Every man, regardless of their sexual orientation, culture, religion, biases, life status or anything else can face bouts of permanent variations of sexual dysfunction. The difference is that sexual health and dysfunction issues are not discussed with homosexual males due to their hesitation to approach the subjects because of the judgment that typically follows (Nat’l LGBT). This disparity in healthcare causes many gay men to avoid seeking out help or talking about their dysfunction issues with their doctors at all (NIH).
Homosexual men are often at a higher risk for sexual health issues, sexual dysfunction issues, and mental health issues because of the more complex behaviors and risks that are shared within the community. These lifestyle choices, attitudes, values, preferences, and concerns affect all who are in the community- just as these health stats and topics do within the heterosexual community (CDC).
Our partners, who are linked in the citations below, created these lists of issues and things that commonly affect gay men and often cause sexual dysfunction issues:
- Loss of libido & desire. There are a multitude reasons a person can face the loss of libido, or desire, for intimacy and/or sex. Depression and anxiety are two of the most common triggers for this, followed closely by medical issues like cancer, illness, surgical intervention, and even gender reassignment surgeries and treatment. Facing this crisis can leave a person feeling alone, undesirable, and unable to connect with others on any intimate level. It is important to address these issues quickly and with a therapist or counselor who is comfortable working with those in the community (CDC).
- Performance anxiety. Stress about sex and intimacy can cause performance anxiety. When a person does not feel adequate, or that they can fulfill their partners’ or their own personal sexual needs, this can cause anxiety that thusly prevents intimate activity from happening in a mental, or a physical manner. Performance anxiety typically results from negative feelings such as:
- Body image
- Penis size
- Perceptions of virility
- Ideas about gender roles and definitions
- Relationship troubles
- The use of internet porn
- Financial concerns
- Family issues
- Stress at work
These issues can be addressed and dealt with by having open communication with yourself, your partner, or a therapist or doctor who knows the demands and lifestyle choices of the gay male.
- Erectile Dysfunction. Erectile dysfunction is a disorder that prevents a male from having an erection that is hard enough for penetrative intercourse. Some men may not be able to achieve any erection, and others will be able to achieve a partial erection, but not have the firmness to insert or “play” with their unit. Often, a man might experience temporary erectile dysfunction due to stress, physical issues, mental instability, or discomfort. There are many things that can cause long-term erectile dysfunction. Some are:
- cardiovascular disease
- diabetes
- cancer
- chronic illness
- autoimmune diseases
- hypertension, or high blood pressure
- high cholesterol
- obesity
- low testosterone levels or other hormone imbalances
- kidney disease
- increased age
- stress
- anxiety
- depression
- relationship problems
- certain prescription medications, such as those used to treat high blood pressure or depression
- sleep disorders
- drug use
- consuming too much alcohol
- using tobacco products
- certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS)
- damage to the pelvic area through injury or surgery
- Peyronie’s disease, which causes scar tissue to develop in the penis (NIH)
There are ways to help your body function for intimacy and sexual acts that do not require medications or harsh therapies. There are numerous holistic options, as well as therapeutic devices, designed to help restore and reintroduce intimacy when erectile dysfunction makes it feel next to impossible.
- Hypoactive sexual desire disorder. HSDD is common among all humans, and means that the person does not have thoughts, fantasies, or a need for sex. These individuals do not pick up on their partners’ sexual cues or suggestions, and often lose interest in the actual act of sex- sometimes as it is happening. This is a recognized disorder, and there are certain “treatments” and medications that might work for your situation. Some of the treatments might include:
- Kegel exercise
- Talking openly with your partner about sexual likes and dislikes
- Exploring porn that brings you feelings of wonder or pleasure
- Masturbating, self-exploration and using therapeutic devices designed for pleasure
- Reducing stress
- Limiting alcohol and stopping smoking tobacco or street drugs
- Exercise regularly
- Meeting with a counselor or therapist to find the root of the issue
If you feel that you are experiencing HSDD, contact your doctor to get a plan in place for treatment.
- Ejaculation disorders. These disorders can occur in various ways, and change frequently depending on the scenario, stress level, and even mood. For many, ejaculation issues do not cause any problems within their life or relationship. For others, it greatly affects performance and mental feelings of inadequacy. The most common forms of ejaculation disorders are early ejaculation, delayed ejaculation, and absent ejaculation (NIH).
- Delayed ejaculation. The psychological definition of delayed ejaculation refers to the inability to have an ejaculation during sexual intercourse. However, this can also be a problem in masturbatory events as well. While there are not many studies done on the “why’s” and “how’s” of delayed ejaculation, many of the same issues that cause ED are also marked with delayed ejaculation. Medications and high stress are often at the top of the list (NIH/CDC).Early ejaculation. This condition was once called, “premature ejaculation,” but medical professionals agreed that the change was necessary for a more adult approach. Early ejaculation is defined as an ejaculation that occurs before it is desired. Typically, the ejaculation has become inevitable either during foreplay or in the first moments following penetration. Despite their best efforts, the male experiences a sense of helplessness in controlling their ejaculation. A significant amount of distress from the male or their partner almost always accompanies an early ejaculation. The partner feels equally unsatisfied and frustrated (NIH/CDC).
- Absent ejaculation. Most bodily functions change with age, and sex is no exception. Men who stay healthy can expect to retain erectile function, and even fertility, throughout life. They can also expect a gradual reduction in libido, penile rigidity, the volume of the ejaculate, the number and activity of sperm, and the intensity of orgasm. Diseases of the spinal cord, surgeries, cancer, and some medications are often responsible for absent ejaculation. Although many males who have had radical prostatectomies for prostate cancer can have orgasms, although none can ejaculate because the necessary structures have been removed (NIH/CDC).
Ejaculatory problems can leave the man feeling the mental and physical toll which is why seeking help is vital to healing and forward progression. Not all medical professionals understand this issue or will take the time to get to the root cause. Ensuring that you have an inclusive, sex-positive doctor will help.
There are also more holistic ways to help with ejaculation problems like desensitizing creams, support sleeves and wearables, masturbation devices, and therapies designed to help the user get to know their bodies in a new, better-defined way for intimacy and sexual pleasure.
- Anodyspareunia. Anodyspareunia is a condition affecting males who have anal intercourse that is accompanied by severe bouts of pain and discomfort during receptive anal sex. In some cases, this pain can be linked to having inadequate amounts of lubrication, uncomfortable positioning, or mental factors. Other notes factors for males were penetration depth, force of the thrust, or lack of social comfort with their partner. Anxiety was also at the top of most study lists, although in some rare cases, actual physical issues, deformities, or abnormalities were cited to blame. If you are experiencing this sort of pain with receptive anal sex, consult your medical care professionals or reach out to a LGBTQIA+ organization that can direct you to a safe, open professional that can help guide you and help you to work through the issue, if mental (CDC/Nat’l LGBT).
Sexual dysfunction can feel like a huge hit to our everyday life, needs, and wants. It is important to recognize these issues and symptoms and deal with them as they arise. Your urologist, medical doctor, or counselor can help to match you with the right medical professionals to help your situation. If you are searching for an inclusive doctor, National LGBT Cancer Network and other LGBTQIA+ support organizations can help direct you to the right doctors in your area.
Sexual dysfunction is not an end all if you are willing to put in the work and effort to restore and take back your lost function!
Citations:
National Institute of Health and Human Services
Harvard Health
Centers for Disease Control and Prevention
National LGBT Cancer Network