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Common erection problems
Erectile dysfunction
Erectile dysfunction, or ED, is the most common sex problem, and it is when you struggle to get or keep an erection.
Premature ejaculation
Premature ejaculation is when someone ejaculates too quickly during sexual activity.
Low libido
Also known as a low sex drive, low libido is when you have a lack of interest in sexual activity.
Erection problems support
Men's Sexual Function Plan
Sexual health advice
Dr James Stevenson answers questions about maintaining sexual health, problems with sexual function, and the difference between the two.
Transcript
Who are you?
So my name's James.
I've been a doctor for 15 years in London.
I've worked a lot within sexual health.
Currently I'm working for Bupa,
and I've been with Bupa for about three and a half years.
What is sexual health?
So sexual health means a lot of different things
to different people, but for doctors, it's a lot
of the diagnosis, management and treatments of infections
and other things that can be psychological
related to sexual health.
What is the difference between sexual health and sexual function?
So sexual health is more about sexual wellbeing
in relation to infections, treatment
that you may want to see a health professional about.
Sexual function is normally talking about
the act of intercourse,
if you're having any issues with getting
or maintaining erections, achieving orgasm,
and those sorts of things relating to the act of sex itself.
How can I look after my sexual health?
Looking after anyone's sexual
health is really, really important.
Getting regularly tested. In big urban areas in the UK,
it is really important that everybody, regardless
of relationship status, gets tested at least annually for
general sexually transmitted infections,
if you do have multiple partners, it's normally recommended
to get tested every three months or so,
and obviously, if anything is picked up to inform any
of your partners and take treatment as directed by a doctor
or healthcare professional.
How can sexual health impact fertility in men?
In men, it is really, really important
to get regularly tested
because untreated sexually transmitted infections can
long-term affect fertility.
What is sexual function?
Sexual function is a phrase used to describe a healthy
and fulfilling sex life.
If you have any issues with this, though,
it can sometimes translate into issues with getting
and maintaining erections and difficulty achieving orgasm
or even premature ejaculation.
What factors can affect sexual health for men?
There are several factors that can affect
sexual health for men.
Unprotected intercourse with multiple partners is one,
and it's really, really important in these cases
to get regularly tested. Other factors, so
using condoms, so that really reduces your risk
for sexually transmitted infections.
So it is really important, again, to use condoms for
any type of sex you are having.
What factors can affect sexual function for men?
So sexual function is really multifactorial.
There are so many aspects of men
and people that can affect sexual function.
One of the commonest things would be smoking, alcohol,
any drugs, they can all affect sexual function.
Again, it's linked to a lot of psychological issues.
So stress, any anxiety, depression,
anything like that can also affect
sexual function quite significantly.
What are some common problems with sexual function?
Some of the commonest problems
with sexual function would be difficulty maintaining
and getting an erection, loss of libido, so that's a loss
of sexual desire, premature ejaculation,
and also difficulty achieving orgasm.
A lot of these problems are really, really common
and they can sometimes be linked
to other underlying disorders.
So it's really, really important
for any man experiencing any of these issues to speak
to a professional about them so they can manage it
or rule out any other issue that might be going on.
What is erectile dysfunction and what causes it?
Erectile dysfunction is an issue
that many men will have over the course of their life about
getting and maintaining an erection.
For us as doctors, thinking about the reasons
behind it is often to do with the blood flow to the penis,
and any reduction in that can cause erectile dysfunction.
So it can often be an early sign
of cardiovascular disease, so it's important
to see a doctor about that, so that could be prevented.
It can sometimes show diabetes, for example.
It is also linked to psychological
and psychosocial factors, so any changes in your mood,
for example, can indicate
or can manifest in erectile dysfunction.
It's often linked to medications you might be on,
or alcohol, smoking, and other lifestyle factors as well.
So it's really, really important to
see a healthcare professional
if you are experiencing any issues
with erectile dysfunction.
What options are available for someone experiencing symptoms of erectile dysfunction?
So there are several options out there
for people experiencing erectile dysfunction.
The first, and something you can do at home is
ensuring you're having a healthy lifestyle.
So eating healthily, cutting back on alcohol,
if you drink alcohol, stopping smoking are the main things.
Otherwise, there are medications
which are often available over the counter.
People have often heard of things like Viagra,
but there are other kind
of similar drugs that do the same thing.
So speak
to a healthcare professional about these
if you are interested.
There are other methods too.
