Male sexual dysfunction
Erectile dysfunction, Peyronie's Disease, ejaculation disorders and low libido
Few men want to talk about their sexual problems, and many don’t seek treatment despite the relief it can bring. Duke’s men’s health specialists understand the impact sexual health has on your quality of life. Sexual problems can cause distress and negatively impact otherwise healthy relationships with your partner. If you experience erectile dysfunction, Peyronie's Disease, problems with ejaculation, low libido, or other low testosterone-related conditions, we can help. We provide medical, psychological and surgical treatment options that help you have a healthy sex life, improve your sense of well-being, and your peace of mind.
What is male sexual dysfunction?
- Erectile dysfunction (ED) is defined as being unable to get or keep an erection that is firm enough to have sex.
- Low T or testosterone deficiency is a drop in the hormone called testosterone. The condition may be associated with ED and is a common occurrence among men as you age.
- Peyronie’s Disease is a form of erectile dysfunction and refers to a build-up of collagen, plaque or scar tissue that causes the penis to bend, curve or form an hourglass deformity, which makes erection painful.
- There are three main types of ejaculation disorders:
- Premature ejaculation refers to ejaculation that occurs before or soon after penetration.
- Inhibited or delayed ejaculation means ejaculation is slow to occur.
- Retrograde ejaculation refers to semen being forced back into the bladder at orgasm, instead of leaving the body through the urethra and out the penis.
Why you should seek treatment for male sexual dysfunction
Symptoms of low testosterone include decreased sex drive, fatigue, falling asleep after dinner, memory and concentration difficulties, bone density loss and diminished work performance. A blood test is used to identify whether your symptoms are associated with low T.
These symptoms can be a sign of an underlying medical condition such as depression, sleep apnea, heart disease and diabetes. Erectile dysfunction, ejaculation disorders, and a loss of sex drive may be symptoms of these conditions as well.
As board-certified urologists, the Duke’s men’s health specialists in our nationally ranked urology program determine the extent of your sexual concerns, whether it can be treated directly, or whether it is related to an underlying cause. If one is found, we arrange timely referrals to our network of specialists in cardiology, sleep medicine, neurology, and endocrinology.
Often, sexual problems that affect men can be effectively treated with medication, psychological counseling, mechanical aids, and surgery. Whether you have ED, Peyronie's Disease, premature ejaculation or low T, we work closely with you to ensure you understand the cause of your sexual problem and how to manage it when it occurs.
Why you should choose Duke Urology
- Our expertise and experience are nationally known. Our urology program is ranked among the nation’s best by U.S. News & World Report, and our doctors are consistently recognized for their experience and expertise,
- Your treatment is personalized. We develop personalized treatment plans that take into account your age and lifestyle. Together we choose the best option for you.
- We have access to a large network of specialists. If your sexual problem is related to a medical condition, we arrange timely referrals to our network of specialists in cardiology, sleep medicine, neurology, and endocrinology.
- We offer guidance and counseling regarding sex after cancer. We work closely with cancer specialists at Duke because male sexual disorders are a common side effect of cancer treatment. Our cancer survivorship program encourages a proactive approach to managing the sexual side effects of cancer treatment. We offer counsel and guidance on the available treatment options before your treatment begins.
- We have convenient locations in Raleigh and Durham. You can make an appointment with a board-certified urologist at one of our convenient locations: Duke Urology of Raleigh, Duke Urology Men's Health Center in Raleigh, or Duke Urology in Durham.
MALE SEXUAL DYSFUNCTION
Erectile dysfunction and Peyronie's Disease
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If you do not have an underlying health problem or physical abnormality, your doctor may suggest an exercise regimen, dietary changes and relaxation techniques that can increase your interest or sexual desire. Smoking cessation is encouraged and current medications are evaluated to look for pharmacological causes of ED.
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May be recommended as the first line of treatment for people with depression or anxiety.
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Several ED medications increase blood flow to the penis. While most are pill form, some are injected directly into the penis or administrated through a suppository placed in your urethra. Medications may also be prescribed to slow the progression of Peyronie's Disease, improve erections, and decrease pain.
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The vacuum erection device is a hollow tube with a hand- or battery-powered pump that promotes erection by increasing blood flow to the penis. It may be recommended if medication is not effective.
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A safe, reliable and effective treatment for erectile dysfunction (ED) and Peyronie’s Disease. An inflatable prosthetic device inserted directly into the penis to provide an erection suitable for intercourse. This minimally invasive procedure is performed through small incisions which minimizes blood loss and recovery time. We use a minimally invasive technique through a small incision which allows quicker return to normal activity.
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Topical gels, creams, patches and injection therapy can restore testosterone to near normal levels and minimize symptoms. Testosterone implants or pellets are a relatively new delivery method. They are placed under the skin of the buttocks and release testosterone over several months. Pellet therapy offers the convenience of extended interval dosing without exposing your spouse or children to hormone therapy.
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A medication is injected into the Peyronie’s scar to straighten the penis without invasive surgery. Traction devices apply upward tension on the penis to stretch it, Over time, this reduces the curvature caused by Peyronie’s Disease.
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Straightens a penis bent by Peyronie’s Disease. Stitches gather tissue along the longer side of the penis so that it matches the short side.
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Lengthens the shorter side of the penis by removing the scar tissue and adding healthy tissue (graft). Occasionally, grafting may be combined with a penile implant.
MALE SEXUAL DYSFUNCTION
Ejaculation disorders
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Your doctor may instruct you in several behavioral changes that can help you learn to delay ejaculation during sex.
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May be recommended to help reduce performance anxiety and help you find better ways to cope with stress.
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May be recommended to reduce sensation and help delay ejaculation during sex.
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Medications that keep the bladder neck muscle closed during ejaculation may be prescribed if retrograde ejaculation results in male infertility. Other medications may be prescribed to delay ejaculation.