obesity,
kidney problems, depression, anxiety disorders, and alcoholism.
Diagnosing male sexual dysfunction
If you think you are experiencing male sexual dysfunction, see your
Your doctor will ask you to describe the problem and will ask
questions to help determine whether the cause is physical, psychological,
or a combination of both.
A general physical examination, including examination of the penis
and testicles, will be performed, and other tests may be done to evaluate
Blood tests may be done to determine if there is a hormonal problem
contributing to sexual dysfunction.
Treating male sexual dysfunction
For psychological causes of sexual dysfunction, such as relationship
problems, counseling, either individually or as a couple, may be beneficial.
Sexual therapy with a therapist who specializes in sexual dysfunction may
Depression or anxiety disorders may need treatment.
Any physical problems that may be affecting sexual function should
If a medication is interfering with sexual function, it may be
possible to change or discontinue the medication.
Prescription medications that treat erectile dysfunction may help
a man achieve and maintain erections.
Hormonal treatment, such as testosterone replacement therapy,
may help with hormone imbalances that are contributing to sexual dysfunction.
For more information
American Association of Clinical Endocrinologists 904/353-7878http://www.aace.com
American Urological Associationhttp://www.UrologyHealth.org
To find this and other JAMA Patient Pages, go to the Patient Page link
on JAMA's Web site at http://www.jama.com.
Many are available in English and Spanish.
Sources: American Association of Clinical Endocrinologists, American
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TOPIC: SEXUAL HEALTH
Parmet S, Lynm C, Glass RM. Male Sexual Dysfunction. JAMA. 2004;291(24):3076. doi:10.1001/jama.291.24.3076
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