So you can get penile pumps, which are used
before intercourse to help improve the blood flow as well.
And there are even injections
that healthcare professionals can give in special cases.
What is premature ejaculation and what causes it?
Premature ejaculation is one of the commonest issues
that men have with sexual function,
and it is the early ejaculation through stimulation.
Bear in mind however, that most men will last from on
average four to seven minutes of stimulation
before ejaculation.
So a lot
of men do come into clinic thinking they have premature
ejaculation, but actually when they last maybe five minutes,
but actually that can be quite normal as well.
The causes, so increased sensitivity
to the area can cause premature ejaculation, as well
as psychological issues that are similar for a lot
of issues within the umbrella of sexual
function. Reassuringly,
however, there is a treatment available,
which is in tablet form that men can take to
counteract premature ejaculation.
But you would need to speak to your healthcare professional
about this if you were interested.
What is low libido and what causes it?
Low libido is a really, really common issue,
and most men will experience it at some point in their life.
It can be caused by anything that life throws at you.
It could be stress, so it could be work, low mood,
kind of changes in your exercise routine, changes to diet
if you're started on any new medication.
Alcohol is a big one. Smoking and drugs as well.
Is sexual dysfunction linked to age?
Yes, a lot of sexual dysfunction is linked to age, so
if you're more advanced in life, then you are more likely
to experience erectile dysfunction, a loss of libido,
and there's lots of causes for this.
Many older men might experience issues with prostate,
which is also linked to sexual dysfunction.
However, this really doesn't mean that if you were younger,
you will not experience sexual dysfunction.
So premature ejaculation and erectile issues
and libido are really common as well in younger age groups.
So it is really important whatever age you are,
if you are experiencing any issues with your sex life
or sexual function, to speak
to a healthcare professional about it.
How can men's mental health impact their sexual function?
Sexual function and mental health are significantly
interlinked. It's really, really important
that if you are having any issues with your mental health,
you do see a healthcare professional
because any major life change, so like moving house, going
through a relationship change, anything else that can cause
depression, low mood, burnout, anxiety,
they're all linked very strongly
to changes in sexual function.
So that can often be linked in the way we
diagnose depression is often a question we would ask is,
have you had loss of libido?
Are your energy levels down
and do you have any sexual function issues?
So it's really important if you do experience any of them
to speak to a healthcare professional
and we can often signpost you to talking therapies
and other support networks as well.
I'd also say that it's really important to try
and improve lifestyle.
So exercise is really good at preventing mental health
issues and speaking to your friends
and your mates down the pub
or playing a sport or something like that.
And opening up often can lift those burdens
of day-to-day life, which then will have a knock on effect
of improving your sexual function.
My sexual function may be having an impact on my mental health. Should I seek help?
So personally and as a doctor, I would say that as soon
as you start worrying
that your sexual function is infecting your mental
health, speak to someone.
And that could be a friend, it could be a colleague,
but it could also be a professional.
So that could be someone from talking therapies
or a doctor such as myself.
And that really is just to try
and reduce the impact of this on your day-to-day life.
I would certainly say if it's been going on for
certainly a good few weeks
or months, then I would definitely speak
to someone about it in a professional status.
I struggle to reach out for support with my sexual function. What can I do?
So I'm speaking to you as a doctor and as a man really,
and it's really difficult to reach out
and take that very, very first step. Speak to a friend,
a colleague, or even I know some people have spoken
to their pets, so their dog
or another animal as that first step just to kind
of get over that barrier of saying those first words
that you might be struggling or having an issue.
And it's just that first step
that can be the most difficult.
If you're not comfortable speaking to someone you know,
then really remember that any conversation you have
with a healthcare professional will be treated
as confidential and won't go any further.
So do make an appointment with your GP
or other healthcare professional to take
that very first step.
What kind of support is out there for a man and his sexual function?
So any healthcare professional is there
to listen and support.
So if you do want to reach out to a healthcare professional,
then you will have the time to feel supported, listened to,
and we may come up with a management plan about how
to move forward with things, which hopefully you would leave
that appointment assessment
feeling a little bit lighter on your shoulders,
and that there is a light at that end of the tunnel.
How do I maintain good sexual health?
It's really important to maintain good sexual health
and wellbeing, and it's something
that is available across the whole of the UK,
and that's in both the public and the private sector.
So regardless of where you live and accessibility really,
and it's really to make sure you test regularly.
So everyone who lives in a kind
of large urban area would be recommended to have a
sexual health test at least annually,
even if you're in a long-term relationship.
