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Difficulties with sex: men

Sexual difficulties are very common for men of all ages. Common guy problems include premature ejaculation or delayed ejaculation – either coming much sooner or much later than you’d like.

Difficulties in bed are quite common, and most people will face them at some point in their lives. Some difficulties are temporary; others require professional attention. Most are easily treated. Usually, the biggest challenge is to admit to having a problem.

You don't need to be embarrassed when you experience sexual difficulties. Many men think they would be considered by others to be less masculine. But having your issues seen to and treated is the best thing you can do for your sexual health and your relationships.

Some sexual difficulties are related to unhealthy lifestyle choices and can be prevented by leading a healthy life: eating a balanced diet, exercising, not smoking and minimizing alcohol consumption. Basically, anything that is good for your overall health is generally good for your sexual health. But of course living a healthy life does not mean you will be immune to having issues in bed – but it might reduce the risk.

When seeing a healthcare provider for issues, the doctor will likely ask you a lot of questions about your sexual, physical and emotional health. The diagnosis will be made a lot easier if you answer these questions as honestly and in-depth as you can – even though it might feel awkward. The doctor will also likely examine you. Don't be ashamed or afraid. Remember: it's very common to have problems and you are doing the right thing by getting treatment.

What you will have to do to resolve the problem depends on the sexual difficulty. Below we cover the most common conditions, their causes and their treatments.

Sexual difficulties affect both partners

There’s no doubt about it: sexual difficulties are bad news for your sex life. If a man is always worried about getting an erection or ejaculating too soon, it’s going to be difficult for him to relax and fully enjoy the experience.
But his partner will also be left unsatisfied, especially if the man is so focused on his fears that he ignores his partner’s sexual needs. As a result, both parties are left wanting. If this continues long enough the couple may begin to avoid lovemaking and even intimacy in general.
So it's good to address any issues as soon as they arise.

Premature ejaculation

One of the most common problems for men, premature ejaculation is when a man orgasms uncontrollably, either before or shortly after sexual stimulation begins. Sometimes it can even occur with little or no physical contact.

With premature ejaculation, the orgasm becomes unwanted, spoiling the sexual experience and leaving both partners unsatisfied. Premature ejaculation affects nearly every man at some point in his life.

It may result from both physical and psychological problems, though it is usually difficult to find the exact cause.

Other psychological factors that can cause premature ejaculation include a religious background in which sex is stigmatised, stress and anxiety, guilt, depression or past sexual trauma. Physical causes may include an oversensitive glans (the top part of the penis), hormonal problems, past injuries, drug side-effects or neurological disease. In some cases, it is simply caused by disinterest or lack of attraction for a sexual partner.

In many cases, it declines as a man gains sexual experience and learns to control his ejaculation. The best way to gain mastery over ejaculation is by identifying the sensations that signal an approaching orgasm and communicating with your partner to temporarily tone down stimulation.

Using a condom or numbing creams and gels, which reduce sensation, can be other options. You could also experiment with different positions, or speak to your doctor about medications that may help treat premature ejaculation. Masturbation, and understanding what excites you, can also help you learn how to control your arousal.

Delayed ejaculation and anorgasmia

The opposite of premature ejaculation, delayed ejaculation means ejaculating way later than desired – or even not at all. Not having an orgasm is also called anorgasmia. The two conditions are not the same, but are often grouped together as 'disordered orgasms'.

Disordered orgasms mostly affect older men.

They can also be caused by psychological factors. This could be fear of sex, having been abused, or thinking that sex isn't good (that it’s, for example, dirty or a sin).

When you see a doctor about this, they will ask you questions about what could be causing the problem and treat you accordingly. This may mean seeing a psychologist to discuss any issues you may have.

Erectile dysfunction

Having erectile dysfunction means being unable to get or maintain an erection. It can also refer to the quality of an erection: that the erection is not hard enough to enter the vagina.

Erectile dysfunction gets more common as men get older, but it can affect men of all ages.
Conditions such as high blood pressure, heart disease and diabetes make it more likely for a man to get erectile dysfunction. But also stress and fear of being unable to perform in bed can cause problems.

