What is Sexual Dysfunction?

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 dysfunction refers to a group of issues or conditions that prevent a person from wanting, engaging in, and enjoying sexual activities.

However, the problems can occur at various stages of the sexual response cycyle, affecting aspects from the desire to have sex to the ability to climax.

Sexual dysfunction is common among males. Research has found it affects more than 50% of males ages 40–70 years.

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 over 40 years old.

Symptoms of ED include a person being:

• Able to get an erection some of the time but not every time they want to engage in sexual activities
• Unable to get an erection at any time
• 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.

Pain and Discomfort

Discomfort and pain may occur in the vagina or pelvis during sex.

Pain may be due to the following:

• 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 the following :

• An infection, such as a sexually transmitted infections(STIs)
• Cystitis
• Endometriosis
• Fibroids
• Genital injury
• Irritable bowel syndrome (IBS)
• Ovarian cysts
• Pelvic inflammatory disease (PID) 
• Uterine prolapse 
• Vaginismus, when the vagina tightens when a person attempts to insert something inside it

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.

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 (hypertension) medication, may contribute to various types of sexual dysfunction.

Psychological

For psychological causes of sexual dysfunction, treatment may involve medication, such as antidepressants, and various forms of therapy. These can include:

• Couples counseling
• Cognitive behavioral therapy
• Sex education and therapy
• Non-genital and genital sensate focus
• Relaxation therapy

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 2023 study found associations between sexual dysfunction and mental health disorders, such as depression and anxiety.

It 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.

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.

Although, types of sexual dysfunction include disorders of sexual desire, arousal, orgasm, and sexual pain. However, 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.