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JAMA Patient Page
June 23/30, 2004

Male Sexual Dysfunction

JAMA. 2004;291(24):3076. doi:10.1001/jama.291.24.3076

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 doctor.

  • 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 your health.

  • 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 also help.

  • Depression or anxiety disorders may need treatment.

  • Any physical problems that may be affecting sexual function should be addressed.

  • 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

Inform yourself

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 Urological Association

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.