Sexual dysfunction is an issue (or issues) that prevents you from being able to enjoy sexual activity to any degree. The disorders are able to harm healthy relationships alongside disrupting the sexual cycle and response. Men and women can both suffer from them, and the likelihood of having some sort of sexual disorder increases as you age. 43% of women and 31% of men in the U.S. have reported that they experience some degree of difficulty in bed, which makes sexual dysfunction a fairly common issue, especially in those 40 years in age or older.
There are numerous causes of the various types of sexual dysfunction. It can be psychological, which includes work-related stress, anxiety, marital or relationship issues, depression, guilt, concerns with body image, or even post-traumatic stress disorder. It can also simply be caused by physical or medical conditions, like diabetes, heart disease, most neurological disorders, hormonal imbalances, and chronic diseases such as kidney or liver failure. Both substance abuse and regulated medications are capable of causing these problems as well.
Disorders in Women
Hypoactive Sexual Desire Disorder
HSDD is a continuous lack of sexual interest in a women, to the point where it causes them excessive distress. It’s normal to not feel constant sexual desire as the libido will fluctuate, the difference is that HSDD is to a point of personal distress. If a woman doesn’t show her concern for her libido or sex drive then she likely isn’t experiencing HSDD.
All age groups are susceptible, and in the U.S. about 1 in 10 women experience HSDD, making it the most common female sexual dysfunction. It’s been concluded that around 40% of women will experience HSDD, and then up to 15% of those same women will experience it continuously, according to the Mayo Clinic.
HSDD is caused by numerous sources, often in combination with one another. It can be the physical result of arthritis, cancer, coronary artery disease, and most commonly menopause. Menopause is the most common reason because it drops two needed hormones for the libido, estrogen and testosterone. As well, the chances in hormone levels from both during and after pregnancy can cause HSDD.
HSDD can also be the result of psychological and emotional stress. Women who suffer from depression, anxiety, or low self-esteem are able to develop HSDD. However, in more serious cases, HSDD can be a direct result from trauma, such as physical abuse, sexual abuse or rape.
HSDD is difficult to diagnose. Since it’s categorized by a lack of sexual drive and that every woman is different, there is no official threshold or diagnostic test that completely confirms if a woman has HSDD or not. Typically psychiatric assessment is required, and with this doctors can assess if a woman is in a distressed state related to her sex life. Once they’ve determined that it is the case, they will then attempt to find the cause and then treat that problem. While she may only need a different prescription, she might also have to go and visit a counselor who actually specializes in sexual disorders. In some cases, women undergo hormonal therapy to regain their libido.
Sexual Arousal Disorder
Sexual arousal disorder should not be confused with other desire disorders, as it is a biological condition. It’s defined as an inability to maintain arousal, or the lack of sexual fantasies and desires in situations that would normally cause some level of stimulation. The short of it is that anyone with sexual arousal disorder will not have a genital response when they are participating in a romantic activity, things like dancing, kissing, and direct physical stimulation.
Symptoms may include:
- Lacking in vaginal lubrication
- Lack of dilation in the vagina
- Decreased genital swelling
- Less sensation in the genitals
- Decreased nipple sensation
Physical factors are far more likely to be a cause of sexual arousal disorder than emotional factors are, though they are possible. The most common causes include nerve damage, reduced blood flow due to a cardiovascular disease, and hormone depletion.
In order to properly diagnose sexual arousal disorder, women must report, for at least six months, three or more symptoms, including reduced interest in sexual activity, significantly fewer sexual fantasies and desires, lack of initiation of sex, lack of receptiveness to sexual activities, lack of excitement or pleasure during sex, reduced responsiveness to erotic cues, and lack of genital response to sexual activity.
Hormone therapy is commonly recommended for treating sexual arousal disorder, but a doctor may recommend blood-flow enhancing medications in order to encourage genital response. In addition, it is also recommended to consult a counselor or sex therapist with treatment to track progress and rule out any possible emotional restrictions towards intimacy.
Female Orgasmic Disorder
Female orgasmic disorder (FOD) is when a woman is constantly unable to achieve an orgasm. The woman is still able to sexually function, so it is different from sexual arousal disorder. While they’re able to become aroused by emotional and physical stimulus, they are unable to, or with great difficulty, reach climax and release the tension. It is a constant state of stimulation with no final release. This can be a point of tension between romantic partners.
FOD may be caused by physical or psychological problems. No matter what stimulation was used, even self-stimulation, the women who have FOD never experience an orgasm during the remainder of the life, as it is a lifelong (or primary) disorder. These women are usually born with FOD, meaning that more than likely it is due to some sort of physiological condition, including but not limited to:
- Damage in the pelvic area to the blood vessels
- Lesions on the spinal cord or nerve damage in the pelvic region
- Removal of the clitoris (also called female genital mutilation, a cultural practice in parts of Africa, the Middle East, and Asia)
FOD is also a possible side effect of certain medications, like narcotics and antipsychotics.