And that would be more frequently if you have symptoms
or if you have more than one sexual partner. Condoms,
or barrier contraception, as we often call it as doctors are
also integral in maintaining good sexual health.
How do I get help for problems with sexual function?
So sexual function such as erectile dysfunction, loss
of libido, premature ejaculation,
difficulty achieving orgasm, can be sought
by speaking to a healthcare professional, such as your GP.
So just make an appointment to speak to them today.
What are some of the common treatments for problems with sexual function?
There are lots of treatments available for issues
with sexual function, and it really depends on the cause.
The first treatment, and it probably covers most issues
with sexual function, is lifestyle.
So reduce your alcohol intake, don't smoke or vape,
and don't take illicit drugs as well.
And improving all of those as well as regular exercise
and a healthy diet will improve sexual function.
If you go see a doctor or another healthcare professional,
they may prescribe medications,
so there's different medications available
for different aspects of issues with sexual function,
and then there's psychological therapy.
So talking therapies
and psychosexual therapy can also help massively
with issues with sexual function.
How can I ask for help or speak to a GP about a problem if I feel embarrassed?
Now all of us feel embarrassed at some point in our lives.
I've certainly been to see a doctor
and worried about an examination
that may or may not happen.
Just remember that you are in control.
If you don't want to be examined, tell your doctor
and they may explore the reasons behind that.
And there may be some topics you are feeling really
embarrassed about talking about.
But remember with doctors
and other healthcare professionals,
everything is confidential.
It won't leave that room.
So just make that small step.
If you don't want to say it out loud,
write it down on a piece of paper or on your phone
and show it to them sort of thing, which
may break down a few
of those worrisome barriers that you might have.
But above all, if you are worried about something,
it's really important to speak to someone.
So do take that step to go to the doctor.
And even if you leave that consultation,
you haven't actually said the embarrassing
thing, you've made that step.
And maybe make an appointment
for a week's time when you're feeling a bit more ready.
But do just make that appointment
with a healthcare professional so you can speak
to someone about the issue you're experiencing.
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Inside Health: erectile dysfunction
Find out what causes erectile dysfunction, from health issues to lifestyle factors. Plus, our advice on what you can do to help.
So, erectile dysfunction simply means struggling to get or maintain an erection, and it's a really common condition.
In fact, it's thought to affect up to 48% of men in the UK during their lives.
There are several things that can cause erectile dysfunction, and this can include problems with blood flow to the penis.
So, for example, problems such as high blood pressure or diabetes.
Men may have certain surgeries to their pelvis which can cause erectile dysfunction as a side effect.
There are certain lifestyle factors that can cause or increase your risk of developing erectile dysfunction, such as being overweight, smoking, or drinking heavily.
It can also be linked to mental health, so depression, anxiety, and even poor sleep.
In some men, it can be linked to low testosterone levels.
So, around 2% of men age 40 to 70 and 5% of men age 70 to 79 may have low testosterone levels, which are linked.
Here are my top tips to help you manage this condition.
Lifestyle factors.
If you're overweight, losing some weight, eating a diet that is low in saturated fat, taking regular exercise, and reducing your alcohol intake.
If you're a smoker, now's a really good time to start thinking about how you might stop smoking.
Partner up with your partner.
Talking about erectile dysfunction can be really difficult, and it can have a significant impact both on self-confidence and your relationships, so it's a really good time to start thinking about being open and honest and having those conversations with your partner.
Speak to your GP.
They may want to ask you some more questions to ascertain if there could be a physical cause for your symptoms, in particular, thinking about cardiovascular issues, diabetes, high blood pressure, and hormone problems.
They may be able to recommend some treatments that they can prescribe.
For some men, talking to your pharmacist may be helpful.
There are certain medications that you can get over the counter that can help improve the blood flow to the penis.
The most important thing is not to suffer in silence.
Erectile dysfunction is a really common problem.
There's lots that can be done to help support you.
Inside Health: prostate health and getting checked out
Getting your prostate checked doesn’t need to be scary or painful. Here’s what you need to know about looking after yours.
Tim, so we got some pre-submitted questions that we're going to get our way through and here comes our first question.
Is it an older mans disease (light music) Kinda depends on how you define old.
I would say it's definitely an older man's disease.
Yeah, it's pretty uncommon under the age of 50.
Once you get to 55, the instance goes up quite steeply.
Once you're into your 70s, it's pretty common.
