Sexual Problems

Sexual health is an important part of overall physical and emotional well-being.

However, many people experience sexual problems throughout their lives that can affect self-esteem, relationships, and quality of life.

Conditions such as erectile dysfunction, premature ejaculation, penile curvature (Peyronie’s disease), or changes in female sexual health are more common than most people think.

Even so, many individuals do not seek medical help, whether due to embarrassment or the belief that there is no solution.

In reality, most of these conditions can be diagnosed and treated. A specialised medical evaluation makes it possible to identify the underlying causes and recommend the most appropriate treatment.

Get to know the Sexuality Unit

Erectile Dysfunction

Erectile dysfunction, also known as impotence, is the persistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual performance.

This condition affects more than 152 million men worldwide and is more common between the ages of 50 and 80. However, erectile dysfunction can affect men of different ages, including younger men.

In Portugal, it is estimated to affect more than 10% of men, which corresponds to around 450,000 people.

Erectile dysfunction may have several causes, including:

Vascular problems;
Hormonal changes (such as low testosterone);
Neurological disorders or psychological factors.

In some cases, it may also be associated with prostate diseases or other health conditions.

For many men, erectile dysfunction affects not only their sex life, but also their self-esteem, confidence, and relationship as a couple.

Erectile Dysfunction Treatment

The treatment of erectile dysfunction depends on the identified cause and may include different medical and therapeutic approaches. In many cases, treatment can significantly improve erectile function and quality of life.

Treatment options include:

Psychotherapy, in cases of erectile dysfunction with a psychological origin;
Oral medication (phosphodiesterase type 5 inhibitors such as sildenafil, tadalafil, vardenafil, or avanafil), as well as topical medication or alprostadil injections;
Vacuum devices, penile constriction rings, or penile prosthesis implantation in selected cases;
Hormonal treatment, when testosterone deficiency is identified.

In some specific situations, penile revascularisation surgery may also be considered, although it is currently less commonly used.

At the Sexual Health Unit of the Instituto da Próstata, we provide a multidisciplinary team, specialised diagnostic exams, and innovative treatments, including regenerative therapies such as low-intensity shockwave therapy, which may be used in some cases of vascular erectile dysfunction.

What is Peyronie’s Disease?

Peyronie’s disease is characterised by a curvature of the penis during erection, caused by the presence of an abnormal fibrous plaque in the corpus cavernosum, leading to a loss of tissue elasticity.

The fibrosis develops in the “covering” of the corpus cavernosum — the tunica albuginea — resulting in a curvature that is only noticeable during erection and tends to worsen progressively in the early stages of the disease.

Over time, the curvature may stabilise, with the angle of deformity no longer increasing.

This condition is named after the physician François de La Peyronie, who first described it in 1743.

Peyronie’s Disease Treatment

During the initial phase of the disease, corresponding to the maturation period of the fibrous plaque — usually between 6 and 12 months after the onset of symptoms — some medical approaches may be considered. At this stage, the scarring process has not yet fully stabilised.

The most effective treatment is surgical correction. Surgery is indicated in cases of significant and stable curvature, generally with an angulation greater than 30 degrees, or when associated with erectile dysfunction. Surgery should only be performed after the curvature has remained stable for a minimum period of 4 to 6 months.

The different surgical techniques (known as corporoplasty) include:

Tunica albuginea plication
Incision and contralateral grafting opposite the plaque
Plaque incision with graft placement
Plaque excision with graft placement
Any of these procedures combined with penile prosthesis implantation

Learn more during a consultation at the Sexual Health Unit, where it is possible to obtain a clear diagnosis, clarify any doubts, and explore the most appropriate treatment options for each individual case.

What is Premature Ejaculation?

Premature ejaculation is the most common male sexual dysfunction, affecting around 20 to 30% of adult men.

It is characterised by difficulty controlling the timing of ejaculation, which often occurs before or shortly after penetration. Although it is a very common condition, many men do not seek medical help because they believe there is no solution or that it is an unavoidable problem.

In reality, premature ejaculation can be treated effectively and, in most cases, results are rapid and long-lasting when the appropriate approach is used.

Premature Ejaculation Treatment

At the Sexual Health Unit of IPIU, treatment may include:

Behavioural therapy
Sexual health counselling
Medical treatment, when indicated

This integrated approach makes it possible to address both the physical and psychological factors involved, helping to improve ejaculatory control, reduce anxiety associated with sexual performance, and enhance overall sexual quality of life.

During a consultation at the Sexual Health Unit, you will be able to clarify any doubts, better understand the causes of premature ejaculation, and explore the available treatment options.

What is Female Sexual Health?

Female sexual health is an important part of a woman’s physical, emotional, and relational well-being. It involves not only sexual function, but also aspects such as desire, comfort, pleasure, intimacy, and quality of life.

Throughout life, women may experience different changes that affect their sexual health, particularly during periods such as pregnancy, postpartum, menopause, or as a result of hormonal, emotional, or medical conditions.

Some of the most common problems include reduced sexual desire, vaginal dryness, pain during intercourse, difficulty achieving orgasm, or changes associated with hormonal imbalance.

Although these situations are common, many women do not seek specialised help, often due to embarrassment, lack of information, or the belief that these changes are “normal” and untreatable.

However, many conditions affecting female sexual health can be evaluated and treated effectively through a personalised and multidisciplinary approach.

Female Sexual Health Treatment

Treatment always depends on the identified cause and may involve a multidisciplinary approach. A clinical evaluation makes it possible to understand the physical, hormonal, psychological, or relationship-related factors that may be affecting sexual health and well-being.

Possible approaches include:

Specialised medical assessment
Sexology counselling or psychosexual support
Individual or couples’ sex therapy
Pelvic floor rehabilitation
Clinical guidance in situations associated with menopause or other medical conditions

Learn more during a consultation at the Sexual Health Unit, where you can clarify any doubts, receive a clear diagnosis, and explore the treatment options most suitable for your individual case.

Dr. José Santos Dias

Clinical Director of the Instituto da Próstata

Graduated from the Faculty of Medicine at the University of Lisbon
Specialist in Urology
Fellow of the European Board of Urology
Author of the books "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" and "Protocolos de Urgência em Urologia"

See Biography