Men are often characterized as being concerned with their sexual health only when they’re unable to achieve or sustain an erection. But men’s sexual health is about so much more than the ability to perform sexually. Physical, psychological, interpersonal and social factors also influence men’s sexual health.

Premature ejaculation and erectile dysfunction (ED)—the inability to get an erection or to maintain it long enough for satisfying sexual activity—are the two most common male sexual health disorders, according to experts. Difficulties related to ejaculation include premature ejaculation, delayed ejaculation and an inability to experience orgasm upon ejaculation, a condition called anorgasmia.

Many problems can cause ED, including stress, depression, relationship issues, abnormally low testosterone, damage from urological surgery and even cholesterol-clogged arteries. Indeed, fatty deposits, or plaque buildup, in the network of vessels that supply the heart with oxygen-rich blood, are often an early warning sign of heart disease. (Treatments for ED include pills, injections into the penis or devices.) 

But other conditions may affect men’s ability or desire to have sex. These include high blood pressure, prostate problems, stroke or nerve damage (from diabetes or surgery), side effects from prescription drugs and a dip in testosterone levels. Substance use and smoking can also interfere with sexual function.

In addition, anatomical abnormalities, such as Peyronie’s disease—an upward or downward curvature of the penis caused by the formation of scar tissue—testicular trauma, and genetic or immunological diseases can result in infertility.

Psychological problems can also affect men’s sexual health. For example, money worries, job stress and relationship troubles can all contribute to premature ejaculation. In addition, anxiety can be both a cause and a symptom of the problem. Depression, fears, guilt or past sexual trauma can also impact male sexual health.

Marital or relationship difficulties and a lack of trust and open communication between men and their partners are examples of interpersonal problems that can compromise men’s sexual health. Couples counseling can help address these issues. If anxiety, fear or inhibition are present, doctors may recommend psychotherapy.

The same social factors that affect female sexual and overall health affect men as well. These include smoking, alcohol use, an unhealthy diet and physical inactivity.

Men who drink heavily, smoke or carry extra weight are more likely to experience ED. Additionally, toxins in cigarettes may damage sperm.

Although male sexual health is still more likely to be defined by the physical ability to perform sexually, experts are increasingly taking a more holistic approach to the sexual wellness of men.

Last Reviewed: January 19, 2021