Human Sexuality > Chapter 9

Chapter 9: Sexual Dysfunction

Sexual dysfunctions and disorders are much more common than many people think. As a matter of fact, many people who believe that they may have problems instigate sexual counseling that may involve but is not limited to arousal, desire, or sexual pain. In many situations, individuals don't share sexually related problems with friends, spouses or close family members, and even counselors, despite the fact that effective treatment and counseling is available for a multitude of major complaints.

It can be said that healthy sexual interaction involves aspects of trust, communication, similar expectations, respect, and love in order to enjoy longevity and pleasure for both individuals involved in any relationship. Relationship issues and lack of intimacy cause one of the major factors that contribute to sexual dysfunction and problems.

The psychological causes of sexual dysfunction cannot be over emphasized. Emotions like stress, depression, anxiety and guilt, and even fear are known to trigger various responses within the endocrine and nervous system that conflict with sexual arousal.

Some of the most common psychological causes of sexual problems are caused by stress related to work, money, family problems, grief, children, and family responsibilities. In addition, partners may feel guilty over past behaviors, lying, deceptions, or betrayal of partners. Anxiety over relationships, the desire to please a partner, as well as lack of sexual experience is common factors in the development of some disorders. Fear of infertility, pregnancy, pain, as well as transmitting or receiving a sexually transmitted disease are also important and common factors in the development of sexual dysfunctions.

[QN.No.#43.The Common factors in the development of sexual dysfunctions are:]

Most relationship issues rely on trust and open communication to thrive. Poor communication inhibits sexual desire and stimulation. Loss of trust commonly affects desire and arousal. In addition, anger and resentment create barriers to sexual intimacy that may develop into inability to achieve any joy or pleasure from sexual activities.

Different expectations when it comes to sex and sexual activities among partners, whether it's based on religious, comfort levels or cultural beliefs that also create barriers that couples must overcome.

Lack of self-esteem, self-respect, and confidence are also important factors in the development of sexual problems. Lack of respect of a partner will eventually undermine desire, feelings, and responses to any sort of intimacy. Mutual respect is highly desirable in any relationship, and each partner in a relationship expects enjoying a sense of value, honor, and courtesy. Without mutual respect, trust, communication, love inevitably suffers.

Types of Sexual Disorders

Many types of sexual disorders develop within certain relationships fraught with abuse and inequality. Others develop from childhood and may be the result of childhood abuse or incidents that have long-lasting effects on a given individual. In others, sex or sexual relationships are just not that important. Some of the most common types of sexual disorders include the following.

Desire disorders, which are defined according to a person's expectations, history, age, sex, and the type of relationship he or she is engaged in. In many relationships, sexual desire is not at the top of the list, which is perfectly normal. In other relationships, sexual feelings or attraction can fade or disappear altogether, often caused by relationship problems, illness, or fatigue.

Sexual dysfunction is the definition of a loss of desire that is persistent, and causes a person concern or worry. Diminished desire can affect both sexes, but is more common among women. As a matter of fact, some people are repelled by the thought of sex, and avoid it at all costs. The condition, known as sexual aversion, lies somewhere between a depressed or decreased sexual desire and one that is repelled by the thought of having sex with another individual.

Some of those most common causes of sexual desire disorders are physical in nature, and may include hormonal difficulties, side effects of medications, chronic fatigue, and illness. Psychological factors may include religious beliefs, a fear of pregnancy, depression, marital difficulties, or even a lack of attraction to one's partner.

Desire disorders aren't easy to treat because they incorporate a multitude of problems and issues that are highly personal and range in importance according to each individual. In many cases, unless desire disorders are determined to be physical in nature, they're very difficult to treat because they involve aspects of personality, sexual history, relationship attitudes, as well as how that person was treated or raised during childhood.

Sexual pain disorders are caused by pain in the genital areas, experienced by both men and women. This condition is called dyspareunia,and while it is rare in males, women experiencing the condition often experience intense levels of anxiety prior to sexual intercourse, which more often than not contributes to fear of men and most sexual behaviors. It can be said that dyspareunia may very well be considered a phobia and should be treated as such. Treatment of sexual pain disorders are generally induced by progressive relaxation techniques, desensitization methods to reduce fear and physical reactions to it such as anxiety and muscle tension, and a great deal of understanding by sexual partners.

