Sexual Dysfunction

When you have problems with sex, doctors call it “sexual dysfunction.” It can happen in both men and women.

Sexual dysfunction occurs when you have a problem that prevents you from wanting or enjoying sexual activity. It can happen anytime. People of all ages experience sexual dysfunction, although the chances increase as you age. Stress is a common cause of sexual dysfunction. Sexual dysfunction can affect any age, although it is more common in those over 40 because it’s often related to a decline in health associated with aging.

Types Of Sexual Dysfunction

Sexual dysfunction generally is classified into four categories:

• Desire disorders: 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

Symptoms Of Sexual Dysfunction

In people assigned male at birth:

1. Inability to achieve or maintain an erection (hard penis) suitable for intercourse (erectile dysfunction).
2. Absent or delayed ejaculation despite enough sexual stimulation (retarded ejaculation).
3. Inability to control the timing of ejaculation (early, or premature, ejaculation).

In people assigned female at birth:

1. Inability to achieve orgasm.
2. Inadequate vaginal lubrication before and during intercourse.
3. Inability to relax the vaginal muscles enough to allow intercourse.

How does sexual dysfunction affect men?

The most common problems men face with sexual dysfunction are troubles with ejaculation, getting and keeping an erection, and reduced sexual desire.

Ejaculation disorders

Problems with ejaculation are:

1. Premature ejaculation (PE) — ejaculation that occurs before or too soon after penetration
2. Inhibited or delayed ejaculation — ejaculation does not happen or takes a very long time
3. Retrograde ejaculation — at orgasm, the ejaculate is forced back into the bladder rather than through the end of the penis

The exact cause of premature ejaculation (PE) is not known. While in many cases PE is due to performance anxiety during sex, other factors may be:

1. Stress
2. Temporary depression
3. History of sexual repression
4. Low self-confidence
5. Lack of communication or unresolved conflict with partner

Studies suggest that the breakdown of serotonin (a natural chemical that affects mood) may play a role in PE. Certain drugs, including some antidepressants, may affect ejaculation, as can nerve damage to the back or spinal cord.

Physical causes for inhibited or delayed ejaculation may include chronic (long-term) health problems, medication side effects, alcohol abuse, or surgeries. The problem can also be caused by psychological factors such as depression, anxiety, stress, or relationship problems.

Retrograde ejaculation is most common in males with diabetes who suffer from diabetic nerve damage. Problems with the nerves in the bladder and the bladder neck force the ejaculate to flow backward. In other men, retrograde ejaculation may be a side effect of some medications, or happen after an operation on the bladder neck or prostate.

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