Sexual Response in Men

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KEY POINTS

• A man’s sexual response includes desire, getting an erection, orgasm, and relaxation. At some time, all men will have problems with one or more of these stages.
• If you are concerned that you have a sexual problem, see your healthcare provider. Physical causes may be treated with medicine or, in some cases, with surgery. Therapy may help you deal with anxieties, fears, or poor body image.
• It’s also important to talk with your partner.

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What is the normal pattern of sexual response in men?

A man’s sexual response has several stages:

• Sexual response starts with a desire for sexual intimacy. This is also called libido.
• During the excitement stage, your testicles get larger and blood flows into the penis, creating an erection. Your heart starts beating faster and your blood pressure goes up. You breathe faster. If you become aroused but do not have sex, your body will slowly go back to its normal, unexcited state.
• During the plateau stage, the head of the penis gets bigger and more purplish in color. Sperm from the testicles and other fluids combine to form semen, which fills the urethra. Some semen and sperm can leak from your penis during this time. You reach a point where it is hard to stop from having an orgasm.
• Orgasm causes muscle spasms in the legs, stomach, arms, back, and penis. The feelings are intense and pleasurable. Ejaculation is when semen comes out of the penis.
• During the resolution stage, you start to relax. Blood vessels in the penis relax, and the erection goes away. Testicles return to their normal size. Your heartbeat and breathing slow down and you may feel sleepy.

Some common myths about the male sexual response are:

• An erection always means a man wants to have sex.
• Lack of an erection means a lack of sexual interest.
• All touching is sexual.
• A real man is always interested in and ready for sex.
• Satisfying sex just happens without any discussion or planning.
• A man who has a regular sexual partner will not want to masturbate.
• Real men do not have sex problems.

What causes problems with sexual response?

All men will have some type of sexual problem at some time. For example:

• You may have problems getting erections. As men get older, it usually takes longer to get a full erection. With aging, erections may not get as firm as they were at a younger age. This is normal.
• You may have less desire for sex due to stress at work, school, or home. You may be tired, depressed, or angry. You may get an erection when you do not want one.
• You may feel like you either reach orgasm too soon or that it takes too long.
• You may feel that you or your partner is not getting enough enjoyment out of sex.
• Your ideas about good sex may be different from your partner's ideas.

What can I do to help myself?

Talking with your partner may be the most important part of a healthy sexual relationship. Open and effective communication can go a long way in solving problems with sexual response.

If you are concerned that you have a sexual problem, see your healthcare provider. Physical causes may be treated with medicine or, in some cases, with surgery. Therapy may help you deal with anxieties, fears, or poor body image.

You can get books to learn more about the emotional and physical aspects of sexuality and sexual response. Talking to a trusted friend or family member may also be helpful.

You can get more information from:

• American Association of Sex Education Counselors and Therapists
  https://www.aasect.org
• Sexuality Information and Education Council of the United States
  212-819-9770
  http://www.siecus.org