Male sexual health encompasses issues such as erectile dysfunction (ED), premature ejaculation, low libido and infertility. These problems can occur at any age and may be early signs of underlying medical conditions like cardiovascular disease, diabetes or hormonal imbalances. Addressing them improves both physical wellbeing and emotional relationships.

Causes / risk factors

• Ageing and chronic conditions (diabetes, hypertension, heart disease)
• Hormonal imbalances (low testosterone) and endocrine disorders
• Stress, anxiety, depression and relationship problems
• Smoking, obesity, excessive alcohol use and sedentary lifestyle
• Nerve injuries from pelvic surgery or trauma and certain medications

Symptoms

• Difficulty achieving or maintaining an erection
• Reduced sexual desire or pleasure
• Ejaculation sooner or later than desired
• Infertility despite regular unprotected intercourse
• Emotional distress, anxiety or loss of confidence

When to seek help / emergency signs

• Persistent erectile dysfunction or inability to maintain an erection sufficient for intercourse
• Sudden onset of sexual problems after surgery or injury
• Pain during intercourse or ejaculation
• Decreased sexual desire accompanied by fatigue, weight gain or mood changes (which may indicate hormonal issues)
• Concerns about fertility or inability to conceive after a year of trying

Diagnosis

We begin with a thorough medical and sexual history, followed by a physical exam. Blood tests evaluate hormone levels, blood sugar and cholesterol. Penile Doppler ultrasound assesses blood flow. The nocturnal penile tumescence test measures erections during sleep. Semen analysis and hormonal profiles help assess infertility. Psychological evaluation may also be recommended.

Treatment options

Treatment is individualised:

• Lifestyle changes – Regular exercise, healthy diet, weight loss, smoking cessation and limiting alcohol.
• Medications – Oral medications like PDE5 inhibitors (sildenafil, tadalafil) for ED; SSRIs or topical creams for premature ejaculation; hormone replacement for low testosterone.
• Counselling and therapy – Addressing stress, relationship issues or performance anxiety through psychotherapy or sex therapy.
• Devices and procedures – Vacuum erection devices, intracavernosal injections, penile implants or corrective surgery for structural issues. For infertility, we offer hormonal treatments, varicocele repair and referral for assisted reproductive technologies.

Prevention / aftercare

Adopting a heart‑healthy lifestyle, managing chronic diseases and reducing stress can improve sexual health. We provide ongoing follow‑ups to adjust treatment, monitor hormone levels and ensure patient comfort and privacy.