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Sexual dysfunction or sexual malfunction or sexual disorder is difficulty experienced by an individual or a couple during any stage of a normal sexual activity , including physical pleasure, desire , preference, arousal or orgasm.
According to the DSM-5 , sexual dysfunction requires a person to feel extreme distress and interpersonal strain for a minimum of six months excluding substance or medication-induced sexual dysfunction. A thorough sexual history and assessment of general health and other sexual problems if any are very important.
Assessing performance anxiety , guilt , stress and worry are integral to the optimal management of sexual dysfunction. Many of the sexual dysfunctions that are defined are based on the human sexual response cycle , proposed by William H. Masters and Virginia E. Johnson , and then modified by Helen Singer Kaplan. Sexual dysfunction disorders may be classified into four categories: Sexual desire disorders or decreased libido are characterized by a lack or absence for some period of time of sexual desire or libido for sexual activity or of sexual fantasies.
The condition ranges from a general lack of sexual desire to a lack of sexual desire for the current partner. The condition may have started after a period of normal sexual functioning or the person may always have had no or low sexual desire. The causes vary considerably, but include a possible decrease in the production of normal estrogen in women or testosterone in both men and women.
Other causes may be aging, fatigue, pregnancy, medications such as the SSRIs or psychiatric conditions, such as depression and anxiety. While a number of causes for low sexual desire are often cited, only some of these have ever been the object of empirical research. Sexual arousal disorders were previously known as frigidity in women and impotence in men, though these have now been replaced with less judgmental terms.
Impotence is now known as erectile dysfunction , and frigidity has been replaced with a number of terms describing specific problems that can be broken down into four categories as described by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders: For both men and women, these conditions can manifest themselves as an aversion to, and avoidance of, sexual contact with a partner.
In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity. There may be physiological origins to these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease can also contribute, as well as the nature of the relationship between the partners. Additionally, the condition postorgasm illness syndrome POIS may cause symptoms when aroused, including adrenergic-type presentation; rapid breathing, paraesthesia, palpitations, headaches, aphasia, nausea, itchy eyes, fever, muscle pain and weakness and fatigue.
The aetiology of this condition is unknown, however it is believed to be a pathology of either the immune system or autonomic nervous systems. It is defined as a rare disease by the NIH but the prevalence is unknown. It is not thought to be psychiatric in nature, but it may present as anxiety relating to coital activities and thus may be incorrectly diagnosed as such. There is no known cure or treatment.
Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis. There are various underlying causes, such as damage to the nervi erigentes which prevents or delays erection, or diabetes as well as cardiovascular disease, which simply decreases blood flow to the tissue in the penis, many of which are medically reversible. The causes of erectile dysfunction may be psychological or physical.
Psychological erectile dysfunction can often be helped by almost anything that the patient believes in; there is a very strong placebo effect. Physical damage is much more severe. One leading physical cause of ED is continual or severe damage taken to the nervi erigentes. These nerves course beside the prostate arising from the sacral plexus and can be damaged in prostatic and colorectal surgeries.
Diseases are also common causes of erectile dysfunctional; especially in men. Diseases such as cardiovascular disease, multiple sclerosis, kidney failure, vascular disease and spinal cord injury are the source of erectile dysfunction. Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil trade name Viagra , in the s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.
It is estimated that around 30 million men in the United States and million men worldwide suffer from erectile dysfunction. The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.
Premature ejaculation is when ejaculation occurs before the partner achieves orgasm, or a mutually satisfactory length of time has passed during intercourse. There is no correct length of time for intercourse to last, but generally, premature ejaculation is thought to occur when ejaculation occurs in under two minutes from the time of the insertion of the penis.
Historically attributed to psychological causes, new theories suggest that premature ejaculation may have an underlying neurobiological cause which may lead to rapid ejaculation.
SSRI antidepressants are a common pharmaceutical culprit, as they can delay orgasm or eliminate it entirely. A common physiological culprit of anorgasmia is menopause , where one in three women report problems obtaining an orgasm during sexual stimulation following menopause.
