There are 4 main components of male sexual function libido erection ejaculation orgasm in the sexual dysfunction is a problem with one of these components, whereby the interest in sex, or the ability to exert this is disturbed. Many medications and numerous physical and psychological changes affect sexual function. Libido Libido is the conscious component of sexual function. The decreased libido manifests itself in a lack of sexual interest or reduced frequency and intensity of sexual thoughts, either spontaneously or in response to sexual stimuli. Libido responds to the testosterone levels as well as on general nutrition, health and medication. Complaints that are reduced libido especially hypogonadism, chronic kidney disease and depression. Up to 25% of men with diabetes diagnosis is true hypogonadism. Among the drugs which may decrease the libido are weak androgen receptor antagonists (eg., Spironolactone, cimetidine), luteinizing hormone-releasing hormone (LHRH) agonists (eg. As leuprorelin, goserelin, buserelin) and antagonists (z. B. degarelix) for the treatment of prostate cancer, anti-androgens, used to treat prostate cancer (e.g.., flutamide, bicalutamide), 5?-reductase inhibitors (eg. as finasteride, dutasteride) for the treatment of benign prostatic hyperplasia, some antihypertensives and almost all drugs acting on the CNS (eg. as SSRIs and tricyclic antidepressants, antipsychotics). The due SSRI or tricyclic antidepressants libido loss can be made by additional administration of bupropion or trazodone sometimes reversed. Erection erection is a neurovascular response to certain psychological and / or tactile stimuli. Signals from the upper cortex and sacral parasympathetic reflexes convey the erectile response. The neural response is made through the cavernous nerves that reach the posterolateral surface of the prostate. Ending in the penile blood vessels, set this nichtandrenergen, nichtcholonergen nervous nitric oxide, a gas-free. Nitric oxide diffuses into penile arterial smooth muscle cells, which causes an increased production of cGMP, which relaxes the artery, and thus more blood can flow through them and into the corpora cavernosa. When the corpora fills with blood, the intracavernous pressure increases increases, which compresses the surrounding veins and leads to reduced venous outflow vein occlusion and. The increased inflow of blood and decreased further outflow increase intracavernous pressure and a contribution to the erection. The ability to erection is affected by many factors (Erectile Dysfunction). Ejaculation and orgasm Ejaculation is controlled by the sympathetic nervous system. The neural stimulation of ?-adrenergic receptors in the male appendages (z. B. penis, testicles, dam, prostate, seminal vesicles) caused contraction of the epididymis, vas deferens, seminal vesicles and prostate, which sperm is transported to the posterior urethra. Then perform rhythmic contractions of the pelvic floor muscles to pulsating ejaculation of accumulated semen. At the same time, the bladder neck closes to prevent retrograde ejaculation of semen into the bladder. SSRIs and alpha blockers can delay ejaculation or inhibit due to receptor inhibition in these places. The orgasm is a pleasant sensation that is perceived in the brain simultaneously with ejaculation. Anorgasmia a physical phenomenon due to the reduced sensitivity may be penile (z. B. neuropathy) or a neuropsychological phenomenon due psychiatric disorders or antipsychotics. Ejaculation An ejaculation means a reduced or no semen volume there. You can by a retrograde ejaculation, which can occur in men with diabetes or as a complication of bladder neck surgery or transurethral resection of the prostate. It can also be caused by a sympathetic interruption, either as a result of operation (z. B. retroperitoneal lymph node dissection) or drugs (such. As guanethidine, phentolamine, phenoxybenzamine, thioridazine). A radical prostatectomy (removal of the prostate gland plus seminal vesicles and regional lymph nodes) eliminates any ejaculation, because the removal of the seminal vesicles and prostate seed production eliminiert.Vorzeitiger ejaculation Premature ejaculation is defined as a earlier than the man or his partner desirable occurring (in) ejaculation and represents a psychological burden. It is usually caused by sexual inexperience, anxiety or other psychological factors, and less frequently by diseases. By sex therapy, tricyclic antidepressants and SSRIs (d. Talk .: n. And antidepressants, PDE5 inhibitor or local anesthetics) it can be successfully treated.