Erectile dysfunction is the most common sexual disorder thatwas seen in almost 80%of the males. Premature ejaculation was seen in about 15% of the males. Lack of Sexual desire, homosexual orientation and Sexual aversion are uncommon Male Sexual problems that are responsible in very few occasional cases.

Erectile dysfunction (ED) can be either due to psychological or organic issues. Most common clinical situation are because of stress or performance anxiety and it is seen that the Male partner is unable to give a semen sample at the time of testing, he can also face temporary erectile dysfunction when he has to perform sexual intercourse at the periodovulatory period or asked to give a semen sample for ART treatment of his wife. This temporary dysfunction can be resolved by giving Sildenafil tablets. It has to be taken an hour before intercourse and not to taken on a full stomach. The fore play is very important for him to get an erection. The tablets are contraindicated in men with cardiac problems. Occasionally if the tablets are ineffective then a vibrator needs to be used. A visit to an Andrologist is important to rule out any organic causes of erectile dysfunction and to discuss other alternative ways to obtain the sperm sample

Premature ejaculation(PE) occurs when a man experiences orgasm and expels semen soon after Sexual activity and with minimal penile stimulation. These men also have emotional and relationship distress and some avoid having sexual intercourse. Some men use the technique of distraction to solve the issue of PE. It is advisable that they visit a Sexual medicine expert who would have a thorough understanding of the problem and give proper treatment. Selective Serotonin reuptake inhibitors (SSRI s) like Duloxetinecould be the drug of choice in premature ejaculation.

It is important to rule out life style issues like smoking, substance abuse, medical illnesses like Diabetes, obesity, hypertension and also the side effects of some drugs which can cause ED and PE.

Fertility and sexual issues are interlinked. Hence a proper history and management will go a long way in helping the couple to achieve a pregnancy naturally and also take care of their psychological problems. If their sexual problems get resolved then the couple can try for a natural conception. If they do not achieve a natural conception, they need the help of a fertility specialist who would advise ART treatment like IUI, IVF or ICSI. Hence prior Counselling and managing their sexual problems helps them to have a good bonding which in turn will benefit them during the treatment cycles.