Sexual Dysfunction

Sexual dysfunction is broadly defined as the inability to fully enjoy sexual intercourse. Specifically, sexual dysfunctions are disorders that interfere with a full sexual response cycle. These disorders make it difficult for a person to enjoy or have sexual intercourse.

While it may not threaten physical health, sexual dysfunction can take a heavy psychological toll on an individual and/or a relationship and bring on depression, anxiety, and debilitating feelings of inadequacy. Causes of sexual dysfunction in men and women can be a result of a physical or psychological problem.

Male Sexual Dysfunction

Types

The three most common male sexual dysfunctions are ejaculation disorders, erectile dysfunction, and decreased libido. 

Ejaculation Disorders

• • Premature ejaculations. Ejaculations that occur before or soon after penetration. (This is the most common form of sexual dysfunction in men.)
  • Inhibited or retarded ejaculation. Ejaculations that are slow to occur.
  • Retrograde ejaculation. When, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis.
• Causes of ejaculation disorders 
  • Premature ejaculation is often due to a man’s nervousness over how well he will perform during sex.
  • Premature and inhibited ejaculation can be caused by other psychological factors including past traumatic events, a strict religious background that causes a person to view sex as a sin, or a lack of attraction for a partner.
  • Certain drugs (including antidepressants)
  • Nerve damage to the spinal cord or back
  • Retrograde ejaculation is common in males with diabetes suffering from diabetic neuropathy or nerve damage.
  • Retrograde ejaculation can also occur after operations on the bladder neck or prostrate or after certain abdominal operations.

Erectile Dysfunction (ED)- Erectile dysfunction, or impotence, is the inability to attain and/or maintain an erection suitable for intercourse.

• Causes of erectile dysfunction include:
  • Diseases affecting blood flow, such as atherosclerosis
  • Nerve disorders
  • Psychological factors, such as stress, depression, and performance anxiety
  • Injury to the penis
  • Chronic illness
  • Certain drugs
  • Peyronie’s disease

Decreased Libido- Decreased libido, or inhibited desire, is a decrease in desire for, or interest in, sexual factors.

• Causes of decreased libido can be either physical or psychological and include:
  • Low levels of the hormone testosterone
  • Anxiety or depression
  • Medical illnesses (such as high blood pressure and diabetes)
  • Certain medications (such as antidepressants)
  • Relationship difficulties

Female Sexual Dysfunction

Types 

• Low Sexual Desire- You have diminished libido or lack of sex drive.
• Sexual Arousal Disorder-While your sex drive is intact, you have difficulty or are unable to become aroused or maintain arousal during sexual activity.
• Orgasmic Disorder-You has persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
• Sexual Pain Disorder-you have pain associated with sexual stimulation or vaginal contact.
• Pelvic Floor Dysfunction– Pelvic floor dysfunction can affect not only a woman’s reproductive system but the urological system as well. Everything is connected and the pelvic floor supports all these systems. This can greatly impact a woman’s sexual health because of issues with burning, pain, and discomfort. There are treatment options that can help alleviate these symptoms and restore better sexual function. 
• Vulvar Pain/Vulvodynia-Chronic, unexplained pain in the area around the opening of the vagina. Vulvodynia can be so uncomfortable that some activities can feel unbearable, such as sitting for long periods of time or having sex. Symptoms include burning and rawness in the genital area. Pain may be constant or occasional and can last for months or even years, then vanish as suddenly as it started.
• Interstitial Cystitis-Interstitial cystitis, also called painful bladder syndrome, is a chronic inflammatory condition of the bladder wall characterized by pressure and pain above the pubic area as well as increased frequency and urgency of urination. A healthy bladder expands until it is full and then signals the brain (through the pelvic nerves) that it is time to urinate. With IC, these signals get mixed up. Individuals feel the need to urinate more often and with smaller amounts of urine than most people. Since the bladder is inflamed and irritated IC can be an extremely painful condition to live with. This can also make any sexual activity extremely painful. Some are unable to do anything sexual because of the disorder.

Causes

• Mental and Emotional Causes- There could be several contributing factors as to why a woman’s mental state is affecting her sexual drive or desire. Many women who experience rape or sexual abuse have physical issues that can make intimacy painful along with mental issues that make intimacy hard. Stress can be a factor along with general mental health such as anxiety and depression. Some women suffer from body dysmorphia disorder that causes them to not see their bodies as they are and to become very unhappy with their own bodies making it difficult to open up to a partner. At ZUrology we treat the whole patient. We can help with not only the physical symptoms and disorders that may be causing sexual dysfunction and we can also help guide you and discuss what mental health supports are available. 
• Physical Causes- This can include hormone problems, pain from an injury, trauma to the body, or other problems such as diabetes. endometriosis or arthritis. 
• Aging- Aging can cause physical issues such as dryness and the narrowing and shortening of the vaginal walls. Menopause can also impact sexual function and desire along with the physical changes that menopause can cause. 
• Medical Treatments-These can be urological or not. If you are receiving care for interstitial cystitis the treatment may be impacting your ability to perform sexually. Surgeries such as back and pelvic surgery can impact sexual desire and performance as well. 
• Certain Medications- These can include those for depression, blood pressure, allergies, and diabetes. Some medications have side effects that can greatly decrease your libido and make you unable to orgasm. 
• Alcohol and drug abuse

Symptoms

• Less desire for sex
• Difficulty feeling aroused
• Inability to have an orgasm
• Pain during sexual activity