Sexual Dysfunction In Males and Females
Both men and women are affected by sexual dysfunction.
Sexual problems occur in adults of all ages. Among those commonly affected are older adults, and they may be related to a decline in health associated with aging. The prevalence of sexual dysfunction is 43% for women and 31% for men in a large American sample. Erectile dysfunction increases as men age, with 52% of men age 40 - 70 having some degree of impotence.
Sexual dysfunction or sexual malfunction is difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including physical pleasure, desire, preference, arousal or orgasm. According to the DSM-5, sexual dysfunction requires a person to feel extreme distress and interpersonal strain for a minimum of 6 months (excluding substance or medication-induced sexual dysfunction). Sexual dysfunctions can have a profound impact on an individual's perceived quality of sexual life.
A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.
Sexual dysfunction can be a result of a physical or psychological problem:
- Physical causes - Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause plus such chronic diseases as kidney disease or liver failure, and alcoholism or drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
- Psychological causes - These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.
Symptoms of sexual dysfunction:
- Erectile dysfunction (ED) - ED can be caused by medical conditions, such as diabetes or high blood pressure, or by anxiety about having sex. Depression, fatigue, and stress can also contribute to erectile dysfunction.
- Low libido - Psychological issues like stress and depression, as well as anxiety about having sex also can lead to a decreased or no sexual desire. Decreased hormone levels (particularly if testosterone is low), physical illnesses, and medication side effects may also diminish libido in men.
- Ejaculation problems - These include premature ejaculation (ejaculation that occurs too early during intercourse) and the inability to ejaculate at all. Causes include medications, like some antidepressants, anxiety about sex, a history of sexual trauma (such as a partner being unfaithful), and strict religious beliefs.
- Difficulty achieving orgasm - Orgasm disorders, such as delayed orgasms or inability to have one at all, can affect both men and women. Again, some antidepressant medications can also cause these problems.
- Low libido - Lack of sexual desire can also be caused by lower levels of the hormone estrogen. Fatigue, depression, and anxiety can also lead to low libido, as can certain medications, including some antidepressants.
- Pain during sex - Pain is sometimes from a known cause, such as vaginal dryness or endometriosis. But sometimes the cause of painful sex is elusive. Known as vulvodynia or vulvar vestibulitis, experts don't know what’s behind this mysterious type of chronic, painful intercourse. A burning sensation may accompany pain during sex.
- Vaginal dryness - This can lead to low libido and problems with arousal and desire, as sex can be painful when the vagina isn't properly lubricated. Vaginal dryness can result from hormonal changes that occur during and after menopause or while breastfeeding, for example. Psychological issues, like anxiety about sex, can also cause vaginal dryness. And anticipation of painful intercourse due to vaginal dryness may, in turn, decrease a woman’s desire for sex.
In both men and women:
- Pain with intercourse
- Inability to become aroused
- Lack of interest in or desire for sex