A large percentage of men with erectile dysfunction (ED) also suffer from other sexual problems that can't be treated with drugs, a new study says. The results show 65 percent of men with ED are unable to have an orgasm, and 58 percent have problems with ejaculation. Approximately 30 million American men, or half of all men ages 40 to 70, have ED, or trouble achieving or sustaining an erection, the researchers said. While medications may help some men maintain an erection, "our research suggests there are other common sexual issues that remain largely unaddressed," said Dr. Darius Paduch, a urologist at New York-Presbyterian Hospital. "We must expand the definition of quality of life when it comes to sexual performance," Paduch said. "For the last few decades, we have focused on penile rigidity, with erection as a synonym of normal sexual function. However, many patients say that problems with ejaculation — like decreased force or volume or decreased sensation of orgasm — are just as critical." The results are published Tuesday (Aug. 23) in the British Journal of Urology International. Sexual problems Paduch and his colleagues analyzed questionnaires from more than 12,000 men with mild to moderate erectile dysfunction enrolled in clinical trials of an erection drug. Men with more severe ED were also more likely to have more severe ejaculation and orgasm problems, Paduch said. However, such problems also occurred in men with very mild ED. Orgasm dysfunction was reported by 26 percent of this group, and ejaculation dysfunction by 18 percent. "This suggests that nonerectile sexual dysfunction is a regular occurrence even in men without ED," Paduch said. The most common ejaculation problem is premature ejaculation, but other problems include delayed ejaculation, inability to ejaculate and painful ejaculation. Orgasm dysfunction is defined as absence of an orgasm. Better treatments The finding "makes sense," said Dr. Andrew Kramer, a urologist at the University of Maryland Medical Center, because erectile dysfunction is known to occur along with other sexual problems. In fact, men likely underreport these other sexual problems, so the actual percentage of men who suffer from them may be higher, said Kramer, who was not involved with the new study. He estimated that in men over 50 in the general population, 30 to 40 percent may experience orgasm and ejaculatory problems. Even if men do tell their doctors they have other sexual problems, there's often very little doctors can do to help them. "You end up treating the ED, but you really have nothing for the ejaculatory issues," Kramer said. Conditions such as orgasm and ejaculation problems are physiologically complicated to treat, Kramer said, noting that Viagra, the first well-known ED drug, was discovered on accident (it was originally made to treat high blood pressure). "I don’t think we're going to get a lucky drug that just happens to give men good orgasms," Kramer said. Paduch said he plans to conduct studies to test whether testosterone-replacement therapy could help men who have sex problems beyond erectile dysfunction. The study was supported by a grant from Eli Lilly and Company, which markets the ED drug Cialis. Some of the study's authors are paid investigators and/or consultants, advisers, or speakers for Eli Lilly. Pass it on: Sexual problems besides erectile dysfunction may be common in men.
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