Author: Dr. Albert A. S​, Senior Consultant – Urology

Introduction

In today’s fast-paced lifestyle, male sexual dysfunction and male infertility are on the rise. Experts note that these conditions contribute to increasing divorce rates and marital problems. While women in the younger generation are increasingly aware of these issues, many men tend to hide their condition and delay seeking treatment. The good news is that modern medicine offers effective treatments for both sexual dysfunction and infertility.

Common Causes of Male Sexual Dysfunction and Infertility

Several lifestyle and health factors can contribute to sexual health problems and infertility:

• Obesity
• Lack of physical activity
• Excessive junk food consumption
• Smoking and excessive alcohol
• Sedentary jobs (e.g., software and desk jobs)
• High sugar and salt intake
• Mental stress – work, family, and lifestyle pressures
• Early-onset diabetes
• Early-onset hypertension
• Dyslipidemia – imbalance in blood lipids

These factors can reduce sexual performance and fertility in men.

Sexual Dysfunction in Men

Male sexual dysfunction generally involves two main conditions:

1. Erectile Dysfunction (ED) – Difficulty Achieving or Maintaining an Erection
   

   Most common after the age of 45 years. Causes include:

   • Androgen Deficiency in Aging Male (ADAM) – reduced testosterone levels
   • Diabetes
   • Hypertension and some blood pressure medications
   • High cholesterol
   • Side effects of certain medications:
     • Antipsychotics
     • Antihypertensives
     • Some prostate medications
   • ED in younger men may be caused by:
     • Psychological factors
     ∙Sedentary lifestyle ∙Obesity and metabolic syndrome ∙Work-related stress ∙Marital or relationship stress 2. Hypogonadism A condition where testosterone levels are low or absent. Hormone supplementation may be required in cases of delayed sexual development. 3. Ejaculatory Dysfunction ∙Premature Ejaculation – early ejaculation ∙Retrograde Ejaculation – semen enters the bladder ∙Anejaculation – absence of ejaculation Though less common than ED, these conditions are treatable. Treatment Options for Erectile Dysfunction ∙Control underlying conditions such as diabetes and high cholesterol ∙Daily exercise and lifestyle modifications ∙L-arginine-rich supplements ∙Medications (under doctor supervision): oSildenafil (Viagra) oTadalafil oAvanafil ∙Penile Prosthesis Implantation for cases unresponsive to medication Male Infertility Definition: Infertility is diagnosed if a couple fails to conceive after 6 months of unprotected intercourse. The male partner should be evaluated first. Diagnostic Tests ∙Semen analysis ∙Testicular ultrasound ∙Hormonal tests: oFSH oLH oTSH oProlactin If the male partner is healthy, then the female partner can be evaluated. Treatment for Male Infertility ∙Most cases (96%) are treatable. ∙Minor surgeries, such as Varicocelectomy (Testicular Vein Ligation), may be required in some cases. ∙Lifestyle modifications and management of underlying medical conditions improve fertility outcomes.

     Prevention and Lifestyle Tips

     • Maintain a healthy weight
     • Exercise regularly
     • Eat a balanced diet rich in fruits, vegetables, and vitamins
     • Avoid smoking and limit alcohol
     • Manage stress and mental health
     • Control diabetes, hypertension, and cholesterol