[QN.No.#44.A sexual pain disorder caused by pain in the genital areas and experienced by both men and women is known as:]

Arousal disorders affect both men and women and include but are not limited to male erectile disorder as well as female sexual arousal disorder, where men and women are unable to respond in what are considered to be "normal" manners to sexual situations. For many individuals, factors such as anxiety, anger, drinking, drug use, and fatigue lead to arousal disorders. For some, an overreaction to a temporary loss of arousal feelings and sensations often causes individuals to develop a never-ending cycle that contributes to further inhibition and difficulties.

[QN.No.#45.The most common types of sexual disorders are:]

Men and women should realize that isolated incidents of sexual performance should not be defined as a sexual dysfunction. Temporary changes or alterations in arousal, sex drive, and psychological considerations involving intimate relationships change over time, and only when performance difficulties become recurrent, persistent, or distressing should a person consider such difficulties of the sexual dysfunction.

The American Psychiatric Association efficiently defines nine basic sexual dysfunctions, described in detail in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

Classification and Description of Recognized Sexual Dysfunctions

According to the American Psychiatric Association, the following provides a list of sexual dysfunctions in their description:

  • Hypoactive Sexual Desire Disorder - recurrently or persistently deficient (or absent) sexual fantasies and desire for sexual activity.
  • Sexual Aversion Disorder - recurrent or persistent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner.
  • Female Sexual Arousal Disorder - persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, and adequate lubrication- swelling response of sexual excitement.
  • Male Erectile Disorder - persistent or recurrent inability to obtain or maintain until completion of the sexual activity and adequate erection.
  • Female Orgasmic Disorder - persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase.
  • Male Orgasmic Disorder - persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity.
  • Premature Ejaculation - persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.
  • Dyspareunia - recurrent or persistent genital pain associated with sexual intercourse in either a male or female.
  • Vaginismus - recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse.

[QN.No.#46.The recurrent and/or persistent absence of sexual fantasies and desire for sexual activity is known as:]

In some cases of sexual dysfunctions, medical causes are responsible for male erectile disorders. Such medical causes may include aging, drug abuse, infections, prescribed medications, vascular disease, and neurogenic and urological concerns.

In most cases of sexual dysfunctions, the emotional state of the individual often serves as a trigger. Such emotions may be external or internal. External triggers include but are not limited to attraction, location, and physical stimulation or lack thereof, while internal triggers may include but are not limited to fantasies, memories, or previous experiences.

Sexual attitudes and behaviors are also influenced by cultural attitudes and expectations. For example, in the Victorian era, women were considered ideal as wives and mothers who are pure in thought, deed, and behavior. During those times, the expression of sexual urges were considered improper, and women were discouraged about discussing sex or intimate issues not only among each other, but with their husbands as well.

In many situations even today, women are hesitant to express or discuss sexual preferences or concerns with boyfriends, spouses, and even among friends. What people desire or fantasize about are intensely personal and private for many. What can be considered "hypoactive" sexual desire is subjective, and it's hard to define, again based on people's cultural backgrounds, traditions, situations, and age.

In many relationships, women, and sometimes men, engage in sexual relationships only because it is desired by the other, and he or she wants to avoid conflict and please their partner.

Sexual Addictions

At the opposite end of the spectrum of hypo-sexuality is hyper-sexuality, also known as a sexual addiction, or nymphomania. Such terms describe excessive sexual desire, though as with hyposexual desires, what determines "excessive" desires are not specifically classified or defined. Many people consider sexual addiction to be similar to addictions experienced a drug addicts and alcoholics. According to Patrick Carnes in his 1983 writings, sexual addiction comprises four specific symptoms:

  • Preoccupation with sex
  • Ritualized sexual behaviors (seeking prostitutes or anonymous sexual partners)
  • Compulsive sexual feelings and behaviors
  • Intense emotion (such as shame or guilt) over such behavior

[QN.No.#47.The term which describes excessive sexual desire is:]

However, such definitions have not been supported by medically viable research. In addition, many studies engaged by individuals purport that many sexual addicts are also involved in heavily preoccupied in pornography, prostitution, and in some cases, child molestation. In many cultures, hypersexuality or nymphomania is considered to be a perversion or disease that has also been linked with compulsive sexual behaviors in individuals with exaggerated sex drives.

However, much like the situations involving decreased or hyposexual behaviors and attitudes, hypersexuality is also difficult to define as every given individual’s situation, circumstances, beliefs and behaviors are different.

Because scientific research has not gained a good understanding of sexual desire, labeling individuals as nymphomaniacs, hypersexual, in conditions such as sexual addiction or disorders creates increased anxiety, stigmatism, and suggest abnormal sexual pathology and behavior in many individuals.

