Elements of male sexual dysfunction:
(1) decreased libido
(2) erectile dysfunction
(3) ejaculatory abnormalities
Factors associated with a decline in libido:
(1) psychological
(2) chronic illnesses
(3) endocrine disorders
(4) drugs and alcohol
Psychological factors:
(1) depression
(2) anxiety
(3) other severe psychiatric illness
Chronic illnesses:
(1) chronic, general ill health
(2) chronic liver disease
(3) temporal lobe damage
Endocrine disorders:
(1) hypogonadism, including testicular atrophy
(2) excess endogenous estrogens (Cushing's disease, cirrhosis, paraneoplastic syndrome)
(3) Addison's disease
(4) hypothyroidism
(5) pituitary adenoma
Drugs and alcohol:
(1) excessive alcohol ingestion (which overlaps with depression and liver disease)
(2) reserpine
(3) propranolol
(4) cimetidine
(5) tricyclic antidepressants
(6) MAO inhibitors
(7) fenfluramine
(8) sedatives
(9) narcotics
(10) exogenous estrogens
