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Conditions: Premature Ejaculation

Men with Infertility

Tony just didn’t know what to do anymore. He and his wife Rebecca had always planned to have a family, a large one. But after a year of trying, they were losing hope that they’d ever conceive a child. They were confused about their next steps. Should they give up? Keep trying? Try in vitro fertilization? Adopt?

Making matters worse, Tony was starting to have some problems in the bedroom. He’d never had trouble getting an erection before, but now he couldn’t count on being able to perform. And since this ability was crucial for starting a pregnancy, he felt like a failure. Rebecca tried to understand, but deep down, Tony knew she was as frustrated and disappointed as he was. Lately, they had started avoiding the subject of sex altogether and he knew that wasn’t good for their relationship. He missed the intimacy they shared.

There are lots of men like Tony. Infertility takes a huge toll on couples, emotionally and sexually.

Unfortunately, it’s fairly common for infertile men to develop sexual problems. Some have erectile dysfunction (ED), the inability to achieve and maintain an erection suitable for intercourse. Others may have premature ejaculation (PE), which occurs when a man ejaculates before he and his partner wish it to happen.

Depression and anxiety often accompany sexual problems. In Tony’s case, he missed the intimacy he once had with his wife. He might feel anxious about pleasing her. The fact that they’re trying to conceive adds even more pressure.

Today, we’ll take a closer look at the extent of sexual problems affecting men with infertility. We’ll also discuss some ways that we, as professionals, might help them.

Recent Research

A study published online in May in theJournal of Sexual Medicine has shed some light on the incidence of sexual and psychological problems among infertile men in China.

Researchers collected data from 1,468 infertile men and 942 fertile men who ranged in age from 23 to 45.

They found that the infertile men had higher rates of erectile dysfunction, premature ejaculation, depression, and anxiety than the fertile men. These rates were as follows:

 

 

Infertile Men

Fertile Men

Premature Ejaculation

19.01%

10.93%

Erectile Dysfunction

18.05%

8.28%

Depression

15.74%

10.08%

Anxiety

38.01%

26.65%

As you can see, infertile men were almost twice as likely to have premature ejaculation when compared to the fertile men. And they were more than twice as likely to have erectile dysfunction.

The study authors noted that their results coincide with the results of other studies that have found higher incidence of sexual and psychological problems among infertile men. However, they also pointed out that cultural and religious factors should be considered when comparing Chinese and Western patient populations. What may be true in one part of the world may not necessarily apply to another.

How Can Practitioners Help?

Still, the results are a worthwhile reminder of issues our patients and clients could be struggling with. So how can healthcare providers help men like Tony?

  • Have compassion. Sexual problems and infertility are difficult enough on their own and can put tremendous strain on relationships. Adding the two together creates an even tougher situation. Keep this in mind when talking to your patient or client.
  • Ask. A lot of men are reluctant to discuss sexual problems with a clinician. Try giving them the opportunity to do so. For example, you might say, “A lot of men dealing with infertility develop sexual problems. Fortunately, there are treatments available. Is this something you’d like to talk about?”
  • Be prepared to make referrals. If sexual problems and infertility are outside your area of expertise, have a list of referrals ready. Men may benefit from counseling, either by themselves or with their partner. Urologists may be able to help with erectile dysfunction. Sex therapists can offer strategies for dealing with premature ejaculation. If these specialists are not part of your practice, ask your colleagues for recommendations.

Even if our patients don’t volunteer much information, being aware of the sexual implications of infertility can help us understand the deeper struggles that may be part of their relationships.

Resources

The Journal of Sexual Medicine

Gao, Jingjing, MM, et al.

“Relationship between Sexual Dysfunction and Psychological Burden in Men with Infertility: A Large Observational Study in China”

(Full-text. First published online: May 20, 2013)

http://onlinelibrary.wiley.com/doi/10.1111/jsm.12207/abstract

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