Acknowledgement

Our thanks to Gila Bronner - certified sex therapist and Director of the Sex Therapy Service in the Sexual Medicine Center, Sheba Medical Center, Tel-Hashomer, Israel - for her help in writing this article.

What is sexual dysfunction?

When you have difficulties with your sexual life or with your intimate relationship, professionals call it ‘sexual dysfunction’.

There are four main areas that affect both men and women:

Desire disorders - lack of interest in having sex or participating in intimate activity. Such difficulties sometimes evolve due to desire differences between partners, when one of you is less interested in sex and/or intimacy than the other.
Arousal disorders - when you feel that you can't respond physically and emotionally to sexual stimulations or you get aroused but can’t sustain it. Men who have arousal disorders can experience difficulties in getting an erection suitable for intercourse. Others may get a good erection, but lose it before they reach their orgasm. These problems are known as ‘erectile dysfunction’.
Orgasmic disorders - women who can't have an orgasm are said to have orgasmic difficulties, also known as ‘anorgasmic’ or ‘preorgasmic’. If men are unable to reach orgasm, this is known as ‘inhibited ejaculation’ or ‘retarded ejaculation’. If they are unable to control their orgasm, and they come too soon, this is known as ‘premature ejaculation’ or ‘rapid ejaculation’.
Sexual pain disorders - sexual pain disorders are divided into three main categories:
- dyspareunia- pain with attempted or complete vaginal entry and/or penile-vaginal intercourse
- vaginismus– inability to have any form of vaginal penetration, including sexual penetration or insertion of tampons
- other pain-related disorders- pain due to medical conditions such as infections, inflammatory conditions, surgery for prolapse or incontinence etc.

What causes sexual dysfunction?

There are many causes of sexual dysfunction, the most common being:

medical conditions, such diabetes, high blood pressure or hormonal changes
medications, such as antidepressants
alcohol
vaginal infections
depression, anxiety, unhappy relationships, abuse (physical, mental and sexual in the past or present)
temporary changes in sexual activity due to events such as divorce, menopause, childbirth, death of a loved one, and retirement
burn-out and a stressful life - job dissatisfaction or being tired as a result of a heavy workload or looking after your family - can affect the ability to initiate or perform sexual activity and may reduce your desire for sex.

Did you know?

The term ‘libido’ is a concept originated by the famous psychiatrist, Sigmund Freud. He used it to label the sexual drive and the instinctual physiological or psychic energy associated with sexual urges. He observed that sexual drive is characterised by a gradual rise to a peak of intensity, followed by a rapid decrease of excitement.

Depression

A mental state of melancholia, unhappiness or sadness characterized by decreased energy, reduced interest in sex, suppressed appetite, too much sleep or sleep disturbance, a pessimistic sense of inadequacy, a despondent lack of activity, despair, and discouragement.

See section on Depression

Burn-out

A physical or psychological condition often induced by overwork or overexposure to stress in the workplace. This causes rises in feelings of being worn out and having diminished interest in performing an activity and the person becomes tired, defensive, frustrated, cynical, bored, and generally pessimistic about the job.

Incontinence

The inability to control accidental or involuntary leaking of urine or stool.

Psychiatrist

A medical doctor (MD) who specializes in treating mental health issues and disorders, such as anxiety and depression.

A psychiatrist evaluates a person’s mental health along with his or her physical health and can prescribe medications to treat mental and emotional disturbances.

Menopause

It is the time when the ovaries stop producing the hormone estrogen and a woman stops having menstrual periods (menstruation). Menopause marks the end of a woman's childbearing years, usually between the ages of 40 and 55.

The word menopause is derived from the Greek 'meno-' (month) and 'pausis' (a pause, a cessation).

The World Health Organization defines this point as one year after the last period.

Antidepressant

A medication / drug or other substance (nutrient or herb) used for to alleviate depression.

Sexual Dysfunction