When looking for the cause of erectile dysfunction, doctors distinguish between three different types of erections: the ones men get in their sleep, the ones they get through mental stimulation (e.g. fantasising) and the ones brought on by touch.

To treat erectile dysfunction, it's very important to understand what causes it and then address that factor. This might involve lifestyle changes, such as a healthier diet or stopping smoking. Sometimes, it's possible to treat erectile dysfunction with medication such as Viagra – but it's best to also get to the root cause of the problem. Also, not all varieties of erectile dysfunctions can be treated with medication. Sometimes, surgery or injections may be required.

It's important to discuss all options with your doctor.

Low libido

Having low libido means that you have no or almost no sexual desire.

Low libido is often caused by psychological factors or by the body not producing enough of the hormone testosterone.

Low libido is more common in older men, or in men who drink a lot of alcohol and who are malnourished. Smoking and drugs can also play a role, as well as some medications used to treat conditions such as prostate cancer.

Stress, depression and relationship problems can also play a factor when it comes to low desire.

Men with low desire will often shy away from initiating any kind of sexual contact, and avoid the topic of sex with their partner. If they try to have sex, they might be having trouble getting or keeping an erection.

In order to treat low libido, a healthcare provider will first need to figure out what causes the problem before developing a treatment plan.This can involve psychological care or a change in medication.

Pain, bleeding, burning

Pain, bleeding, and burning are usually signs that something is wrong. It could be painful to get an erection, penetrate or ejaculate. You may notice blood around your penis, testicles or in your ejaculate. Burning most often happens after sex, when there has been too much friction.

The cause could be an STI or another infection, or a sign that you are allergic to something, such as lube or the condom. Burning can also be caused by a partner who was too dry or anal sex without sufficient lubrication.

If you experience any discomfort regularly, please have a healthcare professional rule out any serious problems. Find the cause of your problem and treat it.

Peyronie's disease

Peyronie's disease means that your penis is bent at an odd angle, making it painful to get an erection.

It can be the result of a previous injury. It is more common in men with certain medical conditions and seems to be hereditary.

Often, the condition goes away on its own after a couple of months to a few years without treatment. But sometimes injections, or even surgery, are required to take care of the symptoms.

Read more about Peyronie's disease here.

Retrograde ejaculation  

This means that, after a man ejaculates, the fluid will run into the bladder rather than leaving the penis.

This often affects men who have nerve damage due to diabetes. Sometimes, it's also caused by certain operations around the stomach.

Hey Winford, It is difficult to say how long it should last since everyone is different. Most of the time the first round is considerably shorter perhaps because the man get too exited too quickly. It maybe important to focus more on quality as opposed to how long it will take. You will find that most women prefer an intense foreplay. Talk with your partner to see what they like. Also sex does not have to come to an end because the man ejaculated, one can take this time to focus on their partner as well. Check out this article for more tips:-
Hi Steve, Delayed ejaculation is when it takes more than 30 minutes to ejculate during sex. Some of the causes can include underlying health issues or treatment one could be taking. Other times it may just be psychological issues such as stress or anxiety. If this is something that is happening to you on a regular basis you may consider seeking medical advice.
Sometimes I experience hard erections and have no problems with ejaculations either. However some other time I find it difficult to get an erection or if I get it, it's very soft for the action. What could the problem Be? During such instances I've used Viagra and it worked pretty well.
Bill, First it is normal to fail to get an erection from time to time, however if this is very frequent it could be a sign Erectile Dysfunction. Check out these articles;-
Hi Charles, this is known as premature ejaculation which is caused by Psychological including stress, anxiety or fear or physical issues. Check out this article on how to overcome it;-
Hi SirFredricq, Premature ejaculation is caused by Psychological issues including stress, anxiety or fear or physical issues. Check out this article on how to overcome it;-

Hello Mugabi, Premature ejaculation is when one ejaculates sooner than they want to, whether this happens during foreplay or after penetration. It also means that they don't have control over their ejaculation. Check out this articles;-

