Sexual dysfunction is when you have a problem that prevents you from wanting or enjoying sexual activity. It can happen anytime, from that first blush of excitement to orgasm.
Men and women of all ages experience sexual dysfunction, although the chances increase as we get older.
Stress is a common cause of sexual dysfunction. It’s hard to feel sexy or be in the mood when you’re fatigued or overwhelmed. Sexual trauma or psychological issues can cause sexual dysfunction. So can diabetes, heart disease, or other medical conditions. Drug and alcohol use and certain medications can also be contributing factors.
When Does a Bad Night Become a Disorder?
Sexual dysfunction can be divided into four categories. None of these should be considered a disorder unless it happens regularly and makes you unhappy.
Desire disorder: It’s okay not to be in the mood sometimes. Desire disorder is when you have little or no interest in sexual relations on an ongoing basis.
Arousal disorder: You’re emotionally in the mood, but your body is just not into it.
Orgasm disorder: You’re totally into it, but your inability to climax leaves you frustrated.
Pain disorder: It hurts when you have intercourse.
In men, low levels of testosterone can cause loss of libido (sexual desire). In women, low estrogen or testosterone levels can affect desire. Hormonal changes following childbirth, breastfeeding, and menopause can interfere with a woman’s interest in sex. Other physical causes include high blood pressure, diabetes, and certain medications.
Relationship problems and sexual inhibitions can be a turnoff. So can stress, fatigue, and fear of pregnancy.
Sexual Dysfunction in Men: Erectile Dysfunction
Erectile dysfunction (ED) is when a man cannot achieve or maintain an erection appropriate for intercourse. This can be due to a problem with blood flow, a nerve disorder, or injury to the penis. It can also be brought about by psychological problems, like stress or depression, or by relationship issues.
Other causes of ED include Peyronie’s disease, chronic illness, and some medications. Ongoing ED can create a cycle of anxiety and embarrassment.
Sexual Dysfunction in Men: Ejaculation Disorders
When ejaculation happens before or immediately after penetration, it is called premature ejaculation. This is often a consequence of performance anxiety. It can also be due to other psychological stressors or sexual inhibitions. Nerve or spinal cord damage and certain medications can interfere with normal ejaculation.
Inhibited ejaculation is when you can’t ejaculate at all. Some men, particularly those who have diabetic neuropathy, experience something called retrograde ejaculation. During orgasm, ejaculation enters the bladder instead of exiting out of the penis.
Sexual Dysfunction in Women: Pain and Discomfort
Many things can cause pain during sexual activity. Inadequate lubrication and tense vaginal muscles make penetration painful. Involuntary vaginal muscle spasms (vaginismus) can make intercourse hurt. These may be symptoms of neurological, urinary tract, or bowel disorders.
The hormonal changes of menopause can make intercourse uncomfortable. A drop in estrogen levels can result in thinning of the skin in the genital area. It can also thin the vaginal lining and decrease lubrication
Sexual Dysfunction In Women: Missing Out On the Big ‘O’
Stress and fatigue are the enemies of orgasm. So are pain and discomfort during sexual activity. Women may be unable to achieve orgasm when their sex drive is low or when hormones are out of whack.
When is a “dysfunction” not a dysfunction? According to Harvard Medical School, a norm for female sexual response is qualitative and not easily measurable and, basically, you don’t have sexual dysfunction if you’re satisfied with your sex life.
When to See Your Doctor
When sexual problems keep happening, both partners can suffer from anxiety. Things can escalate if you’re too embarrassed to discuss it.
If the situation doesn’t improve or you suspect a physical reason, it’s time to see your doctor. Be prepared to give a complete medical history, including a list of prescription and over-the-counter medications. Tell your doctor the specifics of your problem.
Your doctor will begin with a physical exam. Depending on the outcome, this may be followed by a diagnostic testing. If no physical cause is found, consider seeing a therapist.