A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.
While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant or embarrassed to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor.
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Sexual dysfunction can be a result of a physical or psychological problem.
Physical causes. Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause plus such chronic diseases as kidney disease or liver failure, and alcoholism or drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes. These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.
Who Is Affected by Sexual Dysfunction?
Both men and women are affected by sexual dysfunction. Sexual problems occur in adults of all ages. Among those commonly affected are older adults, and they may be related to a decline in health associated with aging.
How Does Sexual Dysfunction Affect Women?
The most common problems related to sexual dysfunction in women include:
Inhibited sexual desire. This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes, medical conditions and treatments (for example, cancer and chemotherapy), depression, pregnancy, stress, and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.
Inability to become aroused. For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. This inability also may be related to anxiety or inadequate stimulation. In addition, researchers are investigating how blood flow problems affecting the vagina and clitoris may contribute to arousal problems.
Lack of orgasm (anorgasmia). This is the absence of sexual climax (orgasm). It can be caused by a woman's sexual inhibition, inexperience, lack of knowledge, and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to anorgasmia include insufficient stimulation, certain medications, and chronic diseases.
Painful intercourse. Pain during intercourse can be caused by a number of problems, including endometriosis, a pelvic mass, ovarian cysts, vaginitis, poor lubrication, the presence of scar tissue from surgery, or a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.