Issues that cause a problem with an individual’s ability to have sexual pleasure are sexual dysfunctions. 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. 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. 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 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
Hypoactive sexual desire disorder (HSDD) is a woman’s continuous lack of interest in sex, to the point that it causes great or heightened personal distress. It’s normal for a woman to not always be in the mood, as the libido will have a natural fluctuation to it, however HSDD is when a lack of desire causes 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.
As the most common female sexual dysfunction, 1 in 10 women in the U.S. experience HSDD, and it is able to occur in all age groups. 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. While the most common physical cause is menopause, it could also be from coronary artery disease, arthritis, and cancer. The reason menopause is the most common is that estrogen and testosterone levels in women drop significantly during it, as they are hormones that boost libido. Additionally, hormonal changes during and after pregnancy can bring on HSDD.
HSDD can be brought on from psychological or emotional stress as well. Women who suffer from low self-esteem, anxiety, or depression are also at risk of developing it. Serious traumas are also able to cause HSDD, including physical abuse, sexual abuse, and 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. By assessing the level of distress as it relates to a woman’s sexual life a psychiatric diagnosis is able to be made. Once they’ve determined that it is the case, they will then attempt to find the cause and then treat that problem. It can be simple, such as a change in prescription, or it could mean that the patient should see a second therapist or a counselor specializing in sexual disorders. In some cases, women undergo hormonal therapy to regain their libido.
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Sexual Arousal Disorder
As sexual arousal disorder is a biological problem it shouldn’t be confused with the other desire based disorders. 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 basic idea is that typically romantic activities, things like dancing, dissing, or direct physical stimulation, do not cause a genital response.
Some symptoms may be:
- A lack of lubrication in the vagina
- Lack of vaginal dilation
- Decreased genital swelling
- Less sensation in the genitals
- Less sensation in the nipple
It is possible that sexual arousal disorder can be caused by more emotional factors (stress, relationships, low self-esteem, etc.), but more than likely it is caused by physical factors. In most cases, women with sexual arousal disorder suffer from depletion of hormones, reduced blood flow brought on by cardiovascular diseases, or some form of 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.
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. As well, its recommended that those who suffer from it should see a sex therapist or counselor in order to track the treatment and ensure there are no emotional restrictions.
Female Orgasmic Disorder
Female orgasmic disorder (FOD) is the constant inability of a woman to achieve orgasm. Different from sexual arousal disorder, the ability of a woman to function sexually is unimpaired. 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. This can be a point of tension between romantic partners.
FOD can be both physical and psychological. 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:
- Pelvic blood vessel damage
- 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)
It is also worth mentioning that certain medications can cause FOD as well, such as narcotics and antipsychotics.
Some women experience secondary, or acquired 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:
- Sexual abuse, incest, rape, or similar traumatic sexual encounters
- Emotional abuse
- Pregnancy fear
- Fear of rejection by partner
- Fear of losing control during an orgasm
- Self-image problems
- Issues between her and her partner
- Stress from life, including divorce, job loss, and financial concerns
- Feeling guilty with regards to sex or sexual pleasure
- How sex is viewed religiously or culturally
- Another mental health disorder, like depression
Just like other sexual dysfunctions, FOD is treated case by case. Medicinal treatment will likely be used for physical problems, and those women are also often encouraged to do a bit more exercise, especially kegel exercises, as they focus on strengthening and tone the muscles in the genital area. Sex education, sex therapy, and psychotherapy may be needed for cases involving emotional related problems.
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. An individual’s pain tolerance levels determine the severity of it. Some may only experience it during vaginal intercourse, but others may experience it in something like inserting a tampon. Originally, GPPD was considered to be two separate conditions, known as dyspareunia and vaginismus, but the American Psychiatric Association combined them together since, while their technical definitions are strictly different, they commonly appear in tandem with one another are are difficult to tell apart in real life.
Some symptoms may be:
- Persistent problems with having intercourse
- Pain in the pelvic or genital area during attempts at penetration
- Major fears or anxieties related to the pain of intercourse This fear may be present before, during, or after vaginal penetration.
- Tensing or tightening of the pelvic floor muscles when attempting vaginal intercourse.
It is still unclear what exactly causes GPPD. 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.
Disorders in Men
Premature ejaculation (PE) is when ejaculation occurs with minimal stimulation before, during, or quickly after penetration. It is completely involuntary, and men who suffer from PE have little to no control over it. It’s the most common sexual dysfunction, with about 30% of men in the U.S. having it, though it’s thought this number is actually higher since it’s considered a taboo in American culture. All age groups are susceptible to PE.
The cause of PE is unknown at this time. 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 most commonly occurs later in life in association with age, but it has also been documented that some men experience this issue shortly after they finish puberty.
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.
When a man has a firm erection and enough stimulation, yet still struggles to ejaculate they have delayed ejaculation, the opposite of PE. About 5% of men in the U.S. suffer from delayed ejaculation.
Currently it’s thought to be a psychological issue. 85 percent of men who struggle with it are able to achieve orgasm with self stimulation. Some other possible causes are drug use, alcohol, medicinal side effects, and even neurological damage.
Due to its major psychological component, sex therapy is a top treatment. If a medication is causing the issue then men should speak with a doctor and look for possible alternative options before they try to cut the medication out.
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. It does not inhibit other healthy sexual functions, such as having an erection or reaching orgasm. There are partial and entire variations, the latter being known as a “dry orgasm” due to the semen not being released. A few possible reasons for this are:
- Damage to the muscles of the bladder or to the nerves that control these muscles after surgery.
- Nerve damage resulting from a medical illness, such as multiple sclerosis or diabetes.
- Certain medications, such as alpha-blockers used to treat benign prostatic hyperplasia (BPH).
- Radiation therapy to the pelvic area.
- A side effect of psychiatric drugs and medications for prostate enlargement and high blood pressure.
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. Men who wish to do artificial insemination might be able to have a urologist extract their sperm from their urine shortly after they orgasm. In short, it’s not impossible for men with retrograde ejaculation to impregnate anymore.
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 primarily affects 40 to 70 year olds, and is currently the most common sexual dysfunction in men, affecting about 100 million Americans.
The most common causes of ED include diabetes, obesity, age, injury, and cardiovascular problems. 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.