Sexual Disorder
In men sexual dysfunction is to have repeated impairment of sexual performance while in women it is more about repeated unsatisfactory sexual experience or decreased desire for sexual activity
Sexual disorders are classified in those that can affect:
- Sexual desire or pleasure
- Genital response, erectile dysfunction in men and lack of arousal in women
- Orgasm, premature of delayed ejaculation in men and poor/no orgasm in women
Erectile Dysfunction (ED) is the most prevalent sexual dysfunction for men. According to the Massachusetts Male Aging Study, 52 per cent of males between the ages of 40 and 70 suffer erectile dysfunction.
Women may not experience genital sensation, vaginal dryness, or clitoris enlargement, which generally occurs during sexual intercourse. There are few dysfunctions like pain during sexual activity can also be put under these like vaginismus in women and painful ejaculation in men.
What causes sexual dysfunction?
Causes of sexual dysfunction can be put in three major categories like biological, psychological and result of sociocultural influences.
- Some biological/medical causes like diabetes and cardiovascular diseases directly contributes to erectile dysfunction in men. Similarly, hormonal changes during menopause in women can lead to vaginismus and vaginal dryness.
- Psychological issues are major contributory factors in sexual disorders these days due to increased amount of stress at work/home. Negative self-image, performance anxiety, fear of rejection may despair sexual function.
- Sociocultural factors like gender inequality, religious practices, lack of privacy and disparate work schedules can all hamper sexual performance.
Erectile dysfunction:
This condition is inability to achieve or sustain penile erection long enough for satisfactory coitus. It may be present since beginning (primary) or it can start later in life after normal sexual functioning (secondary). Low sexual drive, loss of interest in partner, stressful relationship, physical illness, anxiety, depression all can contribute to erectile dysfunction in men
The first line treatment for erectile dysfunction is using PDE-5 inhibitors like sildenafil, tadalafil and vardenafil. The most common side effects using these drugs are headache, flushing and dyspepsia.
Female orgasmic disorder:
Many women do not achieve orgasm while having sexual intercourse. However, most of them do achieve in response to clitoral stimulation. So, failure to reach orgasm is disorder or not has been a question. Nevertheless, it is a problem for few of them and they seek advice for it. Sexual skills training can help women reach orgasm effectively.
Premature ejaculation:
This term refers to early ejaculation either during foreplay before penetration or soon afterwards that the woman has not experience pleasure. PME is more common in young men, especially with those in new relationship. Premature ejaculation can harm self-esteem of men and it can also hamper future sexual encounters.
‘Squeeze technique’ is useful to hold the ejaculation during coitus. If partner is willing, she/he grips the penis at base and squeeze it for few seconds. Intercourse can be continued later. SSRI group of medicines are useful sometimes to delay the ejaculation.
Lack of interest in sexual activities in females:
This can be due to depression, anxiety or other psychiatric disorders. Intramarital relationship issues, stressful environment at home, history of child physical or sexual abuse, all can lead to lack of interest in sex in females. These can further lead to pain during intercourse which is called as dyspareunia or spasm during intercourse which is called as vaginismus. Treatment involves sex therapy techniques, relaxation, counselling and gradual desensitization.
