Sexual dysfunction refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm and resolution.

Causes of sexual dysfunction
Physical causes Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressants drugs, can affect sexual desire and function. Psychological causes These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.

The most common problems related to sexual dysfunction in men include ejaculation disorders, erectile dysfunction and inhibited sexual desire.

Ejaculation disorders
There are different types of ejaculation disorders, including:

Premature ejaculation
This refers to ejaculation that occurs before or soon after penetration.

Inhibited or retarded ejaculation
This is when ejaculation does not occur.

Retrograde ejaculation
This occurs when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis. In some cases, premature and inhibited ejaculation are caused by psychological factors, including a strict religious background that causes the person to view sex as sinful, a lack of attraction for a partner and past traumatic events . Premature ejaculation, the most common form of sexual dysfunction in men, often is due to performance anxiety during sex. However, organic causes are sometimes present. Certain drugs, including some anti-depressants, may impair ejaculation, as can nerve damage to the spinal cord or back. Retrograde ejaculation is most common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backward. In other men, retrograde ejaculation occurs after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation.

Erectile dysfunction
Also known as impotence, erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis nerve disorders; psychological factors such as stress, depression and performance anxiety; and injury to the penis. Chronic illness, certain medications and a condition called Peyronie’s disease (scar tissue in the penis) also can cause erectile dysfunction.

Inhibited sexual desire (reduced libido)
Inhibited desire, or loss of libido, refers to a decrease in desire for or interest in sexual activity. Reduced libido can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone. It also may be caused by psychological problems, such as anxiety and depression; medical illnesses such as diabetes and high blood pressure; certain medications, including some anti-depressants; and relationship difficulties.
Tests help evaluate sexual dysfunction include:
Blood tests These tests are done to evaluate hormone levels. Vascular assessment This involves an evaluation of the blood flow to the penis. A blockage in a blood vessel supplying blood to the penis may be contributing to erectile dysfunction. Sensory testing Particularly useful in evaluating the effects of diabetic neuropathy, sensory testing measures the strength of nerve impulses in a particular area of the body.

How is male sexual dysfunction treated?
Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following:
Homeopathic management
Impotence is the inability to maintain an erection long enough to engage in normal sexual intercourse. Many factors can contribute, including emotional issues, dietary factors, use of alcohol or drugs, and level of physical fitness. Homeopathic remedies sometimes help with temporary difficulties. If the problem is constant or recurrent, a doctor should be consulted to check for physical, hormonal, or nervous system problems. A constitutional remedy and the guidance of an experienced practitioner may help bring balance to a person’s system, both emotionally and physically.