There are women who experience a secondary, or acquired FOD. These women were able to orgasm, however they’ve lost the ability to after emotional trauma, illness, or as a side effect of medication or surgery. Unlike primary FOD where an individual is typically born with the issue, acquired FOD is normally temporary and treatable. Typically these are the result of a psychological problem, including:
- Past rape, sexual abuse, incest, or a similar traumatic sexual experience
- Emotional abuse
- Fear of becoming pregnant
- Fear of rejection by partner
- Fear of losing control during an orgasm
- Self-image problems
- Relationship problems with partner
- Stress from life, including divorce, job loss, and financial concerns
- Guilt about sex or sexual pleasure
- Cultural and religious beliefs regarding sex
- Another mental health disorder, like depression
Similar to the other sexual dysfunctions, FOD will be treated case by case. Physical problems are treated medicinally, and those with them are encouraged to do more exercise, focusing on kegel exercises, which will help improve the tone and strength of the muscles in the genital region. For cases that are more grounded in the emotional realm, a combination of psychotherapy, sex therapy and proper sexual education is recommended.
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Genito-Pelvic Pain/Penetration Disorder
Genito-Pelvic Pain/Penetration Disorder (GPPD) is a condition where women experience extreme difficulty during intercourse because of pain during penetration. The severity of the pain is dependent on the individual’s pain tolerance. Some may only experience it during vaginal intercourse, but others may experience it in something like inserting a tampon. GPPD was originally two separate conditions, vaginismus and dyspareunia, however the American PSychiatric Association has combined them together, as they typically appear together and are difficult to distinguish between them.
- Regularly struggling with intercourse
- Pain in the pelvic or genital area during attempts at penetration
- Significant fear or anxiety associated with the pain of intercourse. This fear may be present before, during, or after vaginal penetration.
- Attempts at vaginal intercourse results in the tensing or tightening of pelvic floor muscles.
What causes GPPD exactly is still relatively unknown. While it’s thought to be similar to other sexual dysfunctions, there are no known specifics currently. It is most commonly accepted that infections in the pelvic region will cause some sort of genital pain which can result in GPPD, but there have been cases of women being born with it as well. Whether or not genital pain might be expected based on these factors can only be determined by your doctor.
Common Disorders Men Experience
PE (Premature ejaculation) is when an ejaculative response occurs with minimal stimulation either before, during, or short after penetration. It is completely involuntary, and men who suffer from PE have little to no control over it. It is one of the most common sexual dysfunction, as almost 30% of men in the U.S. struggle with PE, although it is suspected that number could be higher, as it is considered to be taboo in American culture. PE is able to affect men of any age group.
We currently don’t know exactly what causes PE. Originally it was thought to be psychological, however studies have found changes in receptor sensitivity in the brain or chemical imbalances may also be a problem. It’s mostly seen in the older age groups, however recently post-pubescent men have also reported having it.
While it is not currently understood as to what exactly causes PE, the good news is that there are a number of widely accepted methods of treating PE. Doctors can prescribe desensitization treatments or ointments, or may simply recommend that the patient masturbates before having intercourse. Those who suffer from PE may also find help for it through therapy.
Delayed ejaculation is the exact opposite of PE, in which men have difficulty ejaculating even with a firm erection and sufficient stimulation. About 5% of men in the U.S. suffer from delayed ejaculation.
It’s currently believed to be a psychological problem. About 85% of men who have it are still able to achieve orgasm with self stimulation. A few other possible causes including the side effect of medications, drug use, alcohol, and neurological damage.
Due to its major psychological component, sex therapy is a top treatment. If it’s the result of medication then a plan and possible alternatives must be discussed with a doctor before changes are made.
Retrograde ejaculation is when semen enters the bladder rather than leave via the penis during ejaculation. While it isn’t necessarily harmful, it does make fertilization difficult as it affects the sperm delivery during vaginal intercourse. There’s no sign that it affects other healthy sexual functions, like having an erection or reaching orgasm. It can be partial or whole, which is also known as a “dry orgasm” as no semen is released. Possible causes of retrograde ejaculation include:
- Damage to muscles or related nerves of the bladder after surgery.
- Nerve damage due to medical illnesses, like diabetes or multiple sclerosis.
- Certain medications, such as alpha-blockers used to treat benign prostatic hyperplasia (BPH).
- Radiation therapy to the pelvic area.
- Side effect of certain psychiatric drugs and medications used to treat high blood pressure and prostate enlargement.
Unless it interferes with fertilization, retrograde ejaculation isn’t normally treated as it isn’t normally harmful. The issue will be permanent if it’s a result of surgery or diabetes. If the patient wishes to do artificial insemination then a urologist might be able to extract the sperm from the man’s urine. Those with retrograde ejaculation still have ways to impregnate someone.
Erectile dysfunction (ED) occurs when men have a consistent inability to get or maintain an erection, preventing them from fulfilling sexual needs and desires. Men with ED don’t typically love their sexual desire, so the problem is biological and involuntary. This is the most common sexual dysfunction for men, affecting about 100 million 40 to 70 year olds in America, though there are some that have starting with this issue earlier in life.
The causes are typically related to age, diabetes, obesity, cardiovascular issues, and injury. That isn’t to say that ED can’t be caused by psychological sources, such as stress or depression, but generally speaking, ED is a side effect of a physical condition, so it the most important thing to do is discuss it with a doctor. In most cases, doctors will simply recommend performance enhancing medications, such as Cialis or Viagra, provided that the patient doesn’t suffer from any sort of cardiovascular issue.