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. Both genders are able to suffer from the disorders, and as you age you’ll be more likely to have problems. In the U.S., 43% of women and 31% of men report having some degree of difficulty in the bedroom, making sexual dysfunction somewhat of a common issue, especially in those over 40 years of age.
There are a number of reasons for sexual dysfunction. Some of the possible psychological issues could be anxiety guilt, marital issues, depression, stress, poor body image, and PTSD. It may even be a physical problem, possibly heart disease, diabetes, hormonal imbalances, even liver failure. As well, substance abuse can cause these issues, or certain medications may have it as a side effect of using it.
Common Disorders for Women
Hypoactive Sexual Desire Disorder
HSDD is when a woman experiences a continuous lack of sexual interest, up to the point of it causes her heightened or great stress. 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 isn’t indicating that she feels and distress or concern over her sex drive or libido then she probably isn’t experiencing HSDD.
HSDD is the most common sexual dysfunction in women, affecting about 1 in 10 women in the U.S., and it can occur in every age group. The Mayo Clinic concluded that almost 40 percent of women will experience HSDD, and up to 15 percent of those women will experience it continuously.
HSDD can be the result of numerous issues, and these issues will often work in tandem. It can be the physical result of arthritis, cancer, coronary artery disease, and most commonly menopause. Menopause causes a drop in both testosterone and estrogen in women, both of which are hormones that normally boost the libido. HSDD may also result from the hormonal changes that occur during and after pregnancy.
Emotional and psychological stress can also bring about HSDD. Women who suffer from low self-esteem, anxiety, or depression are also at risk of developing it. However, in more serious cases, HSDD can be a direct result from trauma, such as physical abuse, sexual abuse or rape.
Diagnosing HSDD can be tricky. It’s a lack of a sex drive, and given that each woman is unique there’s no way to set a minimum bar or threshold that can be tested or used to make a confirmation. 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 determine that, they will try to pinpoint the direct cause of that distress and treat that condition. While she may only need a different prescription, she might also have to go and visit a counselor who actually specializes in sexual disorders. Some women use hormonal therapy to return their libido to a more normal level.
Sexual Arousal Disorder
As sexual arousal disorder is a biological problem it shouldn’t be confused with the other desire based disorders. It is defined by a lack or even complete absence of sexual fantasies and desires in situations that would normally produce some level of stimulation, or the overall inability to maintain that arousal. 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.
- Lack of 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. Most cases of sexual arousal disorder are caused by a reduced blood flow due to cardiovascular disease, hormone depletion, and nerve damage.
In order to be diagnosed a woman must report at least three of the following symptoms for a minimum of six months: Reduced sexual interest, lack of initiation of sex, reduced responsiveness to erotic cues, lack of pleasure and excitement during sex, lack of genital response to sexual activity, significantly less sexual desires and fantasies, and lack of sexual responsiveness.
The most common treatment for sexual arousal disorder is hormone therapy, though a doctor may feel the need to recommend medications for blood-flow enhancement to help encourage response in the genitals. 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. Unlike sexual arousal disorder, most of a woman’s sexual functions on unhindered. The women are still able to experience arousal due to physical or emotional stimuli, however they either have extreme difficulty with, or are completely unable to reach climax and release tension. It is a constant state of stimulation with no final release. Romantic partners may become frustrated by this.
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. Almost all of these women are born with this problem, and the physiological conditions can include, though are not limited to:
- Damage to the blood vessels of the pelvic region
- Pelvic nerve damage or spinal cord lesions
- Clitoris removal (also known as female genital mutilation, a practice in Asia, Africa, and the Middle East)
There are some medications that are able to cause FOD as well, including antipsychotics and narcotics.
It can be acquired as well, this is also known as secondary FOD. While they initially were able to orgasm, they have lost that ability as the result of surgery or medication, emotional trauma, or illness. Typically acquired FOD is temporary and treatable, unlike primary FOD. Usually theses cases are caused by psychological influence, including:
- Past rape, sexual abuse, incest, or a similar traumatic sexual experience
- Having been emotionally abused
- Fear of becoming pregnant
- Fear of her partner rejecting her
- Fear of losing control during an orgasm
- Issues with self-image
- Problems in the relationship
- Stress from life, including divorce, job loss, and financial concerns
- Guilt about sex or sexual pleasure
- How sex is viewed religiously or culturally
- Other mental health disorders such as major depression
FOD will also be treated on a case by case basis. If the cause is physical, then those issues are treated medicinally and are encouraged to get more exercise with focus on kegel exercises, which improve the strength and tone of muscles in the genital area. Sex education, sex therapy, and psychotherapy may be needed for cases involving emotional related problems.
