The Urology Center Glossary terms

Sexual Dysfunction:

The term sexual dysfunction includes any and all forms of male and female sexual problems. The study of female sexual dysfunction is in its infancy but active clinical research is in progress concerning hormonal dysfunction and possible congenital blood flow abnormalities. Male sexual dysfunction primarily entails common problems such as premature ejaculation and erectile dysfunction (ED).

Premature ejaculation means the occurrence of a sexual climax, prior to the time that is desired by a man and his partner. The term climax means the combination of orgasm (a purely emotional event which occurs in the brain) with ejaculation (the process whereby fluid is expelled from the urethra). These two do not necessarily occur together.

Again, premature ejaculation and erectile dysfunction commonly occur together. Physical causes of ED may lead to premature ejaculation. Alternatively, premature ejaculation may lead to emotional causes of ED. A common scenario occurs in which premature ejaculation leads to the erectile dysfunction because of emotional anxiety produced by the premature ejaculation. The resulting anxiety is often termed "performance anxiety," a situation not unlike stage fright. That is, when faced with the prospect of being called upon to perform intercourse, men with combined premature ejaculation and ED, commonly back away and make excuses, when in fact they greatly desire to participate in a loving sexual relationship. This may create an emotional rift between partners.

Premature ejaculation is not a pathological process. That is, there are no known physical abnormalities which result in premature ejaculation. However, medical and behavioral treatments are available to delay sexual climax, in order to fulfill the desires of both a man and his partner.

Masters and Johnson described this problem decades ago when they made observations concerning human sexuality. They described a behavioral technique whereby the sexual climax can be delayed. More recently, observations have been made that a class of drugs known as serotonin reuptake inhibitors can retard sexual climax. These medications are commonly used as antidepressants, although there seems to be no direct connection between depression and premature ejaculation. Clomipramine and Zoloft seem to be the medications most commonly used for this purpose.

Erectile dysfunction (ED) implies the inability to achieve or maintain sufficient firmness of the penis to achieve satisfactory intercourse. The older term impotence may be substituted. While some estimates indicate that about 50 percent of older men have this problem, ED is not an inevitable part of aging. However, many men, even in their 80s continue to enjoy an active sex life. Of course, ED also occurs in younger men.

Fortunately, erectile dysfunction is reversible with treatment. Safe and effective treatments are readily available. If you would like additional information concerning erectile dysfunction and premature ejaculation you may find Dr. Watson's book, Impotence-Its Reversible, in Louisiana public libraries. If your library does not have enough copies of this publication, contact us through this website.

(Please visit our Male Urology and Erectile Dysfunction Center of Excellence for additional information.)