Sexual dysfunction is defined as difficulty during any stage of the sexual act (desire, arousal, orgasm and resolution) which prevents the person from enjoying sexual activity. This problem can arise early in a person’s life or may develop after an individual has previously experienced normal sex. It can occur gradually or suddenly. Sexual difficulties can be physical, psychological or both.
Emotional or psychological factors include:
• Relationship/marital problems
• Lack of trust and communication between partners
• Depression
• Sexual fears or guilt
• Past sexual trauma
Physical factors include:
• Trauma that prevents normal sexual act
• Prostate enlargement
• Diseases such as diabetic neuropathy, multiple sclerosis, tumors and rarely tertiary syphilis
• Drugs such as alcohol, nicotine, narcotics, stimulants, medicines that lower blood pressure, antihistamines
and some drugs that treat psychological problems such as depression
• Diseases that affect the thyroid, pituitary or adrenal gland, heart and lungs
• Hormonal deficiencies such as low testosterone levels and estrogen levels
• Nerve or spinal cord damage
• Problems with blood supply to sexual organs
• Some birth defects
Sexual dysfunction disorders are classified into 4 categories:
• Sexual desire disorder
• Sexual arousal disorder
• Orgasmic disorder
• Sexual pain disorder
Sexual desire disorders or decreased libido maybe due to:
• Decreased testosterone production in men and estrogen production in women
• Aging
• Fatigue
• Medications such as antidepressants such as Prozac, Zoloft and Paxil
• Psychiatric conditions such as depression, anxiety
• Decreased blood flow or lack of vaginal lubrication
These conditions may manifest as an aversion or avoidance of sexual contact or lack of sexual excitement and pleasure in sex. For men, there may be complete failure to attain or maintain an erection.
Lack of desire is the most common sexual concern reported by women. A lack of desire is considered a disorder when a woman:
• Does not want to engage in any sexual activity including masturbation
• Does not have sexual thoughts or fantasies
• Is worried or concerned about these sexual issues
Orgasm Disorders:
Orgasm disorders refer to persistent delay or absence of orgasm following a normal sexual excitement phase. Not having an orgasm during sexual activity may not be a problem for some women but for others, this is an issue.
This orgasmic disorder ranges from never having an orgasm to have had an orgasm at one time but no longer have them despite healthy arousal. Another problem maybe that the intensity of orgasm has decreased.
Causes include:
• Poor body image
• Drugs such as antidepressants
• Fear of losing control
• Lack of trust in her partner
Sexual Pain Disorder:
This is also called painful sex. It can be a lifelong or a short-term condition. Pain that occurs during sexual activities other than intercourse is called noncoital sexual pain disorder. Pain during intercourse is called dyspareunia.
Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital