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Genito-Pelvic Pain/Penetration Disorder
GPPD (Genito-Pelvic Penetration/Pain Disorder) is when a woman has extreme difficulty during intercourse due to painful penetration. The severity of it are dependent on the pain tolerance levels of the individual. For some, it only occurs during vaginal intercourse, while for others it can be as simple as inserting a tampon. While dyspareunia and vaginismus were two separate conditions originally, the American Psychiatric Association combined them together into GPPD, as they typically appear together and are hard to distinguish between in real life.
Symptoms may include:
- Persistent problems with having intercourse
- Pain in the genital or pelvic area during vaginal intercourse or attempts at penetration.
- Significant fear or anxiety associated with the pain of intercourse. This fear can be present before, during, or after the vaginal penetration.
- Attempts at vaginal intercourse results in the tensing or tightening of pelvic floor muscles.
GPPD causes are still mostly unknown. Experts suspect that it is similar to any other sort of sexual dysfunction, but specifics simply aren’t known at this time. While the most commonly accepted idea is that infections of the pelvic region can cause this genital pain, leading to GPPD, there have also been cases of women who were born with it. Whether genital pain can be expected based on these factors can only be determined by a doctor.
Common Disorders Men Experience
Premature ejaculation (PE) is when ejaculation occurs with minimal stimulation before, during, or quickly after penetration. Men with PE will have almost no, if any control over it, as it is an involuntary response. 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 can affect men in every age group.
The cause of PE is unknown at this time. It was historically accepted as a purely psychological disorder, but recent studies suggest that it can also be due to chemical imbalances or changes in receptor sensitivity in the brain. It’s mostly seen in the older age groups, however recently post-pubescent men have also reported having it.
Despite the causes still being unknown, there are several methods to treat PE. Doctors can prescribe desensitization treatments or ointments, or may simply recommend that the patient masturbates before having intercourse. There also have been studies showing that therapy can be beneficial to those suffering from PE.
Delayed ejaculation is the exact opposite of PE, in which men have difficulty ejaculating even with a firm erection and sufficient stimulation. It’s not as common as PE, but it does occur in almost 5 percent of men in the U.S.
Generally speaking, delayed ejaculation is considered to be psychological in nature. About 85% of men who have it are still able to achieve orgasm with self stimulation. However, it does has other possible causes, such as being a side effect of certain medications, alcohol or drug use, or even neurological damage in more extreme cases.
Due to its major psychological component, sex therapy is a top treatment. If medication might be the cause, it is important to discuss alternatives with a doctor before proceeding with any decision of cutting out said medication.
Retrograde ejaculation is when semen enters the bladder rather than leave via the penis during ejaculation. Relatively speaking, retrograde ejaculation isn’t harmful but it does make fertilization difficult since it affects the delivery of sperm to the vagina during intercourse. It doesn’t inhibit the other healthy sexual functions, such as reaching orgasm or having an erection. There are partial and entire variations, the latter being known as a “dry orgasm” due to the semen not being released. Some possible causes are:
- Damage to the muscles of the bladder or to the nerves that control these muscles 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 for the pelvic region.
- Side effect of certain psychiatric drugs and medications used to treat high blood pressure and prostate enlargement.
Retrograde Ejaculation isn’t harmful and usually doesn’t require treatment, unless it interferes with fertility. 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.
When men are unable to consistently get or maintain an erection they have erectile dysfunction (ED), and often they will be unable to fulfill their sexual needs and desires. The dysfunction is biological and 100% involuntary, since the men with ED continue to feel sexual desire. 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. You should speak with a doctor about this issue as it is almost always the result of a physical condition, though on occasion there are psychological causes, like stress and depression. If the patient doesn’t have a cardiovascular problem then the doctor will likely recommend the use of performance enhancing medications like Viagra or Cialis.