Specific physical findings and testing procedures depend on the form of sexual dysfunction examined. A complete history and physical exam should be done to identify predisposing illness or conditions; highlight possible fears, or guilt specific to sexual performance; and bring out any history of prior sexual trauma. A physical examination of both the partners should not be limited to the reproductive system.
Treatment measures should be specific to the cause of the sexual dysfunction. Organic causes that are reversible or treatable are usually managed medically or surgically. Physical therapy and mechanical aides may help some people with physical illnesses, conditions, or disabilities. Viagra (sildenafil) often improves both organic and psychological sexual dysfunction in males by increasing blood flow to the penis. Men on nitrates for coronary heart disease should refrain from taking sildenafil, as it may cause dangerous drug interactions. Mechanical aids and penile implants are sometimes used. Men with androgen deficiency sometimes benefit from testosterone shots. Women with androgen deficiency can tolerate smaller doses of testosterone orally or topically with a cream.
Self-stimulation and the Masters and Johnson treatment strategies are just two of many behavioral therapies used to treat problems associated with orgasm and sexual arousal disorders.
Some couples may require joint counseling to address interpersonal issues and communication styles. Psychotherapy may be required to address anxieties, fears, inhibitions, or poor body image. In general, the prognosis is good for physical (organically caused) dysfunctions resulting from treatable or reversible conditions. However, many organic causes do not respond to medical or surgical treatments. In functional sexual problems resulting from either relationship issues or psychological factors, the prognosis may be good for temporary or mild dysfunction associated with situational stressors or lack of accurate information. However, those cases associated with chronically poor-functioning relationships or deep-seated psychiatric problems usually do not have positive outcomes. Some forms of sexual dysfunction may cause infertility.
For impotence caused by fear of infection, use safe sex practices and consider abstinence. Talk to your health care provider if impotence is related to fear of recurring heart problems—sexual intercourse is usually safe.
If the problem is persistent or if there are other associated and unexplained symptoms, call your health care provider.
Persistent sexual dysfunction may cause depression. Sexual dysfunction that is not addressed adequately may lead to conflicts or potential breakups for couples.
Sexual Arousal Disorder. Last reviewed 12/14/2006
Sources:
- Journal of Men's Health and Gender
- Journal of the American College of Cardiology
- National Institutes of Health - National Library of Medicine
