Male sexual dysfunction – I don’t think it’s all in my head.

By Physio Thomas

It makes biological sense that sex is pleasurable; humans need to do it in order to survive as a species, so, the powers-that-be made it as enticing as possible. But what if things just don’t work? You can’t get an erection, there isn’t much sensation, or it feels quite painful? Did you know that 52% of men aged 40-70 suffer from some form of sexual dysfunction, although it is common amongst all ages! Yet in our modern Western society it is still considered a taboo topic.

Hello. My name is Thomas, a physio at Vital Core Physiotherapy, and I have a pelvic dysfunction. In this blog, I will be sharing some very personal stories to try raise the awareness for male sexual difficulties and hopefully encourage more men to seek help.

I first noticed that I had a sexual dysfunction a few months into my first relationship. My willingness for sex and enthusiasm during it was much less than that of my partner’s; I wouldn’t moan, show any visceral changes…even my ejaculation came with no excitement or climax – it merely just happened. I would listen to my partner’s audible pleasure and begin to query why I didn’t have the same reactions to it all.

I thought back and realised that I had never had a potent sex drive, strong erections, or pleasure with ejaculation. I began to Google this, and learnt of the correlations between trauma and sexual dysfunction. Well, that didn’t really fit, I thought – I had not had any sexual trauma, and no prejudice or condemnation of my sexual practices from my loved ones. Google also mentioned how anxiety and mental health may play a role – that didn’t make any sense either, as I wasn’t worried about sex, I simply didn’t feel very much, and it had always been the case since masturbation as a teenager – I was only more aware of it now because I could compare my reactions to my partner’s.

Recognising that something was wrong, I went to a few doctors. Blood tests came back fine, the urologist said things were working – the resounding response from the myriad of allied health professionals was that it was coming from my mind – commonly diagnosed as male hypoactive sexual desire disorder (MHSDD). Several hundreds of dollars later with a sexologist, with whom I had to practise heightening my senses of arousal by – wait for it – repeatedly sniffing a Snickers bar – and I felt like I had gone around in circles. For well over a year, I had seen multiple specialists with little results.

A few months later, I was then at the gym, and, instead of doing anything remotely productive, I was eavesdropping on a physiotherapist providing rehab to a patient. He mentions something about core control and its implications of pelvic floor health, and how this relates to sexual function. This was all utterly gibberish to me, but I thought, well, I had been so physically and mentally invaded by that point, that one more appointment wouldn’t hurt, so I booked in to see him. After a thorough assessment this pelvic health physiotherapist told me…


 “Your pelvic floor muscles are a bit tight and weak, and that is going to prevent blood flow to your penis, and limit sensation.”


The simplicity of his words struck me. That…that made sense. He didn’t blame it on some mental challenges that I swear I didn’t have. There was something physically wrong, and it was so refreshing to know that. After his treatment, I certainly felt less heavy in the pelvis; I continued on his management and homework, and had my first orgasm six weeks later. Hurrah.

Now, it is important to note that, while my pelvic floor dysfunction had physical roots, there are many examples out there that would receive great results from a variety of allied health professionals. So, if this is something you are struggling with, go see your GP and a psychologist, get your bloods tested, etc., and understand that sexual dysfunctions are often multifaceted and require a few specialists to work cohesively together for your best management. Also, note that I am also not an expert – I am merely sharing my story, my history, and what worked or my circumstances. Finally, recognise that while I am focusing on a male’s journey, this story is equally appropriate and relatable for women with sexual dysfunction

But, what I want to focus on is how now is how dark it got. Sex is a very normal part of life, for procreation, for sexual identity, and for pleasure. It is great that, in the media, it is being better recognised and less of a topic of taboo, but there is rarely a platform for those who struggle with sex, be it from a physical or mental standpoint, to voice their concerns and find others who are going through similar things.

So, to begin to realise how far from normality I was, was challenging. Not only was there a year of bouncing from health professionals, where I was infuriated that nothing was working, but I began to question why I was so abnormal, unable to perform in a way that was so biologically ingrained over millennia. “Are you sure there is no history of sexual trauma?” the sexologist asked during our third session. Maybe something had happened? At least that would make sense. It would explain why I was broken like this.

Combining that with my increased unwillingness to be sexual with my partner – I was fine to do it before, when I didn’t realise something was wrong, as some sort of perfunctory ticking of a box – but each moan made me so infuriatingly jealous and sad that I avoided it. I soon resented touch; even romantic hand-holding began to be dreadful. I became comforted in my loneliness, knowing I couldn’t disappoint my partner.

And this isn’t even considering how my partner would have felt – how emotionally taxing it would have been to be unable to please a lover, help them reach erections or orgasms, and how insecure it would make them feel about their own ability or attractiveness. 

Sexual dysfunctions are difficult. You are not only going without a pleasure that everyone else finds so instinctive and natural, but it is often affecting a partner too, someone you love and who loves you back, and just wants to express that physically. But it is important that we start talking about them, and normalise the fact that there are a very large number of people out there who struggle with it, and are trying to recover.

This isn’t a woe-is-me piece – that’s my Fringe show (seriously, watch it). I am just sharing this to let you know that, maybe, there is someone out there who does understand what you’re going through, and someone who can help with your recovery. 

So after excluding medical reasons for pelvic pain or sexual dysfunction, a pelvic floor physiotherapist can assess, diagnose and treat muscular and nervous system contributors to the problem.  If you have any concerns, after chatting to your GP, arrange to see a Pelvic Floor Physiotherapist.



Lei Chen, Guang-rui Shi, Dan-dan Huang, Yang Li, Chen-chao Ma, Min Shi, Bin-xiao Su, Guang-jiang Shi (2019)
Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention,
Biomedicine & Pharmacotherapy, Volume 112