Common Male Sexual Function and Dysfunction

Sex Therapy

Apr 28

In part one of our Sex Plus Symposium session with Barry, we covered what traditional sexuality looks like and how it impacts male sexuality specifically.

In part two, Barry discusses what can be helpful and not helpful during sex therapy practice with male sexual functions and dysfunctions.

Common Male Sexual Problems

Many men present a watered-down version of their sexual history with their partner present during sex or couples therapy. It’s important to share the full picture during sex therapy sessions in order to work on the full picture of the sexual dysfunction.

Ultimately, you’re responsible for your own sexuality, but sex is a team sport. Working with a sex therapist to develop a new narrative that takes in all the strengths and the vulnerabilities will in turn strengthen the sexual relationship.

Many are familiar with the common sexual problems affecting males, such as premature ejaculation and erectile dysfunction. Both of these common issues can lead to low sexual desire.

Typically, the reason men have low sexual desire is that they’re not honest with themselves or their partner about what they desire.

Many men experience embarrassment or shame. Desire comes from arousal, so it’s okay to work through the levels of subjective arousal with your partner in order to stimulate sex.

Another common issue men face sexually is ejaculatory inhibition or delayed ejaculation, which means the man’s erotic flow leading to orgasm is inhibited. In this instance, the body is telling a different story from the level of arousal.

Erectile Self-Efficacy

Erectile self-efficacy has three variables: bio-medical, psychological, and social-relational. Ask yourself, what are your qualifications for when you’ve had good sex in these areas?

For instance, bio-medically, you might want to have sex if you’ve had less than two alcoholic beverages, and psychologically, sex is something you should look forward to. Additionally, ask yourself: what allows you to feel open to arousal and erections?

Part of the treatment for these issues is working through subjective arousal stages. Orgasm is more often reached when a man feels good about himself and good about his performance.

Subjective vs. Objective Arousal

Subjective arousal — or feeling “turned on” — is mental engagement during sexual activity. This is arguably more important than objective arousal, which is characterized by physiological changes that occur in response to sexual stimuli.

It’s key to understand that sex is more than intercourse. Both men and women need to understand that good enough sex is variable and not predictable. It can include a wide variety of sexual encounters other than penetrative intercourse. Many couples only use two gears: affection or intercourse. This results in lower levels of both touch and intercourse.

In contrast, a psychosexual skill exercise used in treatment focuses on the five gears of touch. Barry details the five dimensions of touch in a previous session on overcoming gaps in sexual desire.

While the best sex is synchronous where both parties have a mutual desire, arousal, pleasure, and eroticism, this new model of sexuality also embraces asynchronous sex — or an experience that is better for one partner than the other.