Male Sexual Health

Male sexual dysfunction includes erectile dysfunction (ED), loss of libido (sexual desire), premature ejeculation and difficulty achieving orgasm. Conditions, such as diabetes, heart disease, neurological condition, hormonal imbalance and kidney and liver failure, and in some cases, medications for chronic illness can have an impact on sexual function.

Erection Dysfunction

Erectile dysfunction (ED), also known as impotence, is a type of sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. Erectile dysfunction can have psychological consequences as it can be tied to relationship difficulties and self-image.


Causes of impotence are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects. Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but can often be helped. In psychological impotence, there is a strong response to placebo treatment.

Ejaculation Disorders

There are different types of ejaculation disorders, including:

  • Premature ejaculation. This is ejaculation that happens before or very soon after penetration.
  • Inhibited or retarded ejaculation. This is when ejaculation is slow to occur.
  • Retrograde ejaculation. This happens when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis.


Ejaculation disorders are often due to nervousness over sexual performance. But causes are often unclear. In some cases, premature and inhibited ejaculation are caused by a lack of attraction for a partner, past traumatic events, and psychological factors, including a strict religious background that causes the person to view sex as sinful.

Certain drugs, including some antidepressants, may affect ejaculation, as can nerve damage to the spinal cord or back.

Inhibited Sexual Desire

Inhibited desire, or loss of libido, refers to a decrease in desire for, or interest in sexual activity.

Reduced libido can result from:

  • Physical or psychological factors
  • Low levels of the hormone testosterone
  • Psychological problems, such as anxiety and depression
  • Medical illnesses, such as diabetes and high blood pressure
  • Certain medications, including some antidepressants
  • Relationship difficulties.

In order to diagnose these conditions, Dr Choonara will conduct various tests. He will need to determine the cause of your condition and evaluate the extent of the problem. Depending on your symptoms, you may need to have blood tests taken in order to evaluate your hormone levels, and to check for underlying conditions like diabetes and high cholesterol.

A vascular assessment may also be necessary, as this will help to evaluate the blood flow to the penis and help determine if there is a blockage in the blood vessels. Treatment may include lifestyle changes, or medication, and uncommonly, surgery.

Speak with a Specialist Urologist

Call: (011) 482-2230

Contact us

Call Us

Our Location

Milpark Hospital, Suite 103, Guild Road, Parktown, Johannesburg