Sexual Dysfunction in Men Who Have Sex With Men

Introduction: Historically, sexual health research has focused on men who have sex with women (MSW) and most research examining the sexual health of men who have sex with men (MSM) has focused on HIV transmission. Despite a high prevalence of sexual health disorders among MSM, there is limited research that has evaluated the diversity of sexual issues in these patients. Objectives: The purpose of this review is to describe the unique sexual behaviors, concerns, and dysfunctions of MSM by evaluating the literature on sexual health in this specific patient population. Methods: A PubMed literature search was conducted through December 2020 to identify all relevant publications related to the sexual health, sexual practices, and sexual dysfunction of MSM. Original research, review articles, and meta-analyses were reviewed, including comparisons of sexual behavior and dysfunction between MSM and non-MSM populations and between gay/bisexual men and heterosexual men. Approximately 150 relevant articles were reviewed and 100 were included in the manuscript. Results: Minority stress can lead to an increase in high-risk sexual behavior, sexual dysfunction, and mental health disorders in MSM. MSM engage in a variety of sexual behaviors, which can lead to differences in sexual dysfunction, such as anodyspareunia during receptive anal intercourse. MSM have higher rates of erectile dysfunction than non-MSM counterparts. MSM have unique activators of sexual pathologies, such as insertive anal intercourse for Peyronie's disease. Prostate cancer treatment may cause MSM to change sexual roles and practices following treatment due to ED, anodyspareunia, or decrease in pleasure from receptive anal intercourse after prostatectomy. Conclusion: MSM have been neglected from sexual medicine research, which translates to disparities in health care. Further research that focuses on the MSM population is necessary to better educate healthcare practitioners so that MSM patients can receive adequate care that is tailored to their specific needs. Copyright (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.