Male sexual dysfunction is far more common than most people realize—and far more treatable than many men are led to believe.
According to urologist Dr. Joshua Gonzalez, sexual dysfunction is the most common concern he sees in his men’s health practice. Erectile dysfunction alone increases in prevalence by roughly 10% per decade of life, meaning approximately 30% of men in their 30s and 40% of men in their 40s experience some level of dysfunction. Yet despite how widespread these concerns are, shame, misinformation, and silence still prevent many men from seeking help.
Sexual dysfunction isn’t just a medical issue. It’s a quality-of-life issue that affects confidence, relationships, mental health, and overall wellbeing. Understanding what male sexual dysfunction is—and what it is not—is a crucial first step in reducing stigma and improving outcomes.
What Is Male Sexual Dysfunction?
Male sexual dysfunction is an umbrella term that includes challenges related to:
Erectile function
Sexual desire (libido)
Arousal
Ejaculation
Sexual satisfaction
Sexual pain or discomfort
These concerns can occur at any age and often overlap. Importantly, dysfunction does not mean failure, weakness, or permanent loss of sexual ability. In most cases, it signals that something—physiological, psychological, relational, or lifestyle-related—needs attention.
Dr. Gonzalez emphasizes that many men assume their experience is unique or abnormal, when in reality these concerns are extremely common and well-documented in medical literature.
Erectile Dysfunction: Common, Treatable, and Often Misunderstood
Erectile dysfunction (ED) is one of the most frequently discussed forms of male sexual dysfunction—and one of the most misunderstood.
Many men believe ED is either:
An inevitable part of aging, or
A sign that something is irreversibly “broken”
Neither assumption is accurate.
ED can be influenced by:
Cardiovascular health
Hormonal balance
Neurological function
Stress and anxiety
Sleep quality
Medication side effects
Relationship dynamics
Dr. Joshua Gonzalez notes that men often delay seeking help because they feel embarrassed or assume nothing can be done. In reality, there are numerous evidence-based treatments available, and outcomes improve significantly when men seek care earlier rather than later.
Performance Anxiety and the Cycle of Avoidance
One of the most common patterns seen in male sexual dysfunction is the feedback loop between anxiety and performance.
A single negative sexual experience—difficulty maintaining an erection, delayed arousal, or ejaculation concerns—can create anticipatory anxiety. That anxiety increases nervous system activation, which directly interferes with arousal and erectile response. Over time, this can lead to avoidance of intimacy altogether.
Dr. Gonzalez highlights that many men don’t articulate this cycle unless asked directly. They may simply say, “It’s been a while,” without realizing how long the issue has been affecting their behavior, confidence, and relationships.
Breaking this cycle often requires:
Education about how arousal actually works
Normalizing variability in sexual response
Reducing shame and self-blame
Learning to talk openly about sexual concerns
Why Men Often Struggle to Talk About Sexual Health
Cultural conditioning plays a major role in how men experience sexual dysfunction.
Dr. Gonzalez explains that many women begin engaging with healthcare providers about reproductive and sexual health in adolescence, often through gynecological care. Men, on the other hand, frequently reach adulthood without ever having been asked specific questions about sexual function.
As a result:
Men are less practiced at talking about sex
Sexual concerns may feel deeply tied to identity and masculinity
Open-ended questions often yield limited information
This is why specificity matters. Asking detailed, concrete questions helps men feel guided rather than exposed—and helps professionals understand what’s actually happening.
The Role of Regenerative and Functional Treatments
In addition to traditional approaches, Dr. Gonzalez discusses newer interventions aimed at improving erectile tissue health and sexual function.
These include:
Shockwave therapy
Radiofrequency treatments
Other regenerative modalities
The goal of these treatments is not simply to produce an erection, but to improve the health and responsiveness of erectile tissue itself. Dr. Gonzalez is careful to emphasize that any treatment offered in his practice is selected only after reviewing safety and efficacy data—an important distinction in a field crowded with unproven claims.
This highlights a critical educational point: not all treatments marketed for sexual dysfunction are evidence-based, and professional guidance matters.
Aesthetic Concerns and Sexual Confidence
Another topic Dr. Gonzalez addresses is the growing interest in aesthetic procedures related to sexual health, including penile girth enhancement and scrotal treatments.
While these procedures are often framed as cosmetic, Dr. Gonzalez notes that many men pursue them for functional and psychological reasons, such as:
Discomfort related to tissue tightness
Changes associated with long-term hormone therapy
Body image concerns that affect sexual confidence
Sexual satisfaction is not purely physical—it’s deeply connected to how someone feels in their body. Addressing these concerns thoughtfully and ethically is part of comprehensive sexual healthcare.
Longevity, Hormones, and Sexual Health
Sexual function is closely linked to overall health, including hormonal balance and metabolic function. Dr. Gonzalez discusses growing interest in longevity-focused therapies, such as peptide treatments, alongside more traditional hormone replacement approaches.
While research in this area is still emerging, the takeaway is clear: sexual health is a reflection of whole-body health. Changes in desire, arousal, or function can be early indicators of broader health issues that deserve attention.
Why Shame Is the Biggest Barrier to Care
Across all forms of male sexual dysfunction, shame remains the most consistent barrier to treatment.
Men often believe:
“I should be able to handle this on my own.”
“No one else is dealing with this.”
“If I talk about it, it means something is wrong with me.”
Dr. Gonzalez stresses that nearly every sexual concern he treats has been studied, documented, and addressed successfully in other patients. The problem isn’t lack of solutions—it’s lack of conversation.
Education changes that.
Why Sexual Health Education Matters Beyond the Clinic
Many men first learn about sexual health—not from doctors—but from the internet, social media, and peers. Dr. Gonzalez argues that avoiding these platforms doesn’t protect patients; it leaves them vulnerable to misinformation.
Accurate, accessible education helps people:
Recognize when something is common versus concerning
Understand that help exists
Seek appropriate care sooner
Reduce fear and self-blame
This is where trained sexual health professionals—including sex coaches—play a powerful role.
Where Sex Coaching Fits In
Sex coaches do not diagnose or replace medical providers. Instead, they help clients:
Understand sexual function and arousal
Navigate shame and anxiety
Improve communication with partners
Develop healthier relationships with their bodies and sexuality
Know when and how to seek medical support
A high-quality sex coach certification provides the education, ethical framework, and communication skills needed to support people experiencing sexual dysfunction in responsible, effective ways.
Learning to Guide These Conversations Ethically
Sexual Health Alliance’s sex coach certification program emphasizes:
Evidence-based sexual health education
Clear professional boundaries
Ethical decision-making
Trauma-informed communication
Collaboration and referral when medical care is needed
Professionals trained through SHA are prepared to support clients without overstepping scope—an essential skill in a landscape full of misinformation.
Moving the Conversation Forward
Male sexual dysfunction is not rare, shameful, or untreatable. It is a common human experience that deserves accurate information, compassionate support, and thoughtful care.
As Dr. Joshua Gonzalez makes clear, expanding sexual health conversations—inside clinics and beyond them—is one of the most important shifts happening in modern healthcare.
Education is how that shift continues.
For those who feel called to be part of that change, pursuing a sex coach certification is one way to help ensure that the information people receive is grounded in science, empathy, and integrity.
Want to become an in-demand sexual health professional? Learn more about becoming certified with SHA!