Sex in the United States

Attitudes and expectations promoted by the media as well as gossip play important role in common conceptions of sexual dysfunctions and disorders. Watch the TV for an evening and viewers are more than likely to view at least one television commercial regarding the next, and greatest pill to enhance male sexual capabilities.

For example, take a look at the comment perceptions regarding sex and sexuality commonly dispensed during TV shows and in magazines, books, and movies. Such concepts have created what are known as "fantasy models of sex" that exhibit and encourage how people should relate, look, and have sex. Sexual pressures and attitudes caused by the media will be explored in a later lesson, but suffice it to say that the following conceptions are the most common:

  • The best sex or sexual experience always ends with an orgasm
  • Sex generally means sexual intercourse
  • Women shouldn't have sex if their man's training
  • Most people are open-minded and comfortable when discussing or engaging in sex
  • Most "real" men are not interested in communications or feelings
  • Man are consistently ready, willing, and able to engage in sex
  • Making love should always be spontaneous and natural, but never planned
  • Sex is not possible without a male erection

The above conceptions are false. As a matter of fact, sexual performance and sexual adequacy is not always judged by its outcome. Sexual behavior does not always need to include orgasm in order to be considered optimal, because other aspects of sexual behavior, including intimacy, sharing, a sense of closeness, and pleasure are often typically experienced. As a matter of fact, many men and women have stated that personal satisfaction and pleasure is often achieved by mere acts of hugging, cuddling, and kissing.

Likewise, sex implies a multitude of sexual activities apart from sexual intercourse. Kissing and caressing, most commonly known as foreplay, are a large part of the sexual act. In addition, sexual experiences do not always require a male to achieve an erection, although many men as well as their partners are unfortunately affected by such comments and beliefs, which sometimes lead to dysfunctions caused by feelings of inadequacy or failure.

One of the most prevalent myths regarding men and sex is that men aren't concerned about communicating or feeling. Men who engage in such expressions are often considered to be weak, while men who are stoic are referred to as macho. Unfortunately, attitudes negatively affect behaviors, attitudes, and relationships. Most men feel that their emotions, feelings and ability to communicate are essential for enhancing and maintaining positive relationships with others.

Another common myth is that men are continuously prepared to engage in sexual behaviors. Such attitudes place enormous pressure on both men and women and often lead to misunderstandings, misconceptions, and miscommunication between couples and sexual partners.

In all of the above examples, such misconceptions regarding sex serve to overemphasize a man or woman's ability to perform sexually and sometimes offer fantastical goals that no man or woman can achieve on a regular basis. Indeed, such attitudes and expectations serve to restrict the ability of men and women to engage in comfortable and relaxing sexual activity. Such attitudes or unrealistic and serve to detract from the enjoyment a man or woman may gain from a sexual experience.

What Causes Sexual Dysfunctions?

The causes of sexual dysfunctions include a wide range of scenarios, conditions, beliefs, and hypotheses. In many cases, sexual dysfunctions may be caused by medical conditions as well as legal and illegal drug use. Psychological factors also play an important role in the development of a sexual dysfunction, among both men and women. Cultural beliefs, traditions and attitudes regarding human sexuality cannot be underestimated. Most of the time, a combination of a multitude of factors may eventually lead to sexual dysfunctions. Some of the most common reasons may include a combination of psychological, medical, cultural, and relationship issues.

For example, medical issues such as illness, disease processes, and medications may affect sexual desire and activity. Some prescription medications are well known to interfere with sexual desire. Medications often prescribed for depression, hypertension, high blood pressure, and other conditions impair sexual activity. The most common prescriptions that cause sexual side effects in a majority of individuals who are prescribed them are the use of antidepressants, including the familiar Paxil, Prozac, Wellbutrin, and more. Indeed, sexual desire in such individuals routinely decreases by 20 to 50%.

The chronic use of alcohol and some illegal drugs such as cocaine also impairs sexual desire. Alcohol causes changes in the blood vessels and has also been closely associated with hormonal imbalances and nerve damage.

Psychological factors that may affect sexual function in capabilities may include but are not limited to experiences of sexual trauma, negative beliefs regarding sexual behavior, as well as anxiety. As a matter of fact, anxiety stemming from a fear of performing badly, or of pregnancy, intimacy, or emotional vulnerability experienced by such individuals can severely decrease a person's ability to perform in what he or she believes to be an adequate manner. Many men are so focused on their performance or ability to perform that they lose sexual enjoyment as well as often suffer from erectile problems and dysfunction.

