Sexual dysfunction - causes and what to do

Sexual dysfunction may be a topic of jokes sometimes, but it can also be a serious health problem that affects your overall well-being. People of all ages and genders can experience sexual dysfunction. Sexual dysfunction is the medical term for a problem that keeps you from enjoying sexual activity. If you’re experiencing any of these symptoms, this information can help you talk about them more easily with your healthcare provider.

Sexual dysfunction in penises: erectile dysfunction (ED)

If you’re unable to get or keep an erection firm enough for satisfactory sexual intercourse, the condition is called erectile dysfunction. ED can have physical and/or psychological causes. It can also be the cause of emotional distress. Talk with your doctor about lifestyle changes that may help reduce symptoms.

Some physical causes of ED [1]:

• High cholesterol levels
• High blood pressure
• Neurological disorders
• Diabetes
• Low testosterone
• Medication side effects
• Smoking and abuse of alcohol/recreational drugs

Psychological causes of ED [1]:

• Performance anxiety
• Conscious/subconscious stress
• Depression
• Relationship problems

Sexual dysfunction in penises: ejaculation disorders

Ejaculation disorders can interfere with your enjoyment of sexual activity and your fertility. Like ED, these disorders can lead to depression and anxiety.

• Premature ejaculation — when ejaculation happens sooner than you or your partner would like. Causes include performance anxiety or other psychological factors, nerve or spinal cord damage or some medications.
• Impaired ejaculation — when you can’t ejaculate at all.
• Retrograde ejaculation — when semen goes into your bladder instead of your penis, usually caused by diabetic neuropathy [2].

Sexual dysfunction in vaginas: pain and discomfort

Vaginal pain and discomfort can make sexual intercourse impossible. The anticipation of pain can cause the muscles of the vagina to tighten, making attempts at intercourse more painful. This type of dysfunction can also impact fertility and cause emotional distress.

Common causes of pain and discomfort in vaginas [3]:

• Inadequate lubrication
• Tense vaginal muscles
• Vaginal muscle spasms
• Neurological, urinary tract, or bowel disorders
• Hormonal changes of menopause

Sexual dysfunction in vaginas: difficulty having an orgasm

The inability to reach orgasm or difficulty reaching orgasm can decrease sexual desire over time. Up to one half of women are not satisfied with how often they reach orgasm [3].

Common causes of difficulty having an orgasm include [4]:

• Stress and fatigue
• Pain and discomfort
• Low sex drive
• Hormonal changes

When to see your doctor

If you’re experiencing any of these problems, schedule an appointment with your doctor. There have been recent advances in treatments, and your doctor or a specialist can explain your options. If you’re uncomfortable discussing sexual dysfunction in-person, a telehealth visit may be less intimidating. If the problem isn’t due to a physical cause, a therapist may be able to help.

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References:

1. Erectile dysfunction. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776. Accessed Feb 8, 2022.
2. Retrograde ejaculation. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/retrograde-ejaculation/symptoms-causes/syc-20354890. Accessed Feb 8, 2022.
3. Orgasmic dysfunction in women. NIH. https://medlineplus.gov/ency/article/001953.htm, Accessed Jan 31, 2022.
4. Female sexual dysfunction. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/symptoms-causes/syc-20372549. Accessed Feb 8, 2022.