Cedars-Sinai Blog

Psychology of Men's Sexual Health

Throughout human history, men have tried to improve their sexual health through food, herbs, or medicinal means.

From ancient aphrodisiacs to modern pumps and pills, treatments for men's sexual dysfunction has centered around chemical or anatomical enhancements while paying less attention to psychological and emotional factors.

But researchers at Cedars-Sinai are focusing on the psychosocial factors that contribute to men's sexual dysfunction.

Pills may not be the solution.

"Relying on the use of pills such as Viagra and Cialis can lead couples to ignore the problems in their relationship that may be contributing to men's sexual dysfunction," says Dr. Waguih William IsHak, professor of psychiatry at Cedars-Sinai.

"Whenever we approach a male patient with a sexual issue, the first step is to rule out the effect of medical conditions and substances such as drugs, alcohol, and medications," says Dr. IsHak. "Then our next step is to evaluate the couple's romantic relationship."

There are many factors that could lead to erectile dysfunction that may not be solved by a pill.

Dr. IsHak and his colleagues have been focusing on the psychosocial factors of the two most common sexual disorders among men—premature ejaculation and erectile dysfunction—and how enhancing the couple's romantic health can help.

Premature ejaculation and anxiety

"Premature ejaculation is the most common male sexual disorder," says Dr. IsHak. It's also the easiest to treat.

"The problem is that some men don't address it and it ends up complicating relationships."

Premature ejaculation is defined as reaching ejaculation within one minute of penetration. Dr. IsHak says there are a number of psychosocial factors that can lead to premature ejaculation—many linked to anxiety.

Money troubles, job stress, and relationship problems can all contribute to premature ejaculation. To complicate things even more, anxiety can be both a cause and an effect.

Fortunately, premature ejaculation can be addressed by focusing the attention on the couple's interactions, not some perceived failing by the man.

"We advise couples to try natural methods such as the start-stop technique," says Dr. IsHak.

"The partner gets the man aroused and stops when the man is close to ejaculation, and the cycle starts over again. Commitment and communication are key."

Erectile dysfunction and depression

Dr. IsHak says there are many factors that could lead to erectile dysfunction that may not be solved by a pill.

Relationship conflicts, lack of libido, and inadequate sexual stimulation (foreplay) are the leading contributors to erectile dysfunction. Depression and antidepressants taken over time can lead to a lack of sexual desire in men, as can use of recreational drugs and opiates.

Pornography addiction and its link to excessive masturbation can also zap male libido.

Pills such as Viagra and Cialis cannot solve a lack of sexual desire. Making lifestyle changes and strengthening the health of a man's romantic relationship can help address the underlying issues.

"Erectile dysfunction is emotionally loaded because it's connected to how men perceive their self-esteem," says Dr. IsHak. "Having a supportive partner is crucial."