Male Sexual Health

Male Sexual Dysfunction
男性性功能障礙

1. Premature Ejaculation

  1. Definition: Premature ejaculation (PE) is the most common male sexual dysfunction. DSM-5 revised the diagnostic criteria for premature ejaculation as “ejaculate within 1 minute before orgasm when sexual intercourse begins, this symptom lasts for more than six months and causes troubles and frustrations for personal sex life or communication difficulties with partners.
    定義:
    早洩(Premature ejaculation,簡稱:PE)是最常見的男性性功能障礙,DSM-5將早洩診斷標準修訂為「當插入性活動開始,尚未想射狀況下大約1分鐘內便射精」稱為早洩,且此症狀持續六個月以上,並造成個人性生活困擾與挫折或與伴侶之間溝通障礙等現象。

  2. Cause:
    Psychogenic: Psychological stress causes anxiety, what you want to perform is even worse.

    Organic: The penis is too sensitive or the ejaculatory reflex is over excited.
    病因:
    心因性:心理壓力造成焦慮,想表現的好反而更表現的不好。
    器質性:陰莖過度敏感或射精神經反射太過興奮。

  3. Treatment:
    Drugs:
    Take Priligy as oral medication , apply anesthetic for local anesthesia.
    Surgery: Dorsal penile nerve block.
    Sexual happiness self-aid method: Observe the sensitive parts through the instrument and give desensitization therapy.
    治療:
    藥物:口服為必力勁、外擦以麻藥使得局部麻醉。
    手術:陰莖背神經阻斷術。
    性福自助法:透過儀器觀察敏感部位,給予脫敏療法。

  4. Explanatory video:

2. Erectile Dysfunction

  1. Definition: Impotence or Erectile Dysfunction (abbreviation: ED) In the case of sexual desire, failed to erect or achieve hard erection to enter the vagina subject to sexual stimulation, resulting in incomplete sexual intercourse.
    定義:
    陽痿或陽痿(Erectile Dysfunction。簡稱:ED)在有性慾的情況下,受到性的刺激未能順利的勃起或勃起後無法達到進入陰道的硬度,導致不能完全性交。

  2. Cause:
    Psychogenic: Sudden, temporary, unpredictable, tension relationship with sexual partners, anxiety of penis insertion, work stress, and etc.
    Organic: Hormonal imbalance, drug-induced, aging, systemic diseases, and etc.
    Mixed: Both psychogenic and organic occur at the same time, which is currently more common.
    病因:
    心因性:突發、短暫、時好時壞,與性伴侶關係緊張、陰莖插入焦慮、工作壓力等。
    器質性:荷爾蒙夫調、藥物引起、衰老、全身性疾病等。
    混合性:心因性與器質性二者同時發生,也是目前較為常見的。

  3. Treatment:
    Drugs: Oral medication like Viagra, Cialis, Levitra and etc.
    Surgery: Artificial penile implantation and penile vascular reconstruction.
    Sexual happiness self-aid method: Learn about erectile status through instrument detection, use aid to promote blood circulation of corpus cavernosum.
    治療:
    藥物:口服為威而鋼、犀利士、樂威壯等。
    手術:人工陰莖植入術與陰莖血管重建術。
    性福自助法:透過儀器檢測了解勃起狀態,給予輔助器促進海綿體的血液循環。

3. Ejaculation Disorders

  1. Definition: Refers to the ejaculation time and ejaculation dysfunction, which can be divided into retarded ejaculation, premature ejaculation, anejaculation, retrograde ejaculation.
    定義:
    是指射精時間及射精能力障礙,可分為延遲射精、早發性射精、無射精、逆行性射精。

  2. Cause:
    (1) Retarded ejaculation (abbreviated as RE): Can be classified as psychological, such as lack of concentration, emotional disturbance, work stress, and etc. as well as physiological such as sympathetic nerve damage, multiple sclerosis, pelvic surgery, diabetes pathology, antidepressants, and etc.
    (2) Premature ejaculation (abbreviated as PE): Also known as premature ejaculation. Please refer to the premature ejaculation above.
    (3) Anejaculation: There are many causes of anejaculation, the most common of which are central anejaculation and organic anejaculation.
    (4) Retrograde ejaculation: Backflow of semen to the bladder during ejaculation can be divided into anatomical abnormalities caused by abnormalities in the bladder neck, and functional abnormalities caused by neuropathy due to diabetes or caused by nerve damage due to retroperitoneal surgery and colorectal surgery.
    病因:
    (1) 延遲射精(Retarded ejaculation,簡稱:RE):可分為心理性,如感覺不集中、情緒干擾、工作壓力等,生理性為交感神經受損、多重性硬化症、骨盆腔手術、糖尿病病變、抗憂鬱藥物等導致。
    (2) 早發性射精(Premature ejaculation,簡稱:PE):又稱為早洩請參閱上列早發性射精。
    (3) 無射精(anejaculation):無射精的病因很多項,最為常見是中樞性、器質性等。
    (4) 逆行性射精(Retrograde ejaculation):射精時精液逆流至膀胱可分為解剖構造異常,如膀胱頸異常引起,及功能上異常為糖尿病引起神經病變或後腹腔手術及大腸直腸手術導致神經受損等引起。

  3. Treatment: Drug treatment is given through multiple tests of urology and psychiatry. If the drug treatment is ineffective, it is more likely to be caused by psychology. It can be improved by sensory concentration training.
    治療:
    通過泌尿科與精神病的多方檢測給予藥物治療,若通過藥物治療無效果,較可能為心因性造成,可透過感覺集中訓練法來改善。

4. Low Sexual Drive / Low Libido

  1. Definition and diagnosis: Sexual fantasies for at least 6 months and persistently insufficient sexual desire (or none at all), and the situation causes mild, moderate, and severe distress, also can be divided into:
    (1) General: Not limited to a specific pattern of stimuli, situations or sexual partners.
    (2) Situational: A stimulus, situation, or sexual partner in a specific pattern.
    (3) Lifetime: Distress occurs when an individual has sex.
    (4) Acquired: Distress occurs after a period of relatively normal sexual function. 

    定義與診斷:
    持續至少約6個月對性徑為的性幻想與性慾持續會反覆不足(或完全沒有),其情形引起輕、中及重度的困擾外,又可區分為: 
    (1) 一般型:不限於特定模式的刺激、情境或性伴侶。
    (2) 情境型:只在特定模式的刺激、情境或性伴侶。
    (3) 終生:在個人有性行為時就發生困擾。
    (4) 後天:在相對正常性功能一段時期後發生困擾。

  2. Treatment: Check the physical condition and take the medicine as needed. If it is not a physiological factor, you should consider the psychological effects, such as: performance anxiety, life pressure, and etc. to find the solutions.
    治療:檢視生理狀況後視情形服用藥物,若非生理因素則需考慮心理的影響,例如:表現焦慮、生活壓,找出癥結點來獲得改善。