Dr Charmaine Saunders takes a look at some of the causes of sexual dysfunction in men

We tend to think that because sex is a natural activity – and it is – that it should happen perfectly every time. But males in particular can experience problems in performance that may create tension and anxiety for themselves and their partners. It’s a myth that guys can just turn on at any time and have sex successfully no matter how they feel or who they’re with. We’re not machines, male or female, thus we can all have bad days when libido is down, orgasm is elusive and we feel generally deflated by the sexual experience.

Obviously male and female sexuality is very different, the first being more overt and therefore, more accessible. Nevertheless, men can feel unsexual as much as women. On top of this, men have the additional pressure of being expected to perform regardless.

Male dysfunction usually takes the form of the loss of erectile function or impotence, and premature ejaculation, commonly known as PE. Loss of libido and lack of orgasm are less common.


Any man can experience impotence at any age. As an occasional occurrence, it is not of importance but when chronic, professional advice should be sought. It’s best to first consult a GP who will then refer the patient to a specialist if deemed necessary. There are three main causes for this condition – physical, emotional and hormonal.


At a physical level impotence may be the result of many factors, including medical conditions, medication, physical injuries, drug abuse, stress, fatigue, heart conditions and ageing.
It’s a well-known fact that alcohol affects potence and staying power as well, so for more enjoyable
sex sessions drink less beer and more water!


Inability to perform may be the result of emotional factors including difficult past relationships; fear of rejection; anxiety; poor performance and technique; and inability to relate sexually. These need to be addressed by a psychological therapist.


The easiest one to understand and fix. A simple blood test will reveal if hormone levels are too low and treatment is required.

One other possible cause for impotence is something called ‘distraction.’ This happens when a man is so stressed or tired or preoccupied elsewhere that he’s `distracted’ from sexual activity; put plainly, his mind is not on the job! His body will follow suit and fail to perform. They say that the mind is the most important sex organ. If that’s true, then without focus, there can be no fulfilment in any sexual encounter.


This is a very common condition and many men just suffer in silence. It stems from early masturbation usually starting at puberty then is reinforced during the first sexual experiences that are generally over very quickly. This may stem from over-eagerness or an earlier fear of being caught.

By the time a man gets married or seriously involved, his habit of reaching climax too quickly is already entrenched. Obviously, this is not very satisfying for his female partner even if he’s prepared to expend energy on foreplay or manually bringing her to orgasm. It’s not the same as sustained intercourse which promotes intimacy and mutual pleasure.

As always, owning the problem is the beginning of fixing it. A medical doctor is the first person to consult, simply to rule out any physical causes. PE is less likely to be caused by psychological problems and is more about an over-eager trigger plus it’s usually more chronic where impotence is spasmodic. So, the solution needs to be more practical. Here are some techniques that help:

  • Whilst PE can be handled by an individual, having the support and practical help of a loving partner can be an invaluable tool. From the woman’s point of view, the most important way to help is never to ridicule or pressure, no matter how frustrating the problem gets.
  • Patience is key. You must make sure you get your needs met too but this can be done in a gentle, undemanding way. Performance anxiety is very real and increases any dysfunction many times over.
  • Anxiety in general is a major factor. The sufferer needs to practise relaxation techniques in order to approach sex in a more measured and calm fashion. Deep-breathing, yoga, meditation and light exercise can all help as does a balanced lifestyle, less stress, general fitness and a healthy diet.

Male sexual dysfunction doesn’t only affect men; it damages relationships and hurts the female partners as well. But with more enlightened awareness and practical knowledge and application, it can be significantly reduced. If its onset occurs later in life, it might be able to be traced to a particular incident that brought it on. If it’s chronic, the problem probably stems from past conditioning. Ignoring it will not make it go away; if anything, it will increase the problem. Acknowledge that there’s an issue, identify the cause and try the various solutions until one or more is found to work. Sexual dysfunction does not have to rule a man or woman’s life. With patience and love, it can be overcome.

  • Having more sex – this takes away the over-excitement.
  • Sex without emotional involvement – this reduces the passion as well.
  • Varying the position – female on top helps as he can move less, thus recuding the trigger effect.
  • Spontaneous sex – if he doesn’t have time to think about it, it’s often more sustainable.
  • Positive attitude – anxiety about PE will actually bring it on.
  • Squeeze technique – this involves squeezing the tip of the penis just at the moment of climax to prevent ejaculation. This has to be repeated several times before orgasm is finally allowed. It sounds harsh but is very effective in retraining the body to take it slower.

Another similar technique is the stop-start which involves the same idea but during intercourse itself. When the man thinks he will climax, he pulls out, waits until he gets hard again then resumes. Again, this has to be repeated a number of times in order to work.

  • Masturbating before sex – this might sound odd, but it actually works as it removes the sense of urgency.

If a man relieves himself initially on his own or with his partner, he can then take a more leisurely approach and make love slowly, with more sensuality, and of course, not feel the need to climax immediately.