It’s not just about pleasure, which is important, but also an integral part of intimacy, connection, and fun. Many men have issues with sexual function, which range from low libido to premature ejaculation to erectile dysfunction. Others are concerned about the curvature of their penis (Peyronnie’s disease). In fact, over 30% of men experience some of these issues. So what do you do if you are one of the many guys experiencing these common symptoms?

I get so frustrated that many patients who bring up these issues with me have lived with them for years without telling a health care provider about it. It makes me so crazy because many sexual issues can be treated or at least ameliorated – real progress is more likely than not. I know it can be difficult to discuss these topics, but for those willing to step up to the plate, the benefits can be profound.

First of all, one of the most common causes of sexual dysfunction is low testosterone. While the number of men using testosterone replacement therapy has increased, many men who would benefit from it still aren’t getting it. If you have symptoms of low T (testosterone), have your levels checked. You could be missing out on a higher quality of life. Symptoms of low T include low libido and erectile dysfunction, as well as other less obvious symptoms, such as:

  • Diminished lean muscle mass
  • Depressed mood or lack of motivation
  • Increased blood sugar
  • Hot flashes
  • Fatigue
  • Problems sleeping

If you have these symptoms, have your level checked to see if you would benefit from hormonal therapy. If your level is really low, not only does treatment help your symptoms, but it could also improve your overall health, because low T is associated with increased risk for heart disease and diabetes.

For the other sexual issues I mentioned, while testosterone isn’t the answer, other solutions might exist. For example, taking the anti-depressant Fluoxetine on an as-needed basis can help with premature ejaculation – and there are promising studies about PRP for Peyronnie’s and shock wave therapies like the Gaineswave for E.D..

Whatever you do, seek out an expert who can offer some help. Sex is worth it.

Want to learn from a team of top experts about how to improve your sexual health across a wide range of common issues? Register now for the free online Sexual Vitality Summit that I am taking part in from September 23 – 29th, 2019.


Myles Spar, MD, MPH is board-certified in Internal Medicine and in Integrative Medicine. As a clinician, teacher and researcher on faculty of two major medical centers, he has led the charge for a more proactive, holistic and personalized approach to care that focuses on cutting edge technology and preventative care. Dr. Spar has traveled with the NBA, presented a TEDx Talk, appeared on Dr. Oz, and been featured in publications such as the Men’s Journal and the Los Angeles Times.