Sexual dysfunction is one of the most common side effects of anxiety and depression in individuals, although other factors, such as psychological or cultural beliefs regarding sex, and sexual activity also plays a large role in how any given individual perceives or enjoys sex.

Individuals who have experienced sexual trauma in the past also often experience some sexual dysfunction and disorders that may be treated through counseling, but only when he or she is willing to discuss various circumstances or occurrences that may have led or resulted from such trauma. Many victims of childhood sexual abuse find it difficult to disassociate sexual intimacy with physical as well as emotional pain. Therefore, sexual contact is typically avoided as often as possible.

Drugs and Sexual Dysfunction

Studies have shown a distinct relationship between drug abuse and sexual dysfunctions. We've already briefly discussed alcohol abuse, which involves both immediate as well as long-term effects on sexual functioning, including erectile disorders and desire disorders.

The use of amphetamines also inhibits sexual function and may lead to the laid or inability to ejaculate, delayed orgasm, erectile dysfunctions and disorders, and inhibitions of orgasm. Anal nitrates decrease the ability to ejaculate as well as decrease lubrication and arousal. Barbiturates decrease desire and interfere with the man's ability to achieve an erection. Drugs such as ecstasy and heroine decrease sexual desire, and may affect hormonal balances in the body, also leading to erectile dysfunctions and disorders.

[QN.No.#48.The use of drugs that cause sexual dysfunction are:]

Short-term and long-term use of tobacco has been shown to produce erectile disorders and problems in many.

Relationship Issues

Relationship issues also play a big part in the development of sexual dysfunctions. Conflict, resentment, anger and jealousy are very effective in curbing sexual desire and attractiveness among couples. Because sexual enjoyment and pleasure is not merely a physical reaction, but involves emotions and feelings, a partner's ability to communicate and trust has a great deal of influence over sexual enjoyment or dysfunctions.

Unexpressed issues regarding resentment, anger, jealousy, worry, or concerned are often detrimental to sexual relationships and attitudes among couples and often leads and contributes to sexual dysfunctions.

Loss of trust, poor communication, lack of respect, and conflicting sexual expectations and demands as well as frequency also play a large role in the development of sexual dysfunctions in relationships.

Cultural Issues

Cultural beliefs and traditions differ among individuals, and also play an important role in the development of sexual happiness or dysfunctions. In most societies, "good girls" are highly prized over those who are "promiscuous". Women are generally raised to restrict discussion regarding sexual preferences, sexual encounters, and indeed their own sexuality. Cultural double standards have often inhibited both men and women to pursue open communication regarding sexuality.

In many cultures, it's perfectly acceptable for males to engage in sexual behaviors, while such behavior is considered unacceptable, and often illegal, for females. Many women are brought up to have negative attitudes regarding sex that often stem from religious upbringing. Some women are brought up in cultures that are male-dominated. Regardless of the reasons for sexual dysfunctions, various treatments and therapies are available and involve pills, devices, and therapies.

As mentioned earlier, the ability to travel as well as communicate via the Internet has introduced more cultures to one another than any other time in human history. Free economic trade, online dating, and easier travel encourage relationships that cross boundaries and borders. However, cross-cultural dating and relationships should be aware that ethnic, religious and social backgrounds might play an important role in the development of sexual problems, dysfunctions and attitudes among cross-cultural couples.

In many relationships, deeply believed and ingrained expectations and attitudes regarding sex may clash among cultures. In many cultures, attitudes regarding nudity, sexual roles, responsibilities, privacy, modesty, and body parts are different. Cultural differences and expectations must be understood between partners in order to avoid conflicts or development of sexual issues.

Treatments and Therapies For Sexual Dysfunction

There are many common medical interventions for a multitude of sexual dysfunction issues. For example, typical medical interventions for various erectile problems may include but are not limited to oral medications, injections, surgery, and the use of constriction devices. Nonmedical methodologies include sex therapy, which helps many couples to reduce performance anxiety fears, address and resolve conflicts within the relationship, as well as Miss beliefs are misconceptions regarding sexual behavior.

In the last two decades, advanced techniques and approaches to the treatment of sexual dysfunction has become so standard that male and female enhancement drugs are readily advertised on prime time television and in most magazine ads. Another common treatment for sexual dysfunctions is therapy that is focused on providing behavioral as well as educational aspects that are conducted between couples and a marriage counselor, sex therapist, or psychologist.

Regardless of the therapies and treatments designed for sexual dysfunction, most is beneficial and enhanced by the involvement, understanding, and psychological support of sexual partners. Couples who understand the misconceptions and misinformation regarding sexual aptitude and behaviors also enjoy greater benefits from sexual dysfunction treatments and therapies.

