Male sexual dysfunction can take many forms, including reduced desire, erectile dysfunction (ED), premature ejaculation, or other related issues. Although these concerns are very common, men often find it difficult to discuss them openly. In fact, research shows that many delay seeking help for months or even years before consulting a healthcare professional. Fortunately, modern medicine has advanced significantly in understanding both normal and abnormal male sexual function.
Dr. Sharon Parish, Professor of Medicine in Clinical Psychiatry at Weill Cornell Medicine, runs an active clinical practice focusing on sexual medicine. She emphasizes a comprehensive, whole-person approach: “I evaluate the entire individual,” Dr. Parish explains. “Often, patients first visit a urologist, and then come to me for deeper assessment and a broader discussion of overall health.”
Her insights highlight the strong connections between sexual health, physical well-being, and mental health.
Sexual concerns may signal other health conditions
According to Dr. Parish, men experiencing lasting changes in sexual desire, erection quality, or ejaculation should always consult their primary care doctor. Persistent symptoms may point to more serious medical conditions, such as:
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Premature ejaculation linked to medications, nerve damage, or urinary problems.
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Low libido or ED as an early warning sign of diabetes.
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Reduced sexual function connected to hormonal imbalance.
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Erectile difficulties that may indicate cardiovascular disease or prostate cancer.
The link between sexual health and mental health
Emotional and psychological well-being also play a major role. Anxiety, depression, and other psychiatric conditions often contribute to sexual dysfunction. “The association between depression and ED is very strong,” says Dr. Parish. “For women, depression is more often tied to a loss of desire. Treating the underlying psychiatric illness is key to improving sexual function.”
Therapies like mindfulness, relaxation techniques, and cognitive behavioral therapy can be very effective, helping patients reduce anxiety, be more present, and experience intimacy more fully.
Medication and sexual function
There is a common belief that psychiatric medications cause sexual problems. However, studies show that sexual function usually improves once mental illness is treated. Dr. Parish emphasizes that avoiding treatment for fear of side effects is not a wise decision. While some medications may cause sexual side effects, about half to two-thirds of men never experience them. For those who do, physicians can often adjust medications to minimize impact.
“The most important step,” Dr. Parish stresses, “is to treat the mental health condition first and then address any remaining sexual health issues.”
Normal changes with age
As men age, some degree of change in sexual drive, response, or performance is natural. “Older men may need more time for arousal or stimulation,” explains Dr. Parish. “If that alone doesn’t help, sex therapy can often make a big difference.” However, she warns against dismissing dramatic changes as just “getting older,” since they can sometimes signal medical problems that require treatment.
Lifestyle and overall health matter
Dr. Parish applies the biopsychosocial model, which emphasizes the interconnectedness of body, mind, and environment. Cardiovascular, hormonal, neurological, and psychological systems all interact to affect sexual function. Adopting a healthier lifestyle — balanced diet, exercise, and maintaining a healthy weight — can significantly improve both general well-being and sexual health.
