Sexual dysfunction refers to persistent physical issues, psychological problems, or both that prevent someone from engaging in sexual activities. It can affect any phase of the sexual response cycle, from arousal to orgasm, and can involve various potential causes.
Sexual activity can affect a person’s social health as well as their mental, emotional, and physical well-being. Sexual dysfunction can lower a person’s quality of life and self-esteem, and harm their relationships with sexual partners.
This article looks at the definition and diagnostic criteria of sexual dysfunction and sexual dysfunction in males and females. It also looks at when to contact a doctor and the causes, diagnosis, and treatments for sexual dysfunction.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Sexual dysfunction refers to a group of issues or conditions that prevent a person from wanting, engaging in, and enjoying sexual activities.
The problems can occur at various stages of the sexual response cycle, affecting aspects from the desire to have sex to the ability to climax.
Diagnostic criteria for sexual dysfunction
According to the
- be present 75–100% of the time
- last for at least 6 months
- have caused significant distress
The causes of the dysfunction can encompass complex combinations of physical, emotional, and mental components. Therefore, the DSM-5 does not categorize types of sexual dysfunction as being physical or mental, but based on the type of sexual dysfunction that occurs.
The
- Desire disorder: A condition that people also refer to as hypoactive sexual desire disorder (HSDD), in which a person lacks sexual desire, resulting in distress. The condition manifests differently in males and females.
- Arousal disorders: A person with an arousal disorder may find it difficult or impossible to respond to sexual stimuli, despite their desire for sexual activity.
In males , this may manifest as an inability to achieve or maintain an erection. In females, it may manifest as a lack of vaginal lubrication, among other symptoms. - Orgasm dysfunction: People with orgasm dysfunction find it difficult or impossible to reach orgasm despite experiencing sexual arousal and responding to stimulation.
- Pain disorders: Sexual pain disorders, such as vaginismus, dyspareunia, and painful ejaculation, can result in pain that prevents sexual enjoyment.
Sexual dysfunction is common among males. Research has found it affects
Conditions that cause sexual dysfunction in males most often involve erectile dysfunction (ED) and ejaculation disorders.
Erectile dysfunction
ED is a condition that prevents a person from getting or maintaining an erection firm enough for enjoyable sexual activity. The condition is common and most commonly affects males
Symptoms of ED include a person being:
- unable to get an erection at any time
- able to get an erection some of the time but not every time they want to engage in sexual activities
- able to get an erection but not able to maintain the erection long enough for sexual activity
Ejaculation disorders
There are three main types of ejaculation problems:
- Premature ejaculation: Premature ejaculation is a common sexual dysfunction, in which a male persistently ejaculates more quickly than they or their partner would like during sexual arousal.
- Delayed ejaculation: A male with delayed ejaculation may be unable to ejaculate despite having a normal erection, or may experience a significant delay before they can ejaculate.
- Retrograde ejaculation: Retrograde ejaculation is more uncommon than the other main ejaculation disorders. It occurs when semen passes backward into the bladder rather than through the urethra.
Sexual dysfunction is also common in females. Researchers have found it affects 41% of females of reproductive age.
Common types of sexual dysfunction in females include pain and discomfort during sex and difficulty reaching orgasm.
Pain and discomfort
Pain may occur in the vagina or pelvis during sex. Pain may be due to:
- a lack of sexual arousal
- vaginal dryness as a result of menopause
- irritation from latex condoms or spermicides
Psychological responses to past trauma may also result in painful sex.
Various health conditions can result in sexual pain and discomfort in females. These include:
- vaginismus, when the vagina tightens when a person attempts to insert something inside it
- an infection, such as a sexually transmitted infection (STI)
- endometriosis
- genital injury
- pelvic inflammatory disease (PID)
- fibroids
- cystitis
- ovarian cysts
- irritable bowel syndrome (IBS)
- uterine prolapse
Difficulty having orgasm
Difficulty reaching orgasm can be primary or secondary:
- Primary: This means a person has never had an orgasm.
- Secondary: A person has had orgasms in the past but cannot achieve them anymore.
Some females may be able to orgasm alone but cannot orgasm with a partner. The causes of orgasm disorders may be physical, psychological, or both.
Anyone who experiences sexual dysfunction that causes them distress should contact a doctor.
Sexual dysfunction can significantly affect a person’s quality of life. A
Sexual dysfunction may also indicate underlying health conditions that require treatment. For example, painful sex in females could be a sign of a serious medical condition, such as PID, which could lead to complications.