At the basis of the many sexual dysfunction treatments and therapies is the question of whether or not a sexual problem actually exists. Many people erroneously believe they have a sexual dysfunction when they don't. Most sexual problems or perceptions are self- diagnosed and are based on perceptions and beliefs of any given individual’s sexual behavior.

Evaluating sexual problems involves a three dimensional approach, including:

  • Context
  • Frequency
  • Duration

For example, the context of specific sexual behavior and ability is defined as a problem that occurs for a given individual or couple in various circumstances or settings. For example, concepts regarding sexual dysfunction can be defined as situational or global. A situational sexual dysfunction occurs occasionally, and during specific situations. A global sexual dysfunction is one that occurs during all aspects of sexual behavior and attempts.

Frequency is defined as being partial or total. Total sexual problems or dysfunctions occur every time during given situations, while partial sexual dysfunctions don't occur in every situation, but often enough to cause concern or distress.

Duration of sexual dysfunction can be broken down into two categories; primary or secondary. An individual will be asked how long he or she has been experiencing a particular problem. A sexual dysfunction or problem that is termed primary is one that has been present in the person's sexual life forever. Secondary problems are those that generally occur later in life or over the passage of time.

[QN.No.#49.A sexual dysfunction or problem that has been present in the person's sexual life throughout their life is termed as:]

Some of the most commonly utilized medical treatments for sexual dysfunctions include surgical implants, penile injection therapies, vacuum constriction devices, and vascular surgery. However, one of the most popular and well-known oral medications for erectile disorder is that tiny pill known as Viagra. Introduced in 1998, Viagra was approved by the US Food and Drug Administration for treatment of erectile disorders. The demand for this tiny pill continues to be one of the best-selling pharmaceutical drugs not only in the United States but also around the world. Viagra functions by decreasing blood outflow that results in prolonged erections.

[QN.No.#50.One of the most popular and well-known oral medications for erectile disorder is :]

In most situations, oral medications for sexual dysfunctions are preferable and are less invasive and expensive than other treatments. While Viagra may not be cheap, it has been shown to be extremely effective for roughly between 60% and 80% of those taking it. Unfortunately, Viagra also has the reputation of contributing to a number of deaths in its early years of use in individuals who are currently experiencing cardiovascular issues.

[QN.No.#51.Viagra functions by decreasing blood outflow that results in prolonged erections,but may cause cardiovascular issues.True/False]

In addition, the combination of Viagra and other medications has been known to cause unpleasant side effects and conditions. Because of its success however, studies have developed regarding the potential use of the drug by women.

The importance placed on sexual performance within the media has had a large impact on much of society and its expectations. Because of such attention, many men and women who experience "normal" sexual function have been led to believe that he or she is not normal at all, and should be utilizing and enjoying the benefits of performance enhancing drugs and medications. However, it should be noted that Viagra is not an aphrodisiac, a concept that many individuals fail to realize.

Sex Therapy

Sex therapy is defined as a treatment approach for sexual dysfunctions and includes therapy for sexual problems caused by medical conditions as well as those caused by psychological issues. Sex therapy is designed to provide a psychological approach that alleviates problems and anxiety regarding sexual performance.

Adequate information and education and understanding the attitudes and expectations of couples are the basis of many sex therapy counseling sessions. In addition, mutual responsibility for sexual dysfunction should focus on both partners rather than blame being placed on one or the other. In addition, the elimination of performance anxiety is the ultimate goal of many sex therapy sessions. Interpersonal beliefs and relationships are also among the basic fundamentals of effective and positive sex therapy results.

One common sex therapy technique is known as sensate focus. This therapy is designed to teach and instruct couples how to focus on pleasurable sensations rather than on performance. In many cases, the sensate focus technique is valuable in reducing performance fears and anxieties, and encourages couples to communicate and enjoy intimacy that doesn't always result in sexual intercourse. Such techniques provide couples with self-confidence building skills that help to relieve anxiety regarding sexual performance and capabilities.

[QN.No.#52.Sensate focus is:]


As you have learned throughout this lesson, there are many different types of sexual dysfunctions. In addition, the multiple causes of such dysfunctions can be physical, cultural, or psychological in origination and require that individuals attempting to overcome such dysfunctions examine relationships, including control issues, fear of intimacy, resentment, as well as cultural beliefs that help to alleviate conflicts, inhibitions, and miscommunication.

Human Sexuality > Chapter 9
Page Last Modified On: February 17, 2015, 03:22 AM