In male clinics, the most common male sexual dysfunctions are low libido, erectile dysfunction (impotence), and premature ejaculation. And chronic prostatitis (CP) is also a common and frequent clinical condition. There is a greater chance that the two coexist, so do they have a causal relationship? Or is it simply a coexisting relationship? How to deal with it? 1, the relationship between chronic prostatitis and sexual desire Sexual desire refers to the desire to perform sexual acts under appropriate sexual stimulation, causing sexual excitement, is an impulse or biological drive for sexual activity, but also the desire to pursue sexual satisfaction. Sexual desire is an instinct, but it is also a psychophysiological process with somatic and mental manifestations. Sexual desire is the internal drive of sexual instinct, and when aroused, it produces two processes of sexual activity: one is the process of cumulative desire, in which both sexes accumulate their sexual desire through physical and mental contact with each other; the other is the process of liberation, in which ejaculation occurs and orgasm and satisfaction are achieved. Thus, sexual desire should include both contact desire and swelling and slow release desire, based on the anatomical and physiological basis of the swelling sensation of the internal pressure of the seminal vesicles and the desire sensation of the seminal vesicles being extremely sensitive to the testosterone in the blood circulation, prompting its release. These two aspects also influence each other, as the accumulation and release of the swelling sensation stimulates the desire for contact, while the desire for contact is the basis and prerequisite for the desire for fullness and slow release. The brain is the center of human life activities, dominating all human activities, the gray matter of the brain, hypothalamus and other parts of the “sexual center”, plays an important role in sexual desire. In addition to the control of the brain, sexual desire is also closely related to the endocrine. The physiological basis of sexual desire is a series of physiological changes produced by the body in response to sexual stimulation, and sex hormones play an important role in this regard. The main regulation of libido is testosterone, which is important for the production and maintenance of male libido. Diseases, trauma or congenital malformations that damage the function of the testes can cause hypogonadism. If this damage occurs before puberty, it affects the development of sexual characteristics and reproductive organs, resulting in loss of libido; if it occurs in adulthood, it can cause hypogonadism or even complete loss of libido. Numerous studies have shown that testosterone levels are positively correlated with libido, and within a certain range, the higher the serum T concentration, the greater the ability to generate libido. The main mechanism of low libido is the lack of testosterone and the inability to maintain the attention and response to stimuli produced by the dopamine (DA) receptor system in the limbic, nigrostriatal and hypothalamic areas of the midbrain after receiving stimulus signals, respectively, as well as the autonomous efferent signals to control sympathetic nerve activity in some tissues, resulting in the neural system consisting of the spinal sexual arousal center and sexual stimulus receptor areas and conducting nerves receiving signals to arouse libido The decrease in blood flow to the gonads, which ultimately leads to low libido. In contrast, chronic prostatitis mainly affects urinary symptoms and pelvic pain and is not directly related to sex hormones (testosterone). This is mainly because some false propaganda and information affects the patient’s mood, which in turn causes depression or stressful psychological state, which inhibits the synthesis and secretion of testosterone by interfering with the neuroendocrine system, thus causing low libido. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The relationship between chronic prostatitis and erectile dysfunction is a series of complex and coordinated physiological processes, which are the result of the interaction of various factors such as neuroendocrine regulation, hemodynamic changes and psychological effects, and is a complex reflex process in which sexual stimulation causes the participation of multiple systems and organs throughout the body. Penile erection is actually a series of neurovascular activities. The degree of erection depends on the balance between arterial and venous inflow of blood. When arterial inflow is low and balanced with venous outflow, the penis is in a flaccid state. When arterial inflow increases and venous outflow decreases, the penis swells and becomes erect due to increased blood content. This coordination depends on the consistency of the factors that regulate the contraction and diastole of the penile erection. While chronic prostatitis does not generally affect endocrine regulation and hemodynamics, you can still see many patients with prostatitis accompanied by sexual dysfunction in the clinic. A large sample of data showed that impotence accounted for 14.9% of CP patients. After giving psychological treatment, the patients’ symptoms can be significantly improved. Therefore, it is generally believed that CP causes impotence mainly by being a psychological problem that affects the patient. 3, the relationship between chronic prostatitis and premature ejaculation Ejaculatory function is a complex physiological response of the ejaculatory organ that occurs during the orgasm of the sexual response cycle under the regulation of the central nervous system. The ejaculation marks the onset of sexual climax in the male during sexual life, and it must be accomplished by the coordinated action of various systems such as the central nervous system, peripheral nerves, sympathetic and parasympathetic nerves, gonadal endocrine, external genitalia, bladder neck and pelvic floor muscles. Normal male ejaculation consists of two processes, namely the production and excretion of semen. Premature ejaculation is a common male ejaculatory dysfunction that exists in an age-dependent form in 30% to 40% of sexually active men. Premature ejaculation is mainly characterized by short ejaculatory latency, poor ejaculatory control, and low sexual satisfaction. Its specific manifestations include ejaculation always or almost always occurring within 1 min of penile insertion into the vagina, delayed ejaculation after inability to enter all or almost all of the vagina, negative personal psychosomatic factors, and other a poor clinical symptoms. Chronic prostatitis is the most important cause of premature ejaculation has been widely recognized by the international medical community. The possible mechanism is the local irritation symptoms caused by prostatitis, which causes overburdening of the ejaculatory center and triggers premature ejaculation. The prostate gland is like a valve that controls ejaculation. If this valve is inflamed, it will become allergic and congested due to irritation, and when there is a sexual urge, it cannot be controlled (especially in young adults) and will soon ejaculate. After a long time it causes the threshold of nerve to impulsive stimulation to drop. The treatment of this type of premature ejaculation should first address the prostate inflammation for premature ejaculation to be cured. Therefore, when dealing with patients with premature ejaculation in the clinic, be sure to ask about urinary symptoms and clarify the presence or absence of CP.