A sexual dysfunction can be defined as any condition, organic or psychological, that interferes with an individual’s or couple’s ability to achieve sexual satisfaction.
The range of sexual dysfunctions is great. Many disorders, however, can be divided into four main areas:
- problems with sexual desire,
- problems with sexual arousal,
- difficulty achieving an orgasm or
- having a painful sexual experience. Any of these categories of sexual dysfunction can have physical and/or psychological components.
Difficulties in feeling sexual desire (or loss of libido) can affect either gender. It can be due to interpersonal issues, depression, medications, drug or alcohol use or to a hormonal deficiency. Even women need a small amount of testosterone in their bodies to feel a sense of sexual desire. In older women, the gradual decrease in estrogen they experience can affect libido. Members of either sex can develop a loss of libido simply by having another type of sexual dysfunction that makes the idea of having sex seem unappealing.
Either gender can have problems with sexual arousal. In women, the condition was once called frigidity. In men, the terms impotence or erectile dysfunction are used to describe the inability to obtain sexual arousal resulting in an erection. The causes can be the same as those that cause problems with sexual desire. In men, however, erectile dysfunction is often physical and can be related to diabetes, blood vessel disease, nerve damage or penile trauma. Psychological factors, too, such as anxiety, can play a role in developing this condition.
This kind of disorder involves the normal ability to become sexually aroused and stimulated but with a delay in or absence of an orgasm. This can be due to the couple lacking the knowledge of how to best stimulate one another or, in many cases, the use of certain drugs, most notably SSRI antidepressants.
Sexual Pain Disorders
Pain with sexual activity can affect men or women and can be physical or psychological in origin. Men with Peyronie’s disease (a curvature of the penis) can experience painful erections and painful intercourse. Normal women can find intercourse painful if they have insufficient lubrication, which, in turn, can be caused by low estrogen levels. Vaginismus is a condition involving involuntary spasms of the vagina that prevents intercourse or causes extreme pain with intercourse. This condition is believed to be caused by past psychological trauma. Another female disorder causing sexual pain is vulvodynia which is experienced as a burning pain in the vulvar area and which is worsened during sex. The exact cause is unknown.
While sexual dysfunction can affect anyone, there are two peak ages in which help is requested. Couples in their late twenties to thirties often seek help for a sexual dysfunction; in addition, older couples, often with medical problems, experience an increased incidence of sexual dysfunction.