Raising awareness of Sexual Health in men

Sexual Health in men- it might not be sexy, but it’s important

November is men’s health month and we’re raising awareness for a variety of male health issues. When it comes to health, men are notoriously bad at seeking help, especially for mental health. Breaking down stigmas and demystifying men’s health conditions is crucial to encourage men to speak out.¹ This is equally true for men’s sexual health, which we will be exploring in this article.

What is sexual health in men?

Sex is undeniably a large part of life and plays a role for every person; if nothing else the very reason you are here today is because of sexual reproduction. Beyond the scientific and reproductive side of sex, however, it’s something that gives pleasure and brings people closer together, with sexual thoughts being a regular occurrence for most people.

A popular urban myth is that men think about sex every seven seconds, though research has found evidence giving credence to the notion that thoughts about sex are particularly common in men with sex playing an important role in men's lives. However, sex can also be impacted and hampered by various sex-related health problems in men. ²

According to the Harvard Medical School, men’s sexual health refers to a ‘’state of well-being that lets a man fully participate in and enjoy sexual activity. A range of physical, psychological, interpersonal, and social factors influence a man's sexual health.’’³ This implies that sexual health stretches far beyond simply illness and sexually transmitted diseases. For example, libido forms a crucial part of sexual health as, without it, there would be no drive to engage in sexual activity and the enjoyment of doing so would vanish.  And yet, low libido is one of many serious sexual issues for many men. Others more common than you may think, include erectile dysfunction (ED) and premature ejaculation.  

While these sexual health issues may not seem harmful in the same way as other conditions, issues like ED can present a serious burden for men. Firstly, the inability to get or maintain an erection can lead to mental health disorders and can cause considerable distress among men, such as feelings of depression and lack of self-worth.⁴ It can also be a sign of something sinister below the surface, such as early-stage heart disease. Sexual health is clearly something that ought to be taken very seriously in men, and yet, is often underdiagnosed. Why?

Sexual health issues are often underdiagnosed in men

Hypogonadism, commonly referred to as testosterone deficiency, is the root cause for many troubles surrounding male sexual health, including:⁵

• ED
• Low libido

• Incomplete sexual development  
• Low fertility
• Small testes

Hypogonadism is becoming more prevalent as populations in developed countries become more aged and co-morbid, though it hasn’t always been well-diagnosed. Treatment options include testosterone replacement therapy, but to justify treatment doctors need to identify both symptoms of hypogonadism as well as evidence of low levels of testosterone.

Cut-off values for serum testosterone have varied throughout the years and borderline cases have suffered from being undiagnosed as a result. However, there are now guidelines in place to define low testosterone levels with indications for treatment that should help with diagnosis.⁵

Learn more about hypogonadism here

Arguably the most common reason for the underdiagnosis of sexual health issues in men is the lack of support-seeking behaviours from men. Men with ED often find it hard to seek help as they perceive the condition to be embarrassing and even hesitate to ask for treatment when in front of a specialist.^6,7

The reality is that ED is far more common than people think and should not be a source of embarrassment, though attitudes of doctors have not helped in the past with evidence of younger men being dismissed without a medical exam for ED based on the assumption that it is a ‘self-limiting’ condition- a perception that is gradually changing in the healthcare community, but there’s still a way to go.⁸

Interested in learning more about Erectile Dysfunction?  

So, when is it time to see a doctor?

By checking out for signs of potential sexual health problems yourself, you could catch onto any issues before they are found at routine check-ups later on. Initial signs that something may be wrong can be evident without the need for any specialist knowledge, so look out for:⁹

• lack of interest in sex
• pain or difficulty in experiencing penetrative sex

• being unable to get or keep an erection
• premature ejaculation (ejaculating too soon)
• loss of desire
• difficulty in reaching orgasm

Taking premature ejaculation as an example, physical problems with the prostate and the thyroid could be one potential cause, which you can only learn more about after a consultation with a specialist.¹⁰ But that isn’t to say you shouldn’t continue to seek professional help if the problem isn’t physical. Psychological factors such as depression, stress, relationship issues or anxiety about sexual performance can also be behind problems like premature ejaculation and ED and couples’ therapy or certain medications can help the situation.¹⁰

Sexual health in men is something altogether important and should be monitored. By learning how to identify sexual health problems early, men can seek the required help. Worries about sexual health are common and men and should be able to voice concerns without feelings of embarrassment or shame.

If you have any concerns regarding your sexual health, speak to your healthcare professional to receive a professional diagnosis.

Take-home points:

• Male sexual health extends beyond sexually transmitted diseases, it also entails fully participating in and enjoying sexual activities
• Sexual health issues in men, which include low libido and ED, are commonly underdiagnosed in men
• You can look out for early signs that something may be wrong without medical knowledge
• However, if you are unsure about anything, we would encourage you to speak to your healthcare professional without delay

References

1. Chatmon, B. N. American Journal of Men’s Health 2020 14:1557988320949322.
2. Fisher T. D., et al. The Journal of Sex Research 2012;49(1):69-77.
3. Men’s Sexual Health. Harvard Health Publishing https://www.health.harvard.edu/topics/mens-sexual-health#:~:text=Sexual%20health%20refers%20to%20a,influence%20a%20man's%20sexual%20health.
4. Tomlinson J, Wright D. BMJ 2004;328(7447):1037.
5. Muneer A. Trends in Urology, Gynacology & Sexual Health 2010;15(2):14-17.
6. Carson C. C. Rev Urol 2002;4 Suppl 3(Suppl 3):S2-8.
7. Hoesl C. E., et al. Eur Urol 2005;47(4):511-7.
8. Rastrelli G, Maggi M. Transl Androl Urol 2017;6(1):79-90.
9. Sexual Wellbeing. Royal Free London NHS https://www.royalfree.nhs.uk/services/services-a-z/sexual-health-services/advice-on-sexual-health/.
10. Ejaculation Problems. NHS https://www.nhs.uk/conditions/ejaculation-problems/.

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