Sexual health is an important aspect of the overall health of an individual. Sexual problems are common and are not only underreported and underdiagnosed, but also often improperly treated. These problems need systematic and scientific evaluation to identify the underlying cause and institute appropriate therapy.

Sex hormone disorders occur when there is either an overproduction or underproduction of the hormones responsible for sexual characteristics and development. Depending on the type of hormone disorder males may experience, the following abnormalities:

=> Erectile Dysfunction (Impotence): Erectile dysfunction or impotence is the inability to sustain an erection for sexual intercourse. It is a fairly common problem with an increasing prevalence with increasing age. It can result from a number of causes like diabetes, nerve disease, vascular disease, thyroid disorders, hormonal disorders and certain drugs. In addition, psychological factors and problems in interpersonal relationship are also responsible in some people. The presence of erectile dysfunction may indicate an underlying serious disorder of heart. A systematic approach to identify the underlying cause is needed. The treatment may involve administration of hormones, correction of thyroid abnormality, and certain drugs like sildenafil and tadalafil.

=> Reduced Libido: Reduction in libido or sexual desire is also a common problem. I may occur transiently due to psychological factors and stress. However, it may also indicate an underlying disorder like thyroid disease, testosterone deficiency (hypogonadism) or prolactinoma (increased levels of a hormone called prolactin). Appropriate blood tests are needed to diagnose these disorders. In a majority of cases, these problems can be satisfactorily treated.

=> Premature Ejaculation: Premature ejaculation is a very common complaint in which the ejaculation occurs very early during sexual intercourse. It often has a psychological basis and may signify underlying performance anxiety. After a proper evaluation, it can usually be treated satisfactorily with behavioral therapy and certain drugs.

=> Gynecomastia: Gynecomastia is the enlargement of breasts in men. This is a normal occurrence during puberty. It may also occur because of obesity and certain hormonal disorders like increased prolactin secretion from pituitary gland and hypogonadism. Simple blood tests can identify the underlying cause and can usually be treated with drugs.

=> Hypogonadism: Hypogonadism is the reduced production of hormones like testosterone from testes. It can be because of a testicular problem like infection, trauma; or a pituitary disorder in which there is reduced secretion of regulatory hormones like Follicle Stimulating Hormone and Luteinizing Hormone. Hypogonadism may lead to low libido, erectile dysfunction, low mood, depression, reduced hair on body and in beard area, muscle wasting and reduction in bone density (osteoporosis). Hypogonadism is easily treated with injections or tablets after a thorough evaluation. A proper follow up is necessary to avoid any long term complications of such therapy.

=> Andropause: Andropause is the reduction in testosterone production by testis which occurs with age. It is also called late onset hypogonadism. It can lead to problems in sexual function, depression, frailty and osteoporosis. It is very important to identify and treat this disorder as it severely impairs the quality of life of an individual.

=> Infertility in Men: Infertility in men may be because of reduced or abnormal sperm production by testis. This may be because of infection or trauma to testis, testosterone deficiency, thyroid disorders, varicocoele or obstruction to the flow of sperms from testis. A thorough evaluation may include blood tests, semen analysis and ultrasound of testis. Once the underlying cause is detected, appropriate therapy can be given under expert guidance.

The treatment is directed towards reducing the hormone disbalance and sexual disorders.
Following options are tried alone or in combination :-

- Scrotal ultrasound

- Semen Analysis

- Hormone Therapy

- Behavioral Therapy

- Surgical Treatment

- Medications