Sexuality Across Lifespan IV: Focus on Men’s Vulnerabilities

Male sexuality is a complex and dynamic human experience. It is rooted in biological, psychosexual, relational, and context-dependent factors. Gynecomastia, alcohol and drug abuse, sexually transmitted diseases, and relational factors are the leading causes of psychosexual problems in adolescent boys and young men. With increasing age, the biological factors lead the list of most powerful disruptors of male sexual function. Obesity, diabetes mellitus and metabolic syndrome, arterial hypertension, dyslipidemia, and cardiovascular diseases, along with hormonal factors and urological conditions, may all impair the physiology of male sexual response, with a reciprocal potentiating effect when comorbidity is in play and age increases. In the relational perspective, special attention should be devoted to the role of the “she” or “he” partner as a “symptom inducer” (or co-inducer), while the man complaining of his male sexual disorder (MSD) could just be the “symptom carrier.” This dyadic effect is present lifelong, but it becomes increasingly frequent with aging. Indeed, an untreated genitourinary syndrome of the menopause (GSM) in female partners can be a critical precipitating factor of both erectile deficit and loss of sex drive in men, in the shadow of clinical awareness.