Further to this there are what is called post-orgasm disorders, which would better categorise the condition: Sexual pain disorders affect women almost exclusively and are also known as dyspareunia painful intercourse or vaginismus an involuntary spasm of the muscles of the vaginal wall that interferes with intercourse. Dyspareunia may be caused by insufficient lubrication vaginal dryness in women.
Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by menopause , pregnancy , or breastfeeding. Irritation from contraceptive creams and foams can also cause dryness, as can fear and anxiety about sex. It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma such as rape or abuse may play a role.
Another female sexual pain disorder is called vulvodynia or vulvar vestibulitis. In this condition, women experience burning pain during sex which seems to be related to problems with the skin in the vulvar and vaginal areas. The cause is unknown. Post-orgasmic diseases cause symptoms shortly after orgasm or ejaculation. Post-coital tristesse PCT is a feeling of melancholy and anxiety after sexual intercourse that lasts for up to two hours.
Sexual headaches occur in the skull and neck during sexual activity, including masturbation, arousal or orgasm. In men, postorgasmic illness syndrome POIS causes severe muscle pain throughout the body and other symptoms immediately following ejaculation.
The symptoms last for up to a week. Symptomology of POIS may present as adrenergic-type presentation; rapid breathing, paraesthesia, palpitations, headaches, aphasia, nausea, itchy eyes, fever, muscle pain and weakness and fatigue. Dhat Syndrome is another condition which occurs in men. It is a culture-bound syndrome which causes anxious and dysphoric mood after sex, but is distinct from the low-mood and concentration problems acute aphasia seen in postorgasm illness syndrome.
Pelvic floor dysfunction can be an underlying cause of sexual dysfunction in both women and men, and is treatable by physical therapy. Erectile dysfunction from vascular disease is usually seen only amongst elderly individuals who have atherosclerosis. Vascular disease is common in individuals who have diabetes , peripheral vascular disease , hypertension and those who smoke. Any time blood flow to the penis is impaired, erectile dysfunction is the end result.
Hormone deficiency is a relatively rare cause of erectile dysfunction. In individuals with testicular failure like in Klinefelter syndrome , or those who have had radiation therapy , chemotherapy or childhood exposure to mumps virus , the testes may fail and not produce testosterone.
Other hormonal causes of erectile failure include brain tumors, hyperthyroidism , hypothyroidism or disorders of the adrenal gland. Structural abnormalities of the penis like Peyronie's disease can make sexual intercourse difficult.
The disease is characterized by thick fibrous bands in the penis which leads to a deformed-looking penis. Drugs are also a cause of erectile dysfunction. Individuals who take drugs to lower blood pressure or use antipsychotics , antidepressants , sedatives, narcotics, antacids or alcohol can have problems with sexual function and loss of libido.
Priapism is a painful erection that occurs for several hours and occurs in the absence of sexual stimulation. This condition develops when blood gets trapped in the penis and is unable to drain out. If the condition is not promptly treated, it can lead to severe scarring and permanent loss of erectile function.
The disorder occurs in young men and children. Individuals with sickle-cell disease and those who abuse certain medications can often develop this disorder.
There are many factors which may result in a person experiencing a sexual dysfunction. These may result from emotional or physical causes. Emotional factors include interpersonal or psychological problems, which can be the result of depression , sexual fears or guilt, past sexual trauma, and sexual disorders,  among others. Sexual dysfunction is especially common among people who have anxiety disorders.
Ordinary anxiousness can obviously cause erectile dysfunction in men without psychiatric problems, but clinically diagnosable disorders such as panic disorder commonly cause avoidance of intercourse and premature ejaculation. Physical factors that can lead to sexual dysfunctions include the use of drugs, such as alcohol, nicotine , narcotics , stimulants, antihypertensives , antihistamines , and some psychotherapeutic drugs.
Diseases such as diabetic neuropathy , multiple sclerosis , tumors , and, rarely, tertiary syphilis may also impact the activity, as could the failure of various organ systems such as the heart and lungs , endocrine disorders thyroid , pituitary , or adrenal gland problems , hormonal deficiencies low testosterone , other androgens , or estrogen and some birth defects. Pelvic floor dysfunction is also a physical and underlying cause of many sexual dysfunctions.
