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    Sexual Dysfunction Clinic

    Male

    The most common types of male dysfunction are ejaculation disorders, erectile dysfunction, and inhibited sexual desire.

    Ejaculation disorders:

    Premature ejaculation: In which ejaculation occurs before or soon after penetration.

    Inhibited or retarded ejaculation: Ejaculation is slow to occur. The common causes of male dysfunction due to premature and inhibited ejaculation are caused by a lack of attraction for a partner, past traumatic events, and psychological factors. Premature ejaculation is the most common form of male dysfunction, often due to nervousness. Certain drugs like antidepressants can damage nerves and may affect ejaculation.

    Retrograde ejaculation: The ejaculate is forced back into the bladder rather than through the urethra at the end of the penis. Retrograde ejaculation is a defect in sex dysfunction in males with diabetes and diabetic neuropathy. The nerves in the bladder and the bladder neck allow the ejaculate to flow backward and into the bladder. It can be a post operative problem as in case after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation.

    Erectile Dysfunction:

    Also known as impotence or ED, erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis; nerve disorders; psychological factors, such as stress, depression, and anxiety; and injury to the penis. Chronic illness, certain medications, and a condition called Peyronie's disease (scar tissue in the penis) can also cause erectile dysfunction. Men over age 65 are at higher risk for ED, although ED is not a normal part of aging.

    Inhibited Sexual Desire:

    A decrease in desire for sexual activity is called an inhibited desire, or loss of libido. Reduced libido can result from physical or psychological factors. Endocrine diseases with low levels of testosterone can have an effect on sexual desire. Psychological problems, such as anxiety and depression; medical illnesses, such as diabetes and high blood pressure; certain medications, including some antidepressants; and relationship difficulties can also be responsible for the loss of sexual desire. Decreased sexual desire is the most common complaint among women, affecting up to 43% of women. The problem may be psychological, physical, or a combination of both.

    Diagnosis in male:

    The diagnosis begins with a thorough history of symptoms. The doctor may refer for some tests to rule out any medical problems that may be contributing to the dysfunction. The doctor may refer to other doctors, including a urologist, an endocrinologist, a neurologist, sex therapists, and other counselors.

    Diagnostic test:

    Endocrine tests: Blood tests evaluate hormone levels.

    Vascular assessment: This assesses the blood flow to the penis. A blockage in a blood vessel supplying blood to the penis may be contributing to erectile dysfunction.

    Sensory testing: This is used to rule out diabetic neuropathy; this measures the strength of nerve impulses in a particular area of the body.

    Nocturnal penile tumescence and rigidity testing: This test is used to monitor erections that occur naturally during sleep to identify if a man's erectile problems are due to physical or psychological causes.

    Treatment:

    A variety of psychological, behavioral, and interpersonal therapies are also available for many sexual disorders. Many cases of male sexual dysfunction can be corrected by treating the underlying physical or psychological problems. The success of dysfunction treatment depends on the underlying cause. . Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners. A combination therapy, including both sex therapy and sexual pharmaceuticals, is often the best treatment approach for premature ejaculation.

    Treatment strategies may include:

    Medical treatment: This involves treatment of underlying physical problems.

    Medications: Blood flow to the penis can be increased with medications such as Cialis, Viagra or Levitra. If sexual dysfunction is caused by depression, antidepressants may help. Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can be used for the treatment of (ED) erectile dysfunction but may have potentially serious side effects in some men.

    Hormones: Men with low levels of testosterone may benefit from hormone supplementation called testosterone replacement therapy.

    Psychological therapy: Therapy with a trained counselor can help a person address feelings of anxiety, fear, or guilt that may have an impact on sexual function.

    Mechanical aids: Aids such as vacuum devices and penile implants may help men with erectile dysfunction.

    Education and communication: Education about sex and sexual behaviors and responses may help a man overcome his anxieties about sexual performance. Improve communication with your partner to overcome many barriers to a healthy sex life.

    Complementary and Alternative Therapies: Sexual dysfunction caused by decreased circulation, hormonal imbalance, depression, or anxiety may be helped by alternative therapies. This can be employed in both the sex.

    Nutrition and Supplements: Vitamin C and essential fatty acids increases blood flow. Vitamin E and zinc support hormone production. B-complex helps reduce stress.

    Herbs: Herbs are generally a safe way to strengthen and tone the body's systems.

    Acupuncture and Traditional Chinese Medicine: Acupuncture and Traditional Chinese Medicine have been used for centuries to treat sexual dysfunction.

    Yoga and Meditation: Yoga and meditation can reduce the effects of stress and relieve anxiety about the condition.

    Massage: Therapeutic massage can reduce the effects of stress.

    Surgery: Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involve the insertion of artificial rods into the penis.
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    Dr Kalpana
    M.D(O&G) FNB(Reproductive Medicine)
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    Inauguration of Guru Hospital at Ramnad on 06.03.2016

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