Three sexual problems men refuse to talk about

Premature ejaculation is a type of sexual dysfunction that occurs when a man releases (ejaculates) semen sooner than he or his partner would like. — AFP

Sexual conditions in general can be an embarrassing topic for men to discuss.

However, some sexual problems are more common than others and can be alleviated, as we will discuss in this article.

Erectile dysfunction

Erectile dysfunction (aka impotence) is the inability to get and keep an erection firm enough for sexual intercourse.

Having issues maintaining an erection from time to time isn’t necessarily a cause for concern, but it may warrant medical attention if the issue is much more frequent. Studies indicate that up to 20% of sexually active men suffer from some degree of erectile dysfunction, and the prevalence of the condition increases with age.

It is found that up to 86% of men aged 80 years and above are unable to achieve a satisfactory erection.

There are numerous reasons as to why this condition can persist.

Contributing factors include:

• Diabetes
• Hypertension
• Smoking
• Performance anxiety
• Stress
• Low testosterone

During your consultation, your doctor will examine these risk factors in your history and advise treatment accordingly.

For example, certain conditions can be treated with medication that eases blood flow to the penis to encourage a stronger erection.

Or, if the problems are more serious, it will be treated through other medications or even lifestyle changes.

Premature ejaculation (PE)

Amongst others, PE is the most common sexual problem affecting men, with studies indicating that one in three men may be affected by it.

Usually, PE stems from psychological issues and not physical ones.

Some of these issues include:

• Anxiety
• Poor body image
• Sexual naivety
• Relationship issues
• Depression

However, there may be some cases where it stems from physiological causes such as abnormal hormone levels or inflammation or infection of the prostate or urethra.

PE is usually treated with a combination of as-per-needed medication which is either oral or topical.

Patients can also undergo body and mental training to avoid such issues as well as behavioural changes to prevent this condition from occurring.

Low libido

Low libido, or decreased sex drive, is a condition that can be derived from psychological issues such as depression or anxiety, or medical issues such as hormone issues or low testosterone levels, potentially leading to unsatisfied partners or a reduction in one’s self-confidence.

Your doctor will usually go through your history to investigate if there are any contributing factors. For a clearer image, blood tests may also be taken to examine hormone levels.

Low hormone levels can potentially present not just with a lower than usual level of libido, but also erectile dysfunction, loss of morning erections, weight gain, poor concentration or mood swings.

In order to effectively treat low libido, the root cause must be addressed to determine if it’s psychological or physiological.

Testosterone replacement therapy may be advised if an individual has hormonal issues.

Otherwise, lifestyle changes and encouraging a healthy mind and body connection may also be effective.

Though these conditions can be embarrassing for some people, they are highly treatable, and the first step to mitigate this is to open up and discuss with your doctor.

Dr Chester Lan is a Singapore-based general practitioner. For more information, email [e-mail]. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.