Male Sexual Dysfunction

Overview of Male Sexual Dysfunction

What does Sexual Dysfunction mean?

Male sexual dysfunction can take many forms, ranging from erectile dysfunction and Peyronie’s disease to ejaculatory disorders. As a result, there are also many causes and male sexual dysfunction treatment options.

What is Erectile Dysfunction (ED)?

Erectile dysfunction, or ED, is the inability to achieve or maintain an erection. Learn more about this common form of male sexual dysfunction. Learn more about Erectile Dysfunction.

Peyronie’s Disease

This is a common condition that can cause a curvature, or deformity, of the penis. This curvature is caused by a buildup of plaque, or scar tissue, forming under the skin of the penis. The curvature is more pronounced during an erection and can cause erections and sex to become painful or impossible. Peyronie’s disease can result from genetics or from injury to the penis. There are several treatment options for Peyronie’s disease to help correct the curvature and restore length loss, including:

• Traction therapy, or physical therapy for the penis, which involves manually bending the penis in the opposite direction to lessen the curve
• Injections to break down the plaque, like XIAFLEX
• Surgically placing plication sutures to correct the curvature and pull the penis straight
• Surgery to incise or remove the plaque and place a graft over the area
• Surgery to place a penile implant that corrects the ED and the curvature together

Ejaculatory Disorders

These conditions include premature (too early), delayed (too late) as well as retrograde (goes backwards into the body) ejaculation and disorders of orgasm that often precedes or occurs along with ED. These disorders are treated using a combination of therapies, including medications, topical anesthetics and behavioral cognitive therapy. Oftentimes, treating ED will alleviate ejaculation problems. Your doctor may want to check your hormone levels to see if hormone replacement therapy is an option, especially if you’ve had surgery for testicular or prostate cancers.

Low Testosterone or Hypogonadism

When a man has low testosterone, or hypogonadism, it can cause a low libido (sex drive), low energy, fatigue, decreased lean muscle mass, cognitive effects, depression and many other symptoms. Treatment for this sexual dysfunction is based on what’s causing it. Causes can include prolonged diabetes or heart disease, obstructive sleep apnea, testicular cancer, chemotherapy, radiation and certain surgeries and medications (like hormone blockers and androgen deprivation therapy, or ADT). Your doctor can help you raise your testosterone levels through medications. If it’s important for you to maintain fertility, your doctor may use alternative medications to avoid suppressing the body’s natural ability to make testosterone and sperm, such as using medications like Clomid, hCG or anastrozole.

Priapism

Priapism is a prolonged erection in the absence of sexual activity or desire that lasts more than four hours. Priapism is a medical emergency, and you should go to the nearest ER if you develop symptoms. Priapism requires emergency medical care to aspirate, or drain, the trapped, deoxygenated blood out of the penis. A doctor may inject phenylephrine to constrict blood vessels in the penis to drain it. If these treatments don’t work, a surgeon can place a distal shunt to drain the penis.

Priapism is a common condition among men with sickle cell disease—more than 80% of patients have experienced priapism before the age of 25. When blood stays trapped in the penis, it becomes acidotic and can cause significant pain, scarring in the penis and affect the ability to get an erection. Priapism can impact fertility, masculinity and intimate relationships. It is treated with medications, injections or sometimes a penile implant.

Penile Fractures

Straddle falls, a crushing injury or a sexual trauma can cause a penile fracture, or a tear in the corporal muscle tissue of the penis. This requires emergency surgery to repair the tissue so it does not heal in a bent or ripped position that would affect functionality. Untreated penile fractures can lead to permanent ED or Peyronie’s disease.

Treatment for Male Sexual Dysfunction

At IU Health, we have urologists across the state who are trained to support your care , as well as the only board-certified and fellowship-trained academic urologist in state of Indiana for sexual and reproductive urology. They are here to listen to your individual needs and create a personalized approach to rebuild your confidence and restore your sexual relationship with your partner. Sexual health is important to your overall health, and it can also indicate cardiovascular issues, so it’s important to address this area of your life.

Research

Our partners at the IU School of Medicine offer the only Male Sexual and Reproductive Medicine program in the state with a fellowship to train the next generation of physician leaders. These physicians learn innovative treatments and research to care for patients with sexual dysfunctions and infertility.

Wellness and Support

The IU Health Male Sexual and Reproductive Medicine Program offers quarterly webinars to educate patients on the diagnosis and treatment options for many of these common sexual dysfunctions.