So, it's definitely an older man's disease.
Not unheard of if you're a younger man.
If you're 40 and you've got symptoms it might be related to your prostate gland.
Go get 'em checked out.
Pred examination shouldnt be painful (light music) Prostate examination shouldn't be painful.
It's an inter examination, so yeah, it's embarrassing for some men.
Totally get that.
You wouldn't choose to have it done.
It doesn't last long.
It's possibly a little bit uncomfortable.
There may be reasons why you could have pain if you've got other issues down there like piles, haemorrhoids, that sort of thing.
Speak to the doctor beforehand.
There's stuff they can do to get rid of that, but it really shouldn't be a painful examination.
What they're looking for is have you got a prostate gland that's the right size for your age?
Is it bigger than you'd expect?
Does it feel normal?
A prostate gland's normally quite soft like most body tissues.
Are there any lumps in it?
Is it painful?
All of those things can guide the conversation about what you need to do next and what the possible problems are.
(light music) What is PSA First of all, let's be clear, what is PSA?
PSA, prostate specific antigen, or in other words, a chemical that your prostate gland produces and it produces it all of the time.
Obviously, if your prostate gland's bigger than normal, it will produce more PSA.
If you've got cancer, cancer is rapidly growing cells so you'll produce even more PSA.
So yes, if you've got prostate cancer, your PSA may well be high, but actually in one in seven men with prostate cancer, it isn't.
So, it's not an accurate tool on its own for diagnosing prostate cancer.
Okay, so don't do what I almost did last year where I went online.
You can buy these PSA checkers for about 20 or 25 pounds.
That information is inaccurate.
We're trying to reroute everyone's either pick up the phone to beep up your GP, or even better still, go and see them.
Yeah, absolutely.
(light music) Genetics Undoubtedly there's a genetic element to it, but not 100%.
For example, certain ethnic groups, black men, definitely there's a higher risk of prostate cancer in black men, between two and four times the risk of a white men.
But for Asian men, the risk is actually lower than it is for white men and we don't know what's behind that.
But the assumption is it must be something genetic.
There are some very rare types of prostate cancer that are linked to certain genes, but really they're very uncommon.
So yeah, it can run in families to a degree, but there's no absolutely solid genetic link to it.
I guess if there's someone in your family that has suffered from it, it will heighten your awareness to it so you're more likely to go and get checked.
But what we're saying is if it hasn't been in your family, that doesn't mean that you are free from potential prostate cancer.
Absolutely.
And the fact that it has been in your family doesn't mean you're definitely gonna get it either.
(light music)
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My anxiety story by Joshua Fletcher
Anxiety expert and best-selling author, Joshua Fletcher, talks about his personal experience of anxiety. Plus, shares tips for managing anxiety and explores why speaking up about men’s mental health matters.
Anxiety in men
Joshua Fletcher, psychotherapist and author, opens up about his own personal journey with anxiety.
By sharing his firsthand experiences, Joshua aims to inspire other men to break the silence and seek support for their mental health struggles.
I'm Joshua Fletcher, and I'm a psychotherapist, an author who specialises in anxiety.
I think the reason why some people withhold their emotions, this applies to men and women, but mostly in men, in my opinion, is this whole concept of emotional conservatism.
We're emotionally conservative when we revere the hiding of our emotions.
I used to do this when I was younger.
So as of recent, the Mental Health Foundation reported that 30% of men have reported high levels of anxiety.
I'm no stranger to anxiety.
I became a therapist because I struggled a lot with anxiety, in my young 20s.
I was diagnosed with panic disorder, which is having lots of panic attacks and building my life around trying not to have them.
I was diagnosed with obsessive compulsive disorder, which doesn't mean I'm tidy.
It means I struggle with intrusive thoughts and compulsions that were really debilitating.
Understanding what type of anxiety you have is really important, in my opinion, to to be able to address it and having that self-compassion and to be open and vulnerable and willing to talk about it is a great first step.
With or without insurance, we can help you
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If you don’t have health insurance with us
No problem. We can still help you on a pay-as-you-go basis. Just pay for the treatment you need when you need it.
Children aged between 1 and 18 can have a remote or face-to-face GP appointment. To book, call 0800 665 577^.
Are you struggling with your mental health?
You’re not alone. There’s always someone to listen, day or night. You can call 116 123 to speak to the Samaritans.
If you or someone you know is feeling suicidal or has seriously harmed themselves, call 999.
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