In the context of heterosexual relationships, one of the main reasons for the decline in sexual activity among these couples is the male partner experiencing erectile dysfunction. This can be very distressing for the male partner, causing poor body image, and it can also be a major source of low desire for these men.
If a woman has not been participating in sexual activity regularly in particular, activities involving vaginal penetration with her partner, if she does decide to engage in penetrative intercourse, she will not be able to immediately accommodate a penis without risking pain or injury. According to Emily Wentzell, American culture has anti-aging sentiments that have caused sexual dysfunction to become "an illness that needs treatment" instead of viewing it as the natural part of the aging process it is.
Not all cultures seek treatment; for example, a population of men living in Mexico often accept erectile dysfunction as a normal part of their maturing sexuality. Several theories have looked at female sexual dysfunction, from medical to psychological perspectives.
Three social psychological theories include: The importance of how a woman perceives her behavior should not be underestimated. Many women perceived sex as a chore as opposed to a pleasurable experience, and they tend to consider themselves sexually inadequate, which in turn does not motivate them to engage in sexual activity.
A study has found that African American women are the most optimistic about menopausal life; Caucasian women are the most anxious, Asian women are the most inhibited about their symptoms, and Hispanic women are the most stoic. About one third of the women experienced sexual dysfunction, which may lead to women's loss of confidence in their sexual lives.
Since these women had sexual problems, their sexual lives with their partners became a burden without pleasure, and eventually, they may completely lose interest in sexual activity.
Some of the women found it hard to be aroused mentally; however, some had physical problems.
Before trying herbal remedies, speak with a doctor. Official organizations no not regulate herbal supplements, and they can have side effects or interact with medications. It is important to see a healthcare provider who is knowledgeable about supplements and who can monitor the progress of symptoms. Erectile dysfunction is often due in part to psychological factors. Individual counseling can help a man to address the role of these and other factors in sexual satisfaction. Relationship counseling can help partners to speak openly about sexuality without shame or judgment.
When a man has an underlying health issue, for example, counseling can help him to cope with the stress of erectile dysfunction while communicating about options with a partner. Several medications can help with sexual function, including popular drugs, such as Viagra and Cialis. Medication can be the most rapid treatment option for some men. If a man taking medication for erectile dysfunction also makes lifestyle changes and participates in therapy, they may eventually be able to stop taking the drugs.
A handful of medications can affect sexual satisfaction, libido, and the ability to have or maintain erections. Antidepressants , for example, may change the way a man ejaculates and reduce sexual desire.
Selective serotonin reuptake inhibitors, or SSRIs, may be especially likely to cause sexual dysfunction. A man who takes drugs with sexual side effects should discuss changing the medication, stopping the treatment, or lowering the dosage with a doctor. Erectile dysfunction can be an early warning sign of health issues. It is important to take good care of the body by eating a balanced diet, remaining physically active, and managing stress.
Treating chronic health issues, such as diabetes and heart disease, is also essential. Take medications as recommended and try lifestyle changes that can improve overall health. Sexual dysfunction can be concerning and embarrassing, but these types of issues are common and treatable.
A person can come to feel good about their sexuality by working with a certified sex therapist, communicating openly with partners, and trying different lifestyle changes. Article last reviewed by Mon 2 July All references are available in the References tab. Herbal dietary supplements for erectile dysfunction: A systematic review and meta-analysis [Abstract].
Antidepressants and sexual dysfunction: Mechanisms and clinical implications [Abstract]. Women's experiences with genital touching, sexual pleasure, and orgasm: Results from a U. Current and emerging therapies in premature ejaculation: Where we are coming from, where we are going.
Psychological aspects of erectile dysfunction [Abstract]. Mindfulness-based therapies for sexual dysfunction: A review of potential theory-based mechanisms of change [Abstract]. The link between cigarettes smoking and erectile dysfunction: A systematic review [Abstract]. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.
