Last weeks focus was on female sexual dysfunction, and this one will be on male sexual dysfunction-information taken from a lecture by Barry McCarthy, Ph.D. This topic includes premature ejaculation, erectile dysfunction, inhibited sexual desire (discussed in a previous blog) and ejaculatory inhibition.

  1. Premature Ejaculation is the most common of these sexual dysfunctions. It is defined as ejaculating in less than 2 minutes after intercourse and not feeling in control of when you do so. The key to learning control is to increase comfort, awareness and pleasure, not decreasing stimulation-which may be counter to what many people believe. The stop-start method is shown to be effective (where any movement or stimulation is stopped and then restarted), and the process typically takes 3-6 months to master. Remember, performance is not the goal. The goal is sharing pleasure with your partner.
  2. Erectile Dysfunction is defined as inability to attain or maintain an erection for intercourse. Ninety percent of men will have at least one incident of erectile failure by age 40. This is normal and not considered erectile dysfunction. Most erectile problems (especially if the man is under 50) are due to psychological issues or relationship issues, not medical. It is important to first have a medical exam to rule anything physiologically. It can be due to alcohol abuse, anxiety, anger, depression, diabetes, medication side effects, and vascular or neurological issues. Viagra and Cialis can be helpful. It is a myth that men are ready to have sex with anyone at anytime, which can also add pressure to the relationship. If you view it as a situational problem that you can work on vs. labeling yourself as impotent or a failure, it will help. You can still enjoy each other sexually without intercourse. Also, men lose confidence with their erections about age 50 which can lead to him wanting to stop having sex for fear of failure.
  3. Ejaculatory Inhibition is much more rare (1-2% of males), which involves the inability to achieve orgasm even though physically aroused and erect. The rates increase in men over 50 increase (8-15%). This can be cause by medication side effects, not feeling sexually receptive or responsive, drug abuse, alcohol, lack of partner involvement and fatigue. This person may need multiple forms of stimulation. The most common cause for this is experiencing sex as routine and mechanical.

Remember, the key to healthy sexuality is enjoying each other. It is not as a pass-fail test. If you are having challenges sexually in your relationship, seeking therapy can help.

Debbie Grammas, Ph.D. 713-304-6554