A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.

While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor.

Impotence is a common problem among men characterized by the consistent inability to sustain an erection sufficient for sexual intercourse or the inability to achieve ejaculation, or both. Impotence can vary. It can involve a total inability to achieve an erection or ejaculation, an inconsistent ability to do so, or a tendency to sustain only very brief erections.

The risk of impotence increases with age. It is four-fold higher in men in their 60s compared with those in their 40s according to a study published in the Journal of Urology. Men with less education are also more likely to experience impotence, perhaps because they tend to have less healthy lifestyles, eat a less healthy diet, drink more and exercise less.

Physical exercise tends to lessen the risk of impotence.

Causes of Impotence

• Alcohol Abuse and Alcoholism

• Depression

• Diabetes

• High Blood Pressure

• Kidney Failure

• Multiple Sclerosis

• Prostate Cancer

• Smoking and How to Quit Smoking

• Stress

Other Causes of Impotence

• Atherosclerosis
• Injuries or Surgery (to the penis , spinal cord , prostate , bladder , and pelvis )
• Medications (both Prescription and Non-prescription)

What Causes Sexual Problems?

Sexual dysfunction can be a result of a physical or psychological problem.

•  Physical causes: Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.

•  Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.

Are only Men Affected by Sexual Problems?

Both men and women are affected by sexual problems. Sexual problems occur in adults of all ages. Among those commonly affected are those in the geriatric population, which may be related to a decline in health associated with aging.

How Are Male Sexual Problems Diagnosed?

The doctor likely will begin with a thorough history of symptoms. He or she may order other tests to rule out any medical problems that may be contributing to the dysfunction. The doctor may refer you to other doctors, including a urologist (a doctor specializing in the urinary tract and male reproductive system), an endocrinologist (a doctor specializing in glandular disorders), a neurologist (a doctor specializing in disorders of the nervous system), sex therapists and other counselors.

What Tests Are Used to Evaluate Sexual Problems?

Several tests can be used to evaluate the causes and extent of sexual problems. They include:

•  Blood tests -- These tests are done to evaluate hormone levels.

•  Vascular assessment -- This involves an evaluation of 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 -- Particularly useful in evaluating the effects of diabetic neuropathy (nerve damage), sensory testing 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. This test can help determine if a man's erectile problems are due to physical or psychological causes.

How Is Male Sexual Dysfunction Treated?

Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following:

•  Medical treatment -- This involves treatment of any physical problem that may be contributing to a man's sexual dysfunction.

•  Medications -- Medications, such as Cialis, Viagra or Levitra, may help improve sexual function in men by increasing blood flow to the penis.

•  Hormones -- Men with low levels of testosterone may benefit from hormone supplementation

•  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. Open dialogue with your partner about your needs and concerns also helps to overcome many barriers to a healthy sex life.

Can Sexual Problems Be Cured?

The success of treatment for sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.

Can Sexual Problems Be Prevented?

While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function:

•  Follow your doctor's treatment plan for any medical/health conditions.

•  Limit your alcohol intake.

•  Quit smoking.

•  Deal with any emotional or psychological issues such as stress, depression, and anxiety. Get treatment as needed.

•  Increase communication with your partner.

  When Should I Call My Doctor?

Many men experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the man and his partner, and have a negative impact on their relationship. If you consistently experience sexual function problems, see your doctor for evaluation and treatment.

The most common sexual problems in men are