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Sexual Problems

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Erectile Dysfunction
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Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

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Premature Ejaculation

Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. Premature ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time.

As long as it happens infrequently, it's not cause for concern. However, you might be diagnosed with premature ejaculation if you:

Always or nearly always ejaculate within one minute of penetration Are unable to delay ejaculation during intercourse all or nearly all of the time Feel distressed and frustrated, and tend to avoid sexual intimacy as a result Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed talking about it, premature ejaculation is a common and treatable condition. Medications, counseling and sexual techniques that delay ejaculation — or a combination of these — can help improve sex for you and your partner.

Performance Anxiety

Sex is more than just a physical response. Your emotions have something to do with it, too. When your mind is too stressed out to focus on sex, your body can't get excited either.

Lots of different worries can lead to the problem:

  • Fear that you won't perform well in bed and satisfy your partner sexually
  • Poor body image, including concern over your weight
  • Problems in your relationship
  • Worry that your penis won't "measure up"
  • Concern about ejaculating too early or taking too long to reach orgasm
  • Anxiety about not being able to have an orgasm or enjoy the sexual experience

These things may lead your body to release stress hormones like epinephrine and norepinephrine.

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