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. All people are able to have a sexual disorder, however certain ones increase in likelihood with 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. Some of the possible psychological issues could be anxiety guilt, marital issues, depression, stress, poor body image, and PTSD. 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. In addition, it can result from substance use like alcohol or drug abuse, or it can be the result of side effects from certain medications, such as antidepressants and diuretics.
Disorders in 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.
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. 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.
There are several causes of HSDD, and often they will work together. It can be the physical result of arthritis, cancer, coronary artery disease, and most commonly menopause. 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. As well, the chances in hormone levels from both during and after pregnancy can cause HSDD.
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.
It can be hard to diagnose HSDD. Knowing that women are all unique, there is no way to set a minimum sexual drive to diagnose it. 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. It may be as simple as using a different prescription, however it may require that she visit a therapist who specializes in sexual disorders. Some women may need to undergo hormonal therapy in order to restore 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 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 basic idea is that typically romantic activities, things like dancing, dissing, or direct physical stimulation, do not cause a genital response.
Symptoms may include:
- A lack of lubrication in the vagina
- Lacking in vaginal dilation
- A decreased genital swelling
- Lacking in genital sensation
- Less sensation in the nipple
While emotional factors are a possible cause, it is most likely a result of a physical factor. 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 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 the constant inability of a woman to achieve orgasm. The woman is still able to sexually function, so it is different from sexual arousal disorder. They still experience arousal from either emotional or physical stimuli, but are unable or have extreme difficulty reaching climax and releasing tension. They’re stuck in a constant state of stimulation but are never able to be released. This can be a point of tension between romantic partners.
Both psychological and physical issues can cause FOD. FOD is a primary, or lifelong disorder, and most often the women who have it have never achieved orgasm, no matter what type of stimulation they received. Often these women are born with it, and there are a few physiological conditions that can include:
- Damage to the blood vessels of the pelvic region
- Spinal cord lesions or damage to the nerves in the pelvic area
- 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.
There are women who experience a 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. Unlike primary FOD where an individual is typically born with the issue, acquired FOD is normally temporary and treatable. Usually theses cases are caused by psychological influence, including:
- Sexual abuse, incest, rape, or similar traumatic sexual encounters
- Emotional abuse
- Pregnancy fear
- Fear of her partner rejecting her
- Fear of losing control during an orgasm
- Issues with self-image
- Relationship problems with partner
- Life related stress, like job loss, divorce, or financial fears
- Guilt over sex or sexual pleasure
- Cultural and religious beliefs regarding sex
- Mental health disorders like major depression
Similar to the other sexual dysfunctions, FOD will be 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. For those who have FOD due to an emotional problem they may use a combination of sex therapy, psychotherapy, and full sexual education.
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. For some, it only occurs during vaginal intercourse, while for others it can be as simple as 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
- 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. Currently specifics are unknown, however the thought is that it is similar to other sexual dysfunctions. 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 for Men
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 is able to affect men of any age group.
PE causes are still unknown. While it was originally thought to simply be a psychological problem, it’s been found in recent studies that chemical imbalances or the changes in receptor sensitivity in the brain may also be a factor. While it’s most common in older men, those who has just finished puberty have also reported 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. Those who suffer from PE may also find help for it through therapy.
The opposing end is delayed ejaculation, in which men have trouble ejaculting despite having an erection and stimulation. It’s not as common as PE, but it does occur in almost 5 percent of men in the U.S.
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. 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 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. 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. It can occur partially or entirely, in which case it is referred to as a “dry orgasm”, where no semen is released upon orgasm. A few possible reasons for this are:
- Damage to muscles or related nerves of the bladder after surgery.
- Nerve damage due to medical illnesses, like diabetes or multiple sclerosis.
- Some medications, including alpha-blockers for benign prostatic hyperplasia (BPH).
- Radiation therapy for the pelvic region.
- The side effect of certain psychiatric medications and drugs that are 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. However, if it is a result from surgery or diabetes, it is often not correctable, and it will affect the patient for the rest of his life. Men who wish to do artificial insemination might be able to have a urologist extract their sperm from their urine shortly after they orgasm. It is still possible to impregnate someone with retrograde ejaculation.
Erectile dysfunction (ED) is when a man is unable to fulfill their sexual desires and needs due to their inability to gain or maintain an erection. Its biological in nature and completely involuntary, as men with ED still retain desire for sex. It is the most common sexual dysfunction in men, affecting what it estimated to be 100 million Americans, usually occurring in age groups between 40 and 70, but it can occur in younger age groups as well.
The causes are typically related to age, diabetes, obesity, cardiovascular issues, and injury. While it is possible to cause ED with psychological issues, like depression or stress, but it is most often caused by a physical condition, and should be discussed 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.