Male Sexual Dysfunction

Abstract

Male sexual dysfunction is a series of conditions, most notably including erectile dysfunction (ED), Peyronie’s disease (PD), and premature ejaculation (PE), defined by impaired sexual functioning. The prevalence of male sexual dysfunction increases with age and is relatively high with greater than 50% of men aged 40 to 70 describing some degree of erectile dysfunction. Risk factors for male sexual dysfunction include age, diabetes mellitus (DM), cancer, stroke, hypertension, penile trauma, depression, anxiety, and disturbance in central serotonin neurotransmission and 5-HT postsynaptic receptor functioning. Sexual questionnaires including the International Index of Erectile Dysfunction, Sexual Health Inventory for Men, and the Premature Ejaculation Diagnostic Tool are useful in screening for these disorders. Focused history and physical can establish diagnoses. For a condition to be diagnosed as male sexual dysfunction, the patient or their partner must view their sexual functioning as impaired. Treatment of male sexual dysfunction is etiology dependent. For ED, first-line therapy is a phosphodiesterase-5 inhibitor or mental health care for psychogenic ED. More complicated cases may be treated with injections, surgery, or shockwave therapy. PD is either treated with medications for pain management, collagenase clostridium histolyticum injection, corpoplasty, plication, or shockwave therapy. PE may be treated behaviorally or with SSRIs as first line medication.

The Effect of Cervical and Lumbar Decompression Surgery for Spinal Stenosis on Erectile Dysfunction

“…This is reflective of the fact that several contributing factors influence both the presence and degree of ED which may be predominantly associated with vascular pathways, neural pathways, or both. [23][24][25][26][27][28][29] Any aberration along the tumescence pathway can lead to ED, including pathology of the sacral preganglionic parasympathetic fibers and nervi erigentes which govern nitric oxide release from the cavernous nerve that initiates tumescence, or the maintenance of erection which is secondary to nitric oxide release from vascular endothelial cells. 3,4,17,[23][24][25] With regards to vascular etiologies, hypertension has been identified as a co-diagnosis in 35-40% of men with ED, and hyperlipidemia has been identified in about 42% of men with ED.…”

The potential role of physical activity in the management of male sexual dysfunction

“…Male sexual dysfunction is an umbrella term covering multiple issues such as erectile dysfunction, premature ejaculation in all or most vaginal penetrations, and low libido 1,2 . The global prevalence of erectile dysfunction could be as high as 76.5% 3 .…”

“…In terms of premature ejaculation, prevalence has been estimated from 20% 4 to 30% 5 while low sexual desire may be present in approximately 5% 6 . Commonly associated risk factors for male sexual dysfunction include increasing age, presence of cardiometabolic, neurological or psychological health conditions, as well as lifestyle factors such as smoking, excessive alcohol consumption and physical inactivity 2 . In order to treat male sexual dysfunction, pharmacological strategies have been developed over the past number of years with some success, although it is worth considering that these pharmacotherapies can have wide ranging side‐effects such as headaches, tachycardia and nausea 7 .…”

“…M ale sexual dysfunction is an umbrella term covering multiple issues such as erectile dysfunction, premature ejaculation in all or most vaginal penetrations, and low libido. 1,2 The global prevalence of erectile dysfunction could be as high as 76.5%. 3 In terms of premature ejaculation, prevalence has been estimated from 20% 4 to 30% 5 while low sexual desire may be present in approximately 5%.…”

“…6 Commonly associated risk factors for male sexual dysfunction include increasing age, presence of cardiometabolic, neurological or psychological health conditions, as well as lifestyle factors such as smoking, excessive alcohol consumption and physical inactivity. 2 In order to treat male sexual dysfunction, pharmacological strategies have been developed over the past number of years with some success, although it is worth considering that these pharmacotherapies can have wide ranging side-effects such as headaches, tachycardia and nausea. 7 Therefore, there is a need for non-pharmacological strategies, which are likely to be associated with fewer side-effects.…”