There are various potential causes of sexual dysfunction. Causes may be physiological, psychological, or both.
Physical
Various medical conditions can directly or indirectly affect a person’s sexual organs or the bodily functions that play a role in sexual health. These include:
- Hormonal changes: Conditions that affect the hormones, such as thyroid disorders, can lead to hormone imbalances that affect sexual function. Hormones may become imbalanced for other reasons, such as during menopause for females, or a decrease of testosterone in males due to aging.
- Metabolic conditions: Conditions such as obesity and high cholesterol can lead to various sexual dysfunctions, including a decrease in libido and ED.
- Heart conditions: Heart diseases such as heart failure can
contribute to sexual dysfunction by causing fatigue and shortness of breath during sexual activity as well as restricting blood flow to the sex organs. - Disorders that disrupt sexual function: Conditions such as prostatitis in males and endometriosis in females can cause pain that disrupts the sexual response.
- Neurological disorders: Some disorders, such as
Parkinson’s disease and multiple sclerosis (MS), can affect the nerves responsible for producing sexual responses, like erections. - Substance use, including alcohol use: Substance and alcohol use may lead to sexual dysfunction in males and females.
- Medications: Certain medications, such as birth control pills, antidepressants, and high blood pressure medication, may contribute to various types of sexual dysfunction.
Psychological
Healthcare professionals associate various psychological factors with sexual dysfunction. These include:
The diagnostic process for sexual dysfunction may differ depending on the underlying cause of the condition.
A doctor may examine a person’s medical history. They may ask questions regarding their symptoms, recent illnesses, and current medications. A doctor may also order various laboratory tests, such as:
- thyroid function tests
- blood tests
- samples of vaginal discharge
- hormone profiles
- cholesterol level tests
A doctor may also perform a physical examination. This may include a genital examination, such as a Pap smear for females, and an assessment of the penis and testicles for males.
A doctor may refer a person to a specialist, such as a urologist, gynecologist, or psychologist, based on their findings.
Treatment for sexual dysfunction can vary depending on the underlying causes.
Physical
Treatments for sexual dysfunction with physical origins may depend on comorbid and underlying conditions. Treatments can include:
- treatment of underlying conditions, such as heart disease, obesity, and endometriosis
- hormone replacement therapy (HRT) or testosterone replacement therapy (TRT) to treat hormone-related sexual dysfunction
- medications, such as:
- alprostadil for ED
- PDE5 inhibitors, such as sildenafil (Viagra), for ED
- flibanserin (Addyi) for HSDD
- buspirone for delayed ejaculation
- topical creams, gels, sprays, or wipes that contain numbing ingredients, such as lidocaine, to prevent premature ejaculation
- surgical penile implants to help maintain erection
- penis pumps to stimulate blood flow to the penis for ED
Psychological
For psychological causes of sexual dysfunction, treatment may involve medication, such as antidepressants, and various forms of therapy. These
- sex education and therapy
- couples counseling
- cognitive behavioral therapy
- relaxation therapy
- nongenital and genital sensate focus
The outlook for a person with sexual dysfunction may depend on the underlying causes and type of the condition. Some types of sexual dysfunction may be temporary and treatable. Others may be chronic and require longer treatment times.
A healthcare professional or mental health professional can help a person determine the outlook of their condition.
Below are the answers to some frequently asked questions about sexual dysfunction.
What is the most common treatment for sexual dysfunction?
Treatments for sexual dysfunction vary depending on their type and underlying causes. Common treatments include hormone replacement therapies and medications like PDE5 inhibitors, such as sildenafil (Viagra).
Who is sexual dysfunction most likely to affect?
Sexual dysfunction can affect anyone. A
Study authors report on a survey of 27,500 people that found 43% of men and 49% of women had experienced at least one sexual difficulty within the past year.
How can sexual dysfunction affect a person?
Sexual dysfunction
Sexual dysfunction refers to a group of problems and conditions that can cause consistent difficulty in engaging in, enjoying, or desiring sexual acts. Sexual dysfunction may have physical, mental, or a combination of causes.
Types of sexual dysfunction include disorders of sexual desire, arousal, orgasm, and sexual pain. Treatment can vary depending on the type and underlying cause of the dysfunction.
Various medications and types of therapy may help a person recover from or manage sexual dysfunction.