Sexual dysfunction can exist throughout a person's life or may develop after an individual has previously experienced normal sexual responses. The difficulty may develop gradually over time, or may occur suddenly and present itself either as total or partial dysfunction in one or more stages of the sexual response cycle. The cause may be physical, psychological, or both.
Emotional factors include both interpersonal problems (marital/relationship troubles, lack of trust between partners) and an individual's psychological problems (depression, sexual fears or guilt, past sexual trauma, and so on).
Physical factors include drugs (alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, or most psychotherapeutic drugs); complications related to back, prostate, or vascular surgeries; failure of various organ systems (such as the circulatory and respiratory systems); endocrine disorders (thyroid, pituitary, or adrenal gland problems); neurological problems caused by trauma (such as spinal cord injuries) or disease (such as diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis); hormonal deficiencies (low testosterone or androgens); and some fetal development abnormalities.
Sexual dysfunction disorders are generally classified into four categories: sexual desire disorders, sexual arousal disorders, orgasm disorders, and sexual pain disorders.
Sexual desire disorders (decreased libido) may result from a decrease in normal androgen or testosterone hormone production. Other causes may be aging, fatigue, medications, pregnancy, or psychiatric conditions such as depression and anxiety.
Common causes of impotence
- Medication use (especially antihypertensives)
- Smoking
- High blood pressure
- Hormonal deficiency caused by disease (diabetes) or injury
- Liver disease, usually caused by alcoholism
- Circulation problems (arteriosclerosis, anemia, or vascular surgery)
- Neurological problems (injury, trauma, disease)
- Urological procedures (prostatectomy, orchiectomy, radiation therapy)
- Penile implants (or prostheses) that are not functioning properly
- Depression, anxiety, fatigue, boredom, stress, fear of failure
- Mood altering drugs, alcohol, medications
- Deep-seated psychological problems
Orgasm disorders, which can affect both sexes, are a persistent delay or absence of orgasm following sexual excitement. Sexual pain disorders affect many more women than men and are known as dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the musculature of the vagina that interferes with intercourse). Dyspareunia may be caused by insufficient lubrication in the female, which may result from breastfeeding, irritation from contraceptive creams and foams, aging, or by fear and anxiety. Vaginismus may be caused by a sexual trauma such as rape or incest.
Sexual dysfunctions are more common in the early adult years, with the majority of patients seeking care for such conditions during their late twenties into their thirties. The issues increase again in the geriatric population, typically with a gradual onset of symptoms associated most commonly with organic causes of sexual dysfunction.
Increased risk is often linked to a history of diabetes, degenerative neurological disorders, chronic psychological problems, alcohol use, drug abuse, difficulty maintaining relationships, or chronic disharmony with the current sexual partner.
Prevention
Honest and accurate communication regarding sexual issues and body image between parents and their children may prevent children from developing anxiety or guilt about sex and carrying those emotional responses into their adulthood.
Review all medications (prescription and over-the-counter) for possible side effects regarding sexual dysfunction. Avoiding drug and alcohol abuse may help prevent sexual dysfunction.
Couples engaging in adequate communication may be able to avoid some problems within their relationship that could potentially create some forms of sexual dysfunction.
People who are victims of sexual trauma should receive comprehensive treatment, including individual counseling and group therapy. This may prove beneficial in allowing them to fully enjoy voluntary sexual experiences with a partner of their choice.