Hi Patrick, Penises sometimes have minds of their own meaning one can get an erection even when they don't want to have one. This can be embarrassing especially when it happens public. Best thing to do, is to try and relax, take deep breaths and soon you will loose the erection. Check out this article;-

Hi Vincent, you are experiencing premature ejaculation which means you get sexually excited too quickly leading to ejaculation. There are a few exercises you can preactice to help you gain better control and perhaps last aliitle longer. Some of the things you can do, in the short term, you can try take short breaks during intercourse, you can also apply firm pressure underneath the penis during intercourse to push blood out of the penis hence decreasing sexual tension, distract yourself by thinking about other non-sexual things or use penis desensitizers which come in the form of sprays and creams and can be applied on the penis minutes before intercourse. They help to delay ejaculation. Sometimes a condom can help reduce the sensitivity on the penis.

Onto the second part of your question, it's completely normal for men to have what is called a refractory period, where it cannot get hard right after ejaculation. Your body is just telling you that it needs some time. There is no real way to change it or make it happen less, so just try to work with your own body. If you are really hoping to have more sex, then take the time to recharge and focus on your partner. This is a good time to focus on them and give them pleasure. You will become hard again in no time and continue. 

The following articles provide more information;-

Hi Sara, what your partner is experiencing is known as Premature ejaculation, when a partner ejaculates sooner than he or his partner wishes. There are a few things your partner can do to last longer which include trying to relax during intercourse by taking short breaks and deep breaths. He can also try distract himself during intercourse to reduce the sexual excitement which help last longer. He can also consider using penis desensitizers which come in the form of sprays or creams that are applied on the penis moments before sex. It is however important that you talk with your partner about sex and present these suggestions in a way he will be willing to try them out. Remember the intention is not to focus on what he does not do but rather what can be better to improve the experience for you both. Check out this article for more tips;-

Hey Syl, most of the time understanding how ones body responds to sex and sharing this information with your partner goes along way in getting to orgasm. This is because what works with one person may not work with another. Most women will not get to orgasm from vaginal sex only, this is because the most sensitive part-the clitoris-doesn't receive sufficient attention during vaginal sex. Your partner would have to stroke it by either a finger or even by their tongue. It is important to talk to your partner let them know what feels good for you and what will get you to orgasm. Talking about sex with your partner will greatly you to orgasm. Find a good time and talk to your partner. Check out the following articles for more tips;- 

Hi Love Matters. My boyfriend has never satisfied me during sex is the problem with him or me? Now that he isn't satisfying me can I get pregnant?

Hi Lil Siz, talking about sex with your partner will go along way to make the experience better for both you and your partner. When talking about sex, you get a chance to let your partner know what you like and what and they also get the chance to let you know what they want or like. It is important you talk about this because what your partner thinks is what you like may not be what you actually want. Find a good time to talk about this, you may even have to show your partner what you want so he know exactly what it is you want. On your second concern, even if you are not satisfied you can still get pregnant if you have unprotected sex including getting infected with a Sexually Transmitted Infection (STIs), as long as your reproductive organs are healthy. Using condoms consistently and correctly will help prevent both unplanned pregnancies and STIs. Have a look at the following article for more information;-

Hey Tony, first we are not a dating service for this reason we are not able to help you meet someone. On the other hand, looking for someone who only wants to have sex maybe a challenge. Perhaps you may want to look at starting a relationship and perhaps after, when you both are ready you can talk about having sex and then have sex. You have to keep looking and once you meet someone you like, let them know and hopefully they will be willing to get into a relationship with you. If not, then you move on and meet someone new. Check the following article for more information;-

It is completely normal for men to have what is called a refractory period, where it cannot get hard after ejaculation. Honestly, your body is just telling you that it needs some time. There is no real way to change it or make it happen less, so just try to work with your body. If you are really hoping to have more sex, then take the time to recharge and focus on your partner. This is a good time to focus on them and give them pleasure. You will become hard again in no time and continue. 

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