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Male Sexual Functioning Issues

Sexual dysfunction in Men is common and treatable in most cases. It is important to look at biological as well as psychological issues which may be affecting you. Below are some typical issues I have experienced in my practice.


Pornography use

I'll start with a position statement that "I am not against pornography as a source of entertainment and arousal which can benefit consenting consumers and participants."

The use of the term 'Porn addiction' has been contentious in recent years, however a study done in 2016 showed that viewing porn has a impact on the reward centre of the brain. It lights up the same areas as heroin or alcohol. So while we cannot say porn is addictive because it is not a substance we consume, we can say 'problem porn behaviour' as it results in us acting on our impulses and activating the reward centre. 

What can begin to happen is a separation of sexual identities. There are the sexual behaviours, thoughts and feelings which are associated with porn use (less effort and anxiety, taboo or secretive, feelings of competence and disconnection, less sexual dysfunction experiences eg. premature ejaculation nd erectile dysfunction). 

There are the sexual behaviours thoughts and feelings associated within the relationship such as performance anxiety, less arousal due to less "porn" like activities, less satisfaction and disengagement. This can lead to the break down of relationships or prevent them from happening in the first place. Especially amongst boys who have early exposure to pornography. 


Premature Ejaculation (PE)

The International society of sexual medicine defines early ejaculation as:

“. . . a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of penetration, and the inability to delay ejaculation on all or nearly all penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy."

PE can be experienced as life long, acquired and relational. The most common factor influencing ejaculation is performance anxiety and over sensitivity.

Many men overcome premature ejaculation with experience and an innate ability to relax. The key here is whether or not the issue is causing you distress or issues in your relationship. Medications such as antidepressants have been known to affect ejaculation. Recent studies have shown some hereditary links in the cases of life long cases.

Techniques such as the "Stop start method" have been very useful and effective in the past. However, if the technique is not applied correctly it can frustrate those not gaining success. A combination of methods including practical, mental, toys, creams or partner help ensure the best success.


Erectile dysfunction (ED)

The American Psychiatric Association (APA) defines ED as a "persistent lack of erection rigid enough for penetrative intercourse for 6‐12months (could be acquired or life long)."

ED is an excitement phase dysfunction. It is bound to happen at least a few times during a mans lifetime. The reasons for the occurrence of ED are numerous. Physiological factors need to be assessed. Medications affect the ability to get and maintain an erection, most commonly, anti depressants, blood pressure and diabetic medications.

The mind is a powerful thing has been proven to play a role in a mans ability to become aroused. Depression, performance anxiety, life changes, stress, relationship problems and lack of sufficient stimulation may be a few reasons. The relationship between a man, his penis and his mind can be negotiated effectively with the right techniques and patience.


Delayed or Inhibited Ejaculation

This is a less common issue affecting the ability for men to orgasm. This dysfunction is often confusing as the there is the fact the person can gain an erection and continue to perform for a long period time. Tempered with the frustration of no release or orgasm and some partners who would like shorter encounters. Relationships can at time suffer as the non suffering partner feels they must not be attractive or skilled enough to be able to get their lover to orgasm and there can be too much focus on their own satisfaction and orgasm.


Other male sexual problems:

Male Sexual Pain

Low Desire ( see Couples section)

Coping with disability or surgery.

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