Sexual Dysfunctions

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 includes excitement, plateau, orgasm and resolution.

While research suggests that sexual dysfunction is common (43 percent of women and 31 percent of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and health care provider.

1. Desire

This phase is distinct from any identified solely through physiology and reflects the patient's motivations, drive, and personality. The phase is characterized by sexual fantasies and the desire to have sex.

2. Excitement

This phase consist s of a subjective sense of sexual pleasure and accompanying physiological changes. All the physiological response noted in Master and Johnson's excitement and plateau phase are combined and occur in this phase.

3. Orgasm

This phase consists of a peaking of sexual pleasure, with release of sexual tension and rhythmic contraction of the perineal muscles and pelvic reproductive organs.

4. Resolution

This phase entails a sense of general relaxation, well-being, and muscle relaxation.During this phsae men are refractory to orgasm for a period of time that increases with age,whereas women are capable of having multiple orgasms without a refractory period.

What are the types of sexual dysfunction ?

Sexual dysfunction generally is classified into four categories:
Desire disorders The lack of sexual desire or interest in sex
Arousal disorders The inability to become physically aroused during sexual activity
Orgasm disorders The delay or absence of orgasm (climax)
Pain disorders Pain during intercourse (This condition mostly affects women.)

What are the symptoms of sexual dysfunction ?

In men:
Erectile Dysfunction : Inability to achieve an erection or maintain and erection suitable for intercourse.
Premature Ejaculation : When ejaculation occurs before the partner achieves orgasm.
Orgasm Disorder : When there is absence of orgasm.

In women:
Inability to relax the vaginal muscles enough to allow intercourse
Inadequate vaginal lubrication before and during intercourse
Inability to control the timing of ejaculation (premature or retarded ejaculation)

In men and women:
Lack of interest in or desire for sex
Inability to become aroused
Pain with intercourse

What causes sexual dysfunction ?

Causes of sexual dysfunction include:
Physical causes Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of some medications, including some antidepressants drugs, can affect sexual function.

Psychological causes These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.

How is sexual dysfunction diagnosed ?

The doctor likely will begin with a complete physical and history of symptoms. He or she may order diagnostic tests to rule out any medical problems that may be contributing to the dysfunction. An evaluation of the person's attitudes regarding sex, as well as other possible contributing factors (fear, anxiety, past sexual trauma/abuse, relationship problems, alcohol or drug abuse, etc.) will help the doctor understand the underlying cause of the problem and make recommendations for appropriate treatment.

How is sexual dysfunction treated ?

Most types of sexual dysfunction can be corrected by treated the underlying physical or psychological problems. Other treatment strategies include:

Men and women with hormone deficiencies may benefit from hormone shots, pills or creams. For men, drugs including sildenafil (Viagra) may help improve sexual function by increasing blood flow to the penis.

Mechanical aids such as vacuum devices and penile implants may help men with erectile dysfunction (the inability to achieve or maintain an erection).

Behavioral treatments These involve various techniques, such as self-stimulation, to treat problems with arousal and/or orgasm.

Psychotherapy Therapy with a trained counselor can help a person address feelings of anxiety, fear or guilt as well as poor body image that may have an impact on sexual function.

Education and communication Education about sex, and sexual behaviors and responses may help an individual overcome his or her anxieties about sexual function. Open dialogue with your partner about your needs and concerns also helps to overcome many barriers to a healthy sex life.

Can sexual dysfunction be cured ?

The success of treatment for sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear or anxiety often can be successfully treated with counseling, education and improved communication between partners.