Sexual dysfunction is a broad term that encompasses various problems related to the sexual response cycle, which includes desire, arousal, orgasm and resolution. Sexual dysfunction can affect individuals of any gender and can significantly impact quality of life and relationships.
Categories of Sexual Dysfunction
1. Desire Disorder
Hypoactive Sexual Desire Disorder (HSDD): A lack or absence of sexual desire or interest.
Sexual Aversion Disorder: An aversion to and avoidance of sexual contact with a partner.
2. Arousal Disorder
Female Sexual Arousal Disorder: Difficulty in achieving or maintaining adequate lubrication- swelling response during sexual activity / foreplay.
Male Erectile Disorder (Erectile Dysfunction): Difficulty in achieving or maintaining an erection sufficient for satisfactory sexual performance.
3. Orgasm Disorders
Female Orgasmic Disorder: Delay in, infrequency of, or absence of orgasm following a normal sexual excitement phase and sexual intercourse.
Male Orgasmic Disorder: Delay in or absence of orgasm following a normal sexual excitement phase, masturbation and intercourse.
Premature Ejaculation: Ejaculation that occurs with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. Premature Ejaculation is classified into 3 categories - Prevaginal - Onvaginal - Shortly after penetration before the partner achieves orgasm.
4. Pain Disorders
Dyspareunia: Pain associated with sexual intercourse.
Vaginismus: Involuntary spasms of the muscles of the vaginal wall that interfere with vaginal penetration.
Genito-Pelvic Pain/ Penetration Disorder: persistent or recurrent difficulties with vaginal penetration, pain during intercourse or fear/anxiety about pain related to penetration.
Causes of Sexual Dysfunction
1. Physical Causes:
Medical conditions such as diabetes, cardio vascular diseases, neurological disorders, hormonal imbalances, chronic illness, high cholesterol disease, liver and kidney diseases.
Side effects of medications, including anti-depressants, antihypertensives, antipsychotics, antihistamines, opioid drugs etc
Substance abuse and excessive alcohol consumption.
2. Psychological Causes
Mental health issues such as depression, anxiety and stress.
Past sexual trauma or abuse.
Relationship problems and lack of emotional intimacy.
Performance anxiety or guilt related to sexual activity.
3. Lifestyle Factors
Poor physical health and lack of exercise.
Unhealthy diet and obesity.
Smoking and excessive alcohol consumption.
Diagnosis and Treatment
Diagnosis:
Obtain a comprehensive medical and sexual history.
Physical examination to identify underlying medical conditions.
Psychological assessment to explore mental health issues and relationship problems.
Laboratory tests to check hormone levels and other relevant health markers, as per medical and sexual history
Penile Colour Doppler after inducing erection of penis to assess the blood flow status of the penis.
Treatment :
Medical Intervention: Adjusting or changing medications, treating underlying medical conditions and using specific treatments such as hormone therapy or erectile dysfunction medication (eg: sildenafil).
Psychotherapy: Cognitive behavioural therapy(CBT), sex therapy, and couples counselling to address psychological and relational issues.
Lifestyle Modifications: Improving diet, increasing physical activity reducing alcohol consumption, quitting smoking, managing stress and stopping drug abuse.
Education and Communication: Enhancing sexual knowledge, improving communication with partner, and exploring new sexual technique and preferences.
Sexuality education.
Seeking Help
If you or someone you know is experiencing sexual dysfunction, it is important to seek help from an Andrologist/ Sexual Medicine Specialist. Treatment often involves a multidisciplinary approach and can significantly improve sexual function and overall quality of life.
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