Sexual Difficulties

Sexual Difficulties

An active sex life is a normal and important element for a rich and fulfilling life. However, many people encounter sexual problems at some point in their lives. These problems may be caused by many factors such as stress, tiredness, physical illness, financial and work pressures, relationship problems, or having a new baby.

CATEGORY: Relationships

SOURCES: APS | verywellmind.com | BMD

Number: #18

 

Two Otters Cuddling

 

A study released by the Australian Bureau of Statistics’ National Study of Mental Health and Wellbeing in 2023 (5,500 people aged 16 to 85 years old during 2020-2021) showed that more than two in five Australians experience a mental health issue in their lifetime. In 2020–21 more than 3.4 million Australians sought help from a health care professional for their mental health.

The study is published at https://abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/2020-21

Problems with sex can have impacts on the individual and within relationships, if communication and education about the situation is poor or absent.

Most people find that their sexual problems are temporary, though this is not always the case.

Sexual difficulties might be caused by sexual dysfunction which refers to a challenge that occurs during any stage of sexual activity. This may be a problem that affects the desire for a partner, arousal, penetration, the act of sex itself, or achieving orgasm during intimacy. Instances of sexual dysfunction are fairly common, with both men and women experiencing unique challenges that can affect satisfaction during intercourse.

Symptoms

While sexual dysfunctions are common in both men and women, intimacy challenges are experienced in ways that are unique to each sex.

In Men

  • An unexplainable lack of interest in sexual intercourse
  • Persistent difficulty in producing or maintaining an erection suitable for sex
  • The inability to reach orgasm, or a lengthened delay in climaxing
  • Constant difficulty with regulating moments when ejaculation occurs

In Women

  • A noticeable disinterest in sexual activity
  • Difficulty getting aroused
  • Experiencing pain during intercourse
  • Inadequate lubrication during sex
  • Difficulty relaxing vaginal muscles to permit penetration

Because of the nature of these challenges, people who are experiencing sexual dysfunction often keep it to themselves. It is believed that an estimated 43% of women and 41% of men experience some kind of challenge during intimacy.1

Diagnosis

 W hile men and women experience all forms of challenges associated with sexual contact, these difficulties usually fall into the following classifications:

  • Sexual desire disorders
    Arousal disorders
    Orgasm challenges
    Pain during intercourse

Sexual desire disorders

While it is perfectly normal to have periods where sex takes a back seat during weekly or even monthly activities—this lack of interest may qualify as a disorder when it persists for a long period of time and causes worry. Sexual desire disorders refer to a reduced or absent interest in sexual activity. In such cases, a person usually has little to no sexual fantasies or thoughts. This lack of interest may also cause a lack of responsiveness during intimate situations.

Sexual desire disorders include:

  • Hypoactive Sexual Desire Disorder: This condition is marked by a persistent lack of interest in sexual activities. It is the absence of or reduction in sexual thoughts and fantasies. While men may experience this disorder, it is very commonly observed in women with around 40% of women self-reporting low interest in sex. This disorder causes considerable distress and difficulty with sexual partners.
  • Sexual Aversion Disorder: There are cases where the mere thought of engaging in sexual activities can cause an almost physical recoil in disgust. Sexual aversion disorder is the persistent, and sometimes extreme avoidance of all or most forms of genital contact with a partner. The avoidant nature associated with this condition may cause distress to those living with it, and can cause some tension between sexual partners.

Arousal disorders

Types of arousal dysfunctions include:

  • Erectile dysfunction: This condition may be considered an arousal disorder where men experience difficulty with forming and sustaining erections suitable for sexual activity. However, the first sign of difficulty in achieving or maintaining an erection does not automatically make for a diagnosis of erectile dysfunction (ED). But where these difficulties persist for a period exceeding three months without external causes like surgery or physical trauma, symptoms may be indicative of an arousal disorder.4
  • Lack of vaginal lubrication: Vaginal dryness is a condition that can affect women of different ages. The absence of proper lubrication despite sexual excitement can cause pain and difficulties in intimate moments.5
  • Persistent genital arousal disorder: While continuous arousal is a welcome development in the bedroom, people living with this condition experience unwanted stimulation at work, in school, other public places, and even at home alone with no warning or trigger. These spontaneous and intrusive feelings may or may not produce orgasms, and can be incredibly distressing to those living with them.6

Orgasm Challenges

Some types of sexual dysfunction include difficulties related to orgasm like the following:

  • Premature ejaculation (PE): Observed in men, PE occurs when ejaculation happens earlier than someone desires. This can occur before or during penetration. A person living with this condition usually has no control over the timing of their ejaculation.
  • Delayed ejaculation: Delayed ejaculation can often feel distressing, not just to the person directly affected, but also their sexual partners. Delayed ejaculation refers to an unusually long wait time for achieving orgasm during intercourse.
  • Orgasmic dysfunction: This refers to disruptions to the orgasmic experience. It may be the absence of orgasm following sexual activity, reduced intensity of orgasms despite adequate stimulation, or a noticeable delay in reaching orgasm.
  • Anejaculation: The absence of ejaculate during orgasm.

