Definition

Sexual dysfunction can be a big problem that affects a partner's sexual satisfaction and impacts both men and women. Sexual dysfunction can occur in both men and women. In men, sexual dysfunction is a common disease that occurs with age.

Apart from affecting physical conditions, sexual dysfunction also has an impact on a person's psychological condition. In Indonesia, sexual dysfunction is still considered a taboo subject, so patients generally feel embarrassed to discuss their complaints and receive treatment. If treated well, sexual dysfunction patients can recover, and a good sexual life can improve the quality of life for them and their partners.

Sexual dysfunction is divided into several categories, namely:

• Erectile dysfunction (impotence)

A person's inability to initiate or maintain an erection during their sexual activity.

• Male orgasm disorder

Men are unable to reach orgasm with a partner. In some cases, orgasm can be achieved only by masturbation or oral sex.

• Hypoactive sexual desire

Lack of interest in sexual contact or lack of sexual desire.

• Ejaculation disorders (retrograde ejaculation)

During orgasm, the semen that should come out of the penis instead turns towards the bladder. So, the semen released during ejaculation can be very little or nonexistent. This ejaculation disorder usually occurs in men with nervous disorders due to diabetes.

• Priapism

Prolonged erection that lasts for at least 4 hours and is usually not accompanied by sexual stimulation. This disease is an emergency condition that requires immediate treatment.

Causes

Sexual dysfunction can be caused by physical or psychological causes.

Physical causes include:

• Low levels of the testosterone hormone
• Thyroid hormone disorders
• Injuries to the penis and pelvis
• Certain medications, such as antidepressants and high blood pressure medications
• Blood vessel disorders include atherosclerosis (hardening of the blood vessel walls) and high blood pressure
• Stroke
• Nerve disorders due to diabetes or surgery
• Smoking
• Alcohol or drug abuse

Meanwhile, psychological causes include:

• Excessive anxiety
• Marriage or relationship problems
• Depression
• Feelings of guilt regarding sexual relations
• Having sexual trauma in the past
• Work-related stress

Risk Factor

In men, some factors can increase a person's risk of experiencing sexual dysfunction, including:

• Age over 40 years
• Medical conditions such as diabetes mellitus or cardiovascular disease
• Excess weight or obesity
• History of mental illness and use of antidepressant medication
• Unhealthy lifestyle
• Smoking habit
• Excessive alcohol consumption
• Lack of exercise
• History of bladder disease

Symptoms

Symptoms that can arise from sexual dysfunction in men include:

• Lack of desire for sexual intercourse
• Difficulty arousing sexual desire
• Inability to get or maintain an erection
• Ejaculation disorders
• Ejaculation cannot occur, or a person takes a long time to ejaculate even though sexual stimulation has been given
• During orgasm, semen cannot come out of the tip of the penis
• Inability to control ejaculation time
• Pain during sexual intercourse

Diagnosis

A general practitioner can make a diagnosis of sexual dysfunction. The doctor will conduct an examination in the form of an interview session and physical examination.

Medical Interview

Doctors will generally ask about:

• The main complaint and other complaints that accompany the patient
• How long has the complaint been experienced?
• History of sexual behavior with a partner
• History of other illnesses such as depression or sleep disorders
• History of consumption of certain drugs
• Daily lifestyle

Physical examination

Usually, the doctor will look at the patient's vital signs, such as blood pressure, temperature, pulse, and breathing rate. After that, the doctor will examine the penis and testicles. The doctor can also examine the anus to check the condition of the patient's prostate gland, whether there is infection or enlargement.

Additional Examinations

If the doctor suspects that the patient has another disease that underlies the complaint of sexual dysfunction, such as diabetes, thyroid disorders or cardiovascular disease, the doctor will carry out supporting examinations such as blood tests to check sugar levels, hormones or cholesterol levels.

If it is suspected that sexual dysfunction is caused by another disease, the doctor will refer you to the relevant specialist to treat your disease first before treating your complaint of sexual dysfunction.

Management

There are several types of treatment for male sexual dysfunction, and treatment options depend on the disease causing it. The following are therapy options for sexual dysfunction, namely:

• Drug therapy: Medication may be given to improve sexual function by increasing blood flow to the penis. 
• Hormonal therapy: Since low testosterone levels are one of the causes of sexual dysfunction, hormone therapy may be an option. 
• Psychotherapy: Psychotherapy can be given if the main cause of sexual dysfunction is a psychological disorder. Therapy can be carried out by a psychiatrist to treat anxiety or depression. Usually, psychotherapy can be given in the form of counseling or medication.
• Sex therapy: This therapy is carried out by counselors who are certified and experienced. Includes education about sex, how to have good and correct sexual relations, and sometimes also includes counseling regarding marital relationships. This therapy should be done with your partner to improve the quality of life for both parties.
• Mechanical support: Some mechanical supports can help heal patients with sexual dysfunction, such as penile implants and vacuum devices.

If you are found to be suffering from another disease such as diabetes, high blood pressure, penile injury, or hormonal disorders, usually the disease will be treated first. By routinely controlling this disease, it is hoped that the sexual dysfunction that occurs can also be resolved and not recur in the future.

Complications

Even though it seems trivial and not life-threatening, sexual dysfunction can reduce the sufferer's quality of life for a long time. Complications that can occur include:

• Shyness and lack of self-confidence
• Excessive anxiety and depression
• Unsatisfactory sexual life
• Domestic problems
• Infertility

Prevention

Sometimes sexual dysfunction just happens and can't be prevented. However, the following things can be tried to avoid sexual dysfunction in men:

• Exercise at least 15 minutes of moderate intensity every day
• Avoid obesity and maintain ideal weight
• Eat food with balanced nutrition
• Avoid smoking and drinking alcohol
• Avoid stress
• Honestly and maintain open communication with your partner
• Avoid all risk factors from diseases that can underlie sexual dysfunction, such as high blood pressure, thyroid disorders, or diabetes

When to See a Doctor?

See a doctor if you experience the above symptoms for a long time, appear all the time, and interfere with your partner's life. Even if only one party experiences sexual dysfunction, treatment should be carried out accompanied by a partner. By being accompanied by a partner, the patient will feel more comfortable and calm, reducing the risk of excessive anxiety and helping the healing process.

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