Male Sexual Dysfunction

Amin Herati, M.D., Kevin L. Billups, M.D.


  • A difficulty experienced by an individual or couple during any stage of normal sexual activity that prevents experiencing sexual satisfaction. Male sexual dysfunction (SD) is characterized by impaired or inadequate ability of a man to carry on his sex life to his own satisfaction.
  • Male SD definitions:
    • Erectile dysfunction: consistent or recurrent inability to achieve and/or maintain a penile erection of sufficient quality for satisfactory sexual performance over a minimum duration of 3 months.
    • Ejaculation disorders:
      • Premature ejaculation: ejaculation that always or nearly always occurs prior to or within one minute of penetration and the inability to delay ejaculation on all or nearly all penetrations causing distress, bother, frustration and/or the avoidance of sexual intimacy. Ejaculatory dysfunction and erectile dysfunction often occur together and should be screened for together.
      • Delayed ejaculation: delay in the normal ejaculatory latency that is difficult to define because the “normal” ejaculatory latency time is not well established
      • Anejaculation: the extreme range of delayed ejaculation characterized by complete inability to ejaculate
      • Retrograde ejaculation: retrograde emission of semen into the urinary bladder that may be complete or partial (i.e. man is able to have some antegrade emission just in smaller volumes)
    • Orgasmic dysfunction:
      • Anorgasmia: inability to achieve or experience orgasm independent of whether any or all of the physiologic elements of ejaculation have taken place
      • Marked delay of orgasm
      • Severely diminished intensity of orgasmic sensations
    • Disorders of libido:
      • Hypoactive sexual desire disorder: the persistent or recurrent absence or deficit of sexual fantasies and desire for sexual activity
    • Peyronie’s disease (penile curvature): a fibrotic disorder of the tunica albugeinea that presents with a fibrous, inelastic scar of the tunica albuginea currently believed to occur in genetically susceptible individuals following some form of penile trauma

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Last updated: January 7, 2018