Pain During Intercourse

Sexual dysfunction can also be related to pain during sexual activity:

  • Dyspareunia: People with a vagina who live with this condition experience continuous pain during sex or when attempts are made to initiate penis-vaginal intercourse.
  • Vaginismus: Here, all forms of vaginal entry whether penile, or through the fingers, and sexual objects are met with difficulty. This occurs despite a genuine desire to engage in sex.

Causes of Sexual Dysfunction

Sexual dysfunction typically does not occur overnight. For instance, pain during intercourse or ejaculatory/orgasmic challenges tend to have their roots in other conditions affecting the body. Listed below are likely causes of sexual dysfunction.

Health Changes

When the body endures major illnesses like diabetes, heart diseases, or challenges affecting the blood vessels, this can affect sexual functioning. This is seen in conditions such as erectile dysfunction, and women’s arousal disorders. Conditions such as hyperthyroidism or the excessive production of prolactin (hyperprolactinemia) may cause delayed ejaculation. Likewise, chronic health conditions like kidney or liver failure may affect performance during sexual activity.

Hormonal Imbalance

Hormones play a key role in sexual health and wellness. This is why changes in their production can affect performance and satisfaction during sexual activities. Low testosterone has been linked to low libido in men. Likewise, corresponding effects may be seen in women with low estrogen. This may explain why menopausal women with fluctuating hormone levels, tend to experience vaginal dryness and decreased interest in sex.

Gynecologic Conditions

Women with a vagina that experience conditions such as endometriosis, cysts, and fibroids may also find sex to be a painful activity.

Alcohol and Drug Use

As can be expected, alcohol and drug use have many downsides including a negative impact on sexual performance. Decreased desire, pleasure, arousal, orgasm, and ejaculation difficulty are some of the sexual challenges experienced following drug or alcohol use.

Psychological Factors 

In some cases, the pressures of a work deadline, school assignments, anxiety about upcoming obligations, sexual identity or gender dysphoria concerns, or even performance during sex can contribute to challenges during intimate moments. Depression, worries about body image, and guilt over sexual encounters may also contribute to sexual dysfunction.

Self Help Tips

You can try the following things and see how that goes:

 

 

  • Talk to your partner – assure them you are aware of the problem and you’re not belittling or ignoring their concerns
  • Resolve any relationship issues outside the bedroom
  • Modify your lifestyle – stop smoking, reduce alcohol, eat well and undertake regular exercise
  • Slow down – don’t rush into sex, take time to relax and have fun alone and together
  • Take time to enjoy intimacy with a partner – plan activities like a relaxing massage without sexual intercourse and try being sensual before being sexual

 

If problems persist, therapy can assist people with overcoming the difficulties that prevent them from engaging in and/or enjoying satisfactory intercourse and orgasm.

Therapy | Treatment

 

Treatment for sexual dysfunction can be challenging. It doesn’t help that these conditions are often considered private affairs, making their management incredibly isolating.

Despite the perceived challenges of living with sexual dysfunction, these conditions are manageable and may even be treated with the right care. Some ways to manage sexual dysfunction are discussed below.

Therapy

Talking to a therapist about the anxiety, feelings of guilt, or shame associated with sexual acts may help with overcoming the difficulties these feelings produce during sex

The role of a therapist in cases of sexual difficulties is to firstly to identify the problems that you are facing and what you want to achieve or improve in your sexual relationships.

The therapist will work with you to uncover underlying causes of your problems, explore various options and identify solutions. This may include getting clarification about physical or organic problems that might be contributing to the situation, and looking at relationship issues that might be impacting.

A therapist will also for example help you  develop new responses and habits using techniques that address problems, improve sexual techniques and lead to rekindling of passion and desire. Sometimes Sensate Focus is an approach used by therapists to help people with sexual problems.

Medication

Certain drugs and supplements can help to improve sexual function in men and women. In men, generic medications such as sildenafil, tadalafil, stendra, and vardenafil can act as vasodilators, helping to improve blood flow to the penis. They help to boost erectile function and stamina during intercourse.

Hormonal supplements such as testosterone and estrogen may also help to mediate difficulties associated with hormone imbalances.

Likewise, in cases where sexual dysfunction is a known side-effect of medication, swapping said drug for a less disruptive option is advisable.

Mechanical Assistance

For men that experience difficulties with forming and maintaining erections, a little outside help can make all the difference. Vacuum devices and penile implants can help with achieving and sustaining satisfactory erections for the duration of intercourse.