Many of the underlying conditions which can cause erectile dysfunction may also cause other complications. In a study of 597 men with erectile dysfunction, 56.4% reported one or more related conditions1.
Difficulty Ejaculating (Male Orgasmic Disorder, or MOD)
Male Orgasmic Disorder – sometimes called impaired ejaculation – is a condition in which it takes an extended period of sexual stimulation for a man to reach orgasm and ejaculate. Some men with MOD are unable to ejaculate at all.
This disorder can be caused by many things: lack of testosterone, thyroid disorders, diseases that affect the nervous system (such as diabetes or Parkinson’s disease), substance abuse, surgery or radiation treatment for prostate cancer, certain medications, or psychological factors.
Because there are many causes for this condition, there is little clinical evidence of effective treatments2. Doctors must therefore approach the problem on a case-by-case basis.
Frequent Urination simply means having to pee frequently. Sometimes the need can be very urgent, and can even result in accidental leakage (see Urinary Incontinence).
There are a number of causes of frequent urination, including prostate problems, diabetes, an over active bladder (OAB), stroke or other neurological conditions, urinary tract infections (UTI), and even certain medications.
Depending on the underlying cause, treatments may include:
- Bladder retraining by monitoring and gradually increasing the time between peeing.
- Avoiding certain foods, including alcohol, caffeine, carbonated drinks, tomato-based products, chocolate, artificial sweeteners, and spicy foods.
- Limiting fluid intake before bedtime.
- Changing prescription medications.
- Kegel exercises.
- Taking medications to reduce bladder spasms.
- Botox injections into the bladder muscle causing the bladder to relax, increasing its storage capacity, and reducing episodes of leakage.
- Surgical insertion of small devices that electrically stimulate nerves that control the pelvic floor muscles.
Peyronie’s Disease (PD)
Peyronie’s Disease is connective-tissue disorder, frequently characterized by the development of scar tissue within the penis, which can cause curved, painful erections, difficulty ejaculating, and difficulty urinating. PD is usually caused by physical trauma to the penis. It can develop in men who use Penile Injections as a long-term treatment for ED.
Some men develop Peyronie’s Disease over time without experiencing any obvious injury or trauma; the underlying cause in these cases is not understood, but may be genetic.
Approximately 1% of adult men in the United States have been diagnosed with Peyronie’s Disease, but the actual number of men suffering from the condition may be as high as 5%.
There is one drug, Collagenase Clostridium Histolyticum (CCH), which is approved for the treatment of Peyronie’s Disease. Several other drugs are sometimes used “off label.” These are drugs that are FDA approved for other conditions, and which are believed to aid in the treatment of PD.
A variety of new drug treatments3 are currently being tried to correct Peyronie’s Disease.
Several studies have also tested the use of traction devices, vacuum pumps, or Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) for treating PD.
The curvature caused by Peyronie’s Disease can also be corrected with surgery, or with the insertion of a Penile Implant.
For more information on the causes and treatment of Peyronie’s Disease, visit peyronies.org.
Premature Ejaculation (PE)
Premature Ejaculation is a condition in which a man orgasms and ejaculates with little stimulation, sometimes without penetration. The average length of time before ejaculation during vaginal intercourse is 5.4 minutes4. The International Society for Sexual Medicine defines premature ejaculation as consistently ejaculate within one minute of vaginal penetration. For most men this is not a useful definition. Premature ejaculation might better be defined as simply not being able to last as long as you and your partner would like.
There are many causes of PE, including diseases that affect the nervous system (such as diabetes or Parkinson’s disease), thyroid problems, or prostate disease. It is often caused by psychological factors.
Treatments may include counseling or coaching, pelvic floor (kegel) exercises, antidepressant medications or analgesics5, topical preparations which reduce penile sensitivity, devices to help “train” the user, or wearing condoms.
For more information see our article on Premature Ejaculation Causes and Treatment.
Priapism means an erection that won’t go down. This is a serious condition that can result in permanent damage to this penis.
See our article on Priapism.
Incontinence means the unintentional release of urine (also called leakage). Leakage is common when muscles are “stressed” by sneezing, coughing, or bending over. Some men experience urinary leakage during sexual intercourse.
There are many causes for incontinence, including Urinary Tract Infections, prostatitis, weakened pelvic floor or bladder muscles, conditions that affect nerve signals from the brain (such as diabetes, Parkinson’s disease, or stroke). Men who have had radiation or surgical treatment for prostate cancer frequently experience incontinence.
For further information and treatment options, see our article on Incontinence.
Urinary retention is the inability to empty the bladder. Acute urinary retention may cause severe discomfort or pain, and a need to urinate without being able to.
Causes may include prostate enlargement, bladder stones, obstructions in the urinary tract, nerve problems that interfere with signals between the brain and the bladder, and some medications (including over-the-counter cold and allergy medications).
Treatment depends on the underlying cause, but may include medications to treat an enlarged prostate, catheterization, or surgery to remove blockages. Men can also “train” their bladder by gradually increasing the length of time between urinating.
Urinary Tract Infections (UTI)
A urinary tract infection is a viral or bacteria infection within the urinary tract (bladder and urethra). UTIs are common among men who have compromised immune systems or poor circulation within the penis. Symptoms include:
- strong, sudden, and frequent urge to urinate.
- cloudy, bloody, or strong-smelling urine.
- pain or a burning sensation when urinating.
- in severe cases, nausea, vomiting, muscle aches and abdominal pains.
Urinary tract infections are generally treated with antibiotics, and medicines to relieve pain and inflammation. Men who are prone to UTIs may take a low-dose antibiotic daily in order to combat infections.
Patients should also drink lots of liquids to flush the bacteria out of their system. Drinking cranberry juice has also been shown to be effective in reducing the frequency of UTIs, and speeding recovery6.
- Nicholson, Robert T. “Comprehensive Study on the Impact of Erectile Dysfunction.” ED Treatment Information Center. 30 Mar 2018. <https://edtreatment.info/ed-impact-study/>
- Abdel-Hamid, Ibrahim A; Elsaied, Moustafa A; Mostafa, Taymore. “The drug treatment of delayed ejaculation.” Translational Andrology and Urology. Aug 2016. 5(4): 576–591. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001980/>
- Joice, Gregory A; Burnett, Arthur L. “Nonsurgical Interventions for Peyronie’s Disease: Update as of 2016.” World Journal of Men’s Health. 23 Aug 2016; doi: 10.5534/wjmh.2016.34.2.65. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999492/>
- Waldinger, M D; Quinn, P; Dilleen, M; Mundayat, R; Schweitzer, D H; Boolell, M. “A multinational population survey of intravaginal ejaculation latency time.” Journal of Sexual Medicine. July 2005; 2(4):492-7.
- McMahon, Chris G. “Emerging and investigational drugs for premature ejaculation.” Translational Andrology and Urology. Aug 2016. 5(4): 487–501. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001989/>
- Takahashi S; Hamasuna R; Yasuda M; Arakawa S; Tanaka K; Ishikawa K; Kiyota H; Hayami H; Yamamoto S; Kubo T; Matsumoto T. “A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection.” Journal of Infection and Chemotherapy. 19 Feb 2013:112-7. doi: 10.1007/s10156-012-0467-7. <https://www.ncbi.nlm.nih.gov/pubmed/22961092>