sexual dysfunction | psychology | Dr Zahid Qutab Psychiatrist

Sexual dysfunction psychology is related to any problem that prevents a person or couple from experiencing satisfaction from sexual activity. Some 43% of women and 31% of men suffer from some degree of sexual dysfunction.

What is sexual dysfunction?

Sexual dysfunction is a problem that can happen to anyone during any phase of the sexual response cycle. It prevents one from experiencing satisfaction from sexual activity.
The sexual response cycle includes excitement, plateau, orgasm and resolution. Desire and arousal are both part of the excitement phase of the sexual response. It is important to know that women don’t always go through these phases in such order. What are the types of sexual dysfunction? Sexual dysfunction is classified into four categories:

Desire disorders: one experiences lack of sexual desire or interest in sex.
Arousal disorders: inability to become physically aroused or excited during sexual activity.
Orgasm disorders: delay or absence of orgasm (climax).

• Pain disorders: pain during intercourse.

Who is affected by sexual dysfunction?

Sexual dysfunction can affect anyone of any age although it is more common in over 40 because it’s often related to normal process of aging.

What are the symptoms of sexual dysfunction?

In men:

Inability to achieve and maintain an erection (hard penis) required for intercourse (erectile dysfunction).
Absent or delayed ejaculation despite repeated sexual stimulation (retarded ejaculation).
Inability to control the timing of ejaculation (early, or premature, ejaculation).

In women:

Inability to achieve or maintain orgasm.
Insufficient vaginal lubrication before and during intercourse.
Inability to even relax the vaginal muscles enough to allow intercourse.

In men and women:

Lack of interest in or desire for sex.
Inability to become physically aroused.

• Pain with intercourse.

What causes sexual dysfunction?

Physical causes: Many physical and medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, alcoholism and drug abuse.

In addition, the side effects of some medications, including some antidepressant drugs, can affect sexual function.

Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, concerns about body image and the effects of a past sexual trauma.

What medications can cause sexual dysfunction?

Some prescription medications and even over-the-counter drugs can have an impact on sexual functioning. Some medications can affect libido (desire) and others can affect the ability to become aroused or achieve orgasm.

The risk of sexual side effects increases many folds ,when an individual is taking multiple medications.

Sexual side effects reported with the following medications:

Non-prescription medicines

Some over-the-counter antihistamines and decongestants can cause erectile dysfunction or problems with ejaculation.

Antidepressants

Tricyclic antidepressants, including amitriptyline, imipramine , and nortriptyline .
Monoamine oxidase inhibitors (MAOIs), including phenelzine and tranylcypromine .
Antipsychotic medications, including thioridazine , and haloperidol (Haldol)
Anti-mania medications such as lithium carbonate.
Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine , sertraline , and paroxetine.

The following medications may cause erectile dysfunction:

Anti-hypertensive medications (used to treat high blood pressure)

Diuretics, including spironolactone , and the thiazides .
Centrally acting agents, including methyldopa
a-Adrenergic blockers, including prazosin and terazosin
b-adrenergic (beta) blockers, including propranolol and metoprolol

How is sexual dysfunction diagnosed?

Inmost cases you recognize that something is missing or interfering with your enjoyment (or a partner’s enjoyment) of a sexual relationship.

Your doctor usually begins with a complete history of symptoms and a physical examination.

Doctor may order diagnostic tests to rule out medical problems that may be contributing to the dysfunction.

An evaluation of attitudes about sex, as well as ruling out other possible contributing factors such as;

1.Fear related to sexual activity,

2.Anxiety related to performance,

3.Past sexual trauma/abuse,

4.Bad relationship concerns, medications,

Alcohol or drug abuse, etc. — helps a clinician understand better the underlying cause of the problem and recommend the right treatment.

MANAGEMENT AND TREATMENT

How is sexual dysfunction treated?

Most types of sexual dysfunction can be treated by treating the underlying physical or psychological problems.

Other treatment strategies include:

Medication: When a medication is the cause of the dysfunction, a change in the medication may help.

Men and women with hormone deficiencies may benefit from hormone shots, pills or creams.

For men, drugs including sildenafil, vardenafil etc, may help improve sexual function by increasing blood flow to the penis.

For women, hormonal options such as estrogen and testosterone can be used (although these medications are not approved for this purpose).

Sex therapy: Sex therapists can help people experiencing sexual problems .

Behavioral treatments: These involve different techniques, including insights into harmful behaviors in the relationship.

Psychotherapy: Therapy with a trained metal health professional can help you addressing sexual trauma from the past, feelings of anxiety related to sexual performance, fear, guilt and poor body image. All of these factors may affect sexual function.

Education and communication: Education about sex life and sexual behaviours and responses may help you overcome anxieties. Open uo and communicate with your partner about your or your partner’s sex related problems.

FAQ

Can sexual dysfunction be cured?

The success of treatment for sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a condition that can be treated or reversed.

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