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Register for a free account Sign up for a free Medical News Today account to customize your medical and health news experiences. Register take the tour. A set of simple lifestyle changes can help to: Thirteen ways to improve sexual performance The following methods can help to reduce erectile dysfunction, increase stamina, and improve the overall quality of sex: Focus on foreplay Simple lifestyle changes can help to improve erectile dysfunction and reduce anxiety.
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Are gut bacteria the key to healthy aging? Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring. The idea is to enable women to stay focused on sex by integrating the physical with the mental so that mental excitement can heighten physical arousal and vice versa.
To try it at home, Brotto suggests spending 10 minutes a day paying very close attention to any activity — walking the dog, washing dishes, drinking a cup of coffee. To achieve this, imagine putting your wandering thoughts on a conveyor belt and watching them slowly roll away.
Brotto advises next getting familiar with your body by examining and touching yourself during or after a shower, experimenting with what feels good. When you're ready, work toward incorporating the focusing exercise while you're aroused, either alone or with your partner. Eventually you'll become attuned to what you're feeling during sex rather than letting your thoughts escape the bedroom. A slightly different aspect of desire has been the focus of studies by University of Utah psychologist Lisa Diamond, Ph.
She's been interviewing a group of roughly women for nearly 15 years, asking them questions about changes in their sexual cravings and reactions over time.
One of Diamond's subjects is a straight woman who became intimate with her female roommate. Diamond has been grappling with the question of why some friendships take a turn toward the physical while most don't, and she's drawn some preliminary conclusions.
In cases where both women identify themselves as heterosexual, a series of what she calls "situational factors" come into play. One is relationship status: If neither woman has a boyfriend, they're more likely to become strongly emotionally invested in the friendship.
The other is proximity: There's something very powerful about spending a lot of time together — as roommates, travel partners, or close colleagues, Diamond says. The woman in the study ended up in a two-year relationship with the roommate, after which she went back to sleeping with men. Diamond's research reiterates the fact that female desire defies easy categorization.
University of Nevada psychologist Marta Meana, Ph. Meana originally set out to see how men's and women's visual attention patterns differ from one another when they look at erotic images — in this case, very sexy shots of nearly naked people in a panoply of sexual positions.
Meana outfitted her research subjects with eye-tracking goggles, which measured eye movement per millisecond. They spent most of their time looking at the women. In women, there was an almost split. She acknowledges that they may have been turned on by images of other women, but she thinks it's more likely that they were trying to measure themselves up — a finding supported by some of her previous research, which found that sexual desire boils down to how a woman feels about herself; specifically, how she feels about her body.
Women have to be convinced that they are desirable in order to believe that anyone else finds them desirable. If you haven't been in the mood lately, it might be because you're feeling unattractive gained a few pounds, noticed your breasts sagging, spotted a new dimple of cellulite , and figure your man couldn't possibly think you look hot.
In her private counseling practice, Meana sees many couples in which the woman "will completely avoid certain sex positions because she's embarrassed by how she thinks her body looks. But the husband hasn't even thought of that. He's shocked 'That's why you won't get on top? Because you think your breasts sag?! Sometimes, the key to better sex might be repairing your relationship with yourself.
There's no one-size-fits-all solution, but Meana works with her patients to help them figure out what would make them feel desirable. For some women, it might be as easy as buying sexy lingerie. For others, it might be overcoming physical insecurities by adopting a new workout routine.
One thing she doesn't recommend, though, is dimming the lights during sex even using candlelight! Meana's research may be easier to digest than Chivers's or Diamond's, both of which point out women's potential to desire some rather shocking things.
These will result in more expensive repairs as your home incurs more damage over time. By dealing with urgent jobs first, regardless of if the handyman charges at an hourly or flat rate, you will save money — and a lot more — in the long run. Labor rights and women’s rights are inherently entwined. With the international attention focused on the garment industry in South Asia right now, an industry comrpised primarily of female workers, it is an important place to begin promoting women's rights at work on the ground. sold into the sex trade because of filial obligations to their families.7 In fact, some became victimizers by speculating in the trade of human chattel and selling the services of other women. In San Francisco, a number of women escaped a lifetime of.