Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 3/02/2021
Problems in the bedroom can really sap your confidence and hit your relationships hard. Any guy who’s had a misfire, failure to launch or just a bad night in bed knows that it’s a terrible feeling, and much worse when it goes from a single episode to a pattern.
If you’ve had problems getting it up, keeping it up or finishing during sex, you may be experiencing the effects of a sexual disorder.
Whether it’s the first time or the time that made you finally say “enough is enough,” it’s good that you’re facing the problem and looking for treatment. We’re here to help you get what you need.
Before we make any recommendations, though, first we need to lay out some basic information about sexual disorders: what they are, and what treatments you can expect your healthcare provider to suggest.
Let’s first start with a quick breakdown of how your penis is supposed to work, because it’s going to make things easier once we start talking about what’s going wrong.
Two long chambers inside the penis called the corpora cavernosa contain blood vessels and tissues, as well as major arteries. When you’re turned on, your brain sends signals to dilate these blood vessels, so blood can flow in, get trapped in the corpora cavernosa and give you an erection.
When things work properly, arousal makes it hard, and it stays that way until you orgasm, which, in turn, causes you to ejaculate. Arousal, erection, sex, orgasm, ejaculation — that’s the gist of it, fellas.
Sexual disorders are a wide-net term for anything that negatively impacts your ideal sexual experience and ability to have a fulfilled intimate episode. They are typically categorized according to which part of the sexual experience they impact: arousal or orgasm.
Disorders can be part of one or both categories, and so they’re typically named according to one of three groups: desire disorders, premature ejaculation and erectile dysfunction.
Desire disorders can have a variety of causes, from physical and emotional difficulties, to substance abuse and even questions about sexual preference.
A desire disorder may also come from hormone or medication imbalances, and other things like depression that a psychotherapist might address.
Desire disorders can also be the result of previous performance issues.
If you’ve recently experienced erectile dysfunction, or are suffering from a fear of failure to perform or even from low self esteem, it may be causing you enough stress and anxiety to derail your desire for sexual activity.
Men with erectile dysfunction sometimes do simply lose interest in sexual activity, often as a way of avoiding further embarrassment.
Because the causes of desire disorders are so many, consulting a physician and/or therapist is the first best step, as there might be one or more root causes acting in tandem to cause the problem.
Put simply, premature ejaculation is ejaculating before orgasm or, sometimes, before penetration even begins.
It can negatively impact sexual and psychological health, damage relationships and for any guy who has experienced it, can be very embarrassing to say the least.
Ejaculating prematurely may mean less than a few minutes (if any) pleasure, and it may mean no orgasm at all for you (and probably not for your partner either). As much of a bummer as that is, it’s a bigger bummer to know that it’s actually quite common.
Premature ejaculation affects as many as a quarter of adult men, and there hasn’t been a lot of medical research put into solutions, though SSRIs and numbing agents are sometimes used.
As with arousal disorders, a holistic treatment looking at overall mental and physical health is generally the preferred course of action, and it starts with consulting a healthcare professional who may refer you for psychological counseling or behavioral therapy.
Erectile dysfunction is not a phrase any man wants to hear, and its causes can be ambiguous, because a multitude of factors can impact your erection success and sustainability.
Everything from poor diet, obesity, stress and anxiety can contribute to ED, as well as drugs like antidepressants and illicit ones, lifestyle choices and hormone imbalances.
The National Institutes of Health (NIH) defines erectile dysfunction as a “condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse,” which is all-encompassing of the potential causes.
And as a result, there are a lot of guys suffering from it. ED affects an estimated 52 percent of men between the ages of 40 and 70 in the U.S. alone — that’s between 30 million and 50 million men nationwide. That’s a huge number.
ED can generally be broken into three problems: getting hard, staying hard and failing to complete before going soft.
We say difficulty because you might still have ED if you’re able to perform some or many times. One of the most glaring symptoms of ED is off-and-on ineffectiveness, caused by anxiety or other changes from encounter to encounter.
Getting it up is great, but erections are like phone calls: it’s not a success if it drops every 30 seconds. Whather you have partial erections or go fully flaccid, repeated issues staying stiff are a likely sign of ED.
Difficulty finishing is one of the most likely signs that something psychological is going on to cause your ED. Stress, wandering minds, lost focus or a general disinterest in your partner may be causing this form of erectile dysfunction, which basically can be compared to a car running out of gas before it gets to the station.
While other sexual disorders may require several treatments to see results, ED can be a more straightforward problem to solve.
As we mentioned, erectile dysfunction can definitely be the result of psychological factors, but after you or a healthcare professional rule those out, there are specific mechanisms of biology that should be addressed to treat ED.
Drug use, diet, weight, blood pressure, and alcohol intake can all be treated with lifestyle changes, and we could all be taking better care of ourselves anyway. But beyond these things, there’s also medical help in the form of prescriptions like Viagra® (sildenafil) and Cialis® (tadalafil).
Cialis and Viagra are both phosphodiesterase type 5 (PDE5) inhibitors. Essentially, they block the breakdown of certain substances in your body (PDE5s) which keeps your blood vessels dilated longer and your penis, therefore, hard. Tadalafil is a longer-effect medication, whereas sildenafil(generic Viagra) is a pill you take a certain amount of time before you’re trying to get to business.
Because they work on blood vessels, most of these drugs have or are still part of the treatment option for hypertension (and because of that, you’ll want to check with a doctor before taking them if you have high blood pressure or are on other blood medications).
Both medications can offer a solution if your problem is biological, and can also be part of the boost to get things normalized again if some of your issues are psychological.
If you’re having problems in the bedroom or avoiding the bedroom altogether (and not just because the kitchen is more fun), the first and best thing you can do is talk to a healthcare professional.
We know these problems can feel embarrassing to discuss, but there’s no reason to be ashamed. Statistically a good number of your friends are dealing with similar issues, and even if they’re not, a large portion of the people you pass each day are struggling too.
The difference between you and other men isn’t that you have a disorder, it’s how you address the disorder. Getting help is what determines whether you’re going to be a success story, or suffer indefinitely.
The road ahead might not be easy — therapy may take time, and medication may take some trial and error before you find the right solutions to get your flag back to full mast. But there’s help and hope to be found.
Action is what determines success, so if you’re just beginning your journey to sexual wellness, reach out to a healthcare professional for advice on what comes next.