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Sexual Dysfunction: Facts, Causes and Treatments
Sexual dysfunction is a wide-reaching umbrella term for—putting it as simply as possible—anything which goes wrong or doesn’t function correctly between a couple in what can be quaintly called the “bedroom department.”
Both men and women can be affected by one or more forms of sexual dysfunction at any time throughout life, and at its best it can be a mildly embarrassing issue that can sometimes be laughed about and brushed off. However, sexual dysfunction can wreck people’s confidence and make them feel like they are somehow “less”. At its worst, sexual dysfunction can cause marriages and relationships to fracture or break up, can contribute to psychological issues such as chronic depression, and even lead to suicide in the most extreme cases.
It’s something that we laugh at. Comedians joke about it, boys make fun of other boys about it, and girls tease boys about it—heck, it seems that everyone teases everyone about sexual dysfunction. We laugh and make fun of sexual dysfunction because we often either suffer from some form of it ourselves and are embarrassed about it, or because we’re adopting a “there but for the grace of God go I” approach about the whole thing.
Because sex is such an integral part of our lives, the thought of somehow not being able to “perform” scares the heck out of us. But as so many of us suffer from – or will suffer from – some form of sexual dysfunction during our lifetimes, we nervously shake the whole thought of it out of our minds and make ourselves feel better about it by laughing about it. That’s not an entirely bad thing, but a little bit of knowledge about the subject goes a long way as well. That is what this article is all about.
Underlying Causes of Sexual Dysfunction
There are so many different forms of sexual dysfunction that it’s hard to lay down specific reasons and causes for any one individual suffering from any one type of dysfunction. However, it is possible to place the causes of all sexual dysfunctions down to two general underlying sources:
The physical or psychological.
Any sexual dysfunction will either be a physical issue or a psychological one, although that is sweeping over the issue with a broad brush.
Physical Causes of Sexual Dysfunction
In both men and women, sexual dysfunction can be caused by physical factors such as disease or alcohol or drug abuse. Drugs that are prescribed by doctors for various conditions can also cause sexual dysfunction in many people, as a side effect. So oftentimes that means that even if a particular disease or illness did not interfere with your ability to have sex, the actual treatment for said disease or illness might very well do.
Pretty much everyone has heard of the expression “brewers droop”. This comes from the ability of a man to get or to maintain an erection because of alcohol. The expression itself comes from just one night going out drinking and not being able to perform. In the short term—for men, alcohol affects the flow of blood to the penis, which means he gets the dreaded “droop”. In the long term, chronic drinking or alcoholism affects one’s hormones, causing serious, long term sexual dysfunction.
In the case of recreational drugs—as opposed to prescription drugs given by a doctor—there are often similar consequences for men as there are from abusing alcohol. A common expression among cocaine users is “coke dick”, where a man’s penis is unable to get erect due to the abuse of the drug. Cocaine affects parts of the brain that affect desire and thus the ability to get an erection. Many other drugs have the same affect in some degree or the other.
Any disease or illness is possible to cause sexual dysfunction—a good basic example being, how many people still feel like having sex when they’re sick with the flu or a bad cold? Although not a real dysfunction in the basic sense of the term, for that limited period of time, it might well be. But putting that aside as an example of the generality of the issue, some of the main conditions that actually can physically cause sexual dysfunction are listed below:
- Cardiovascular disease (including hypertension or high blood pressure)
- Cancer (especially prostate cancer)
- Depression (a two-edged sword here—sexual dysfunction can also cause depression)
- Menopause (affects women only).
As already mentioned, pretty much any ailment or illness can cause some form of sexual dysfunction or some change in life where sex becomes an issue, but the five conditions listed above are easily the most common ones that act as direct causes of the loss of libido or ability to “perform”.
Cardiovascular disease causes sexual dysfunction in a number of ways. Any disease which affects the heart, and the way that blood is pumped around the body is bound to affect one’s sex life in a number of ways. Firstly, if blood vessels in the body are damaged, this can affect the flow of blood to the genital areas, which impedes arousal. After all, in men for example, an erection is caused by tissues within the penis filling up with blood. If that blood is unable to reach the penis, then an erection is impossible to achieve.
With women, blood being unable to reach the vagina also means that she’s unable to become aroused. These are two examples of sexual dysfunctions right there. Cardiovascular problems also affect sexual ability because they can cause fatigue or chest pain. Sex is physical exercise too, and many people with heart problems are unable to perform in the same way that going for a run might cause a heart attack.
Sufferers of diabetes face many of the same problems regarding sexual dysfunction as those with cardiovascular problems. Unsurprising really, as heart problems and diabetes pretty well go hand in hand together. Diabetics often experience a narrowing and hardening (no pun intended) of the blood vessels that supply blood to the tissues inside the penis that cause erections. Just as with cardiovascular diseases, if less blood can reach the penis, the more difficult it is to get and maintain an erection. Women diabetics have exactly the same issue—with them, diabetes causes a narrowing and hardening of the blood vessels around the vagina, again causing less blood to flow in that area and less chance of arousal. If a woman is not aroused due to a lack of blood flow to the vagina, then her vagina will be dry, as healthy blood flow creates the vaginal lubrication that a woman needs in order to have sex.
The word cancer on its own is enough to turn many people off sex for life. There’s probably not a more frightening word in the English language. But prostate cancer in particular will physically cause erectile dysfunction in men. We’re talking about men here, as prostate cancer is overwhelmingly a man’s cancer. In truth, it’s actually not the cancer itself that causes the sexual dysfunction (although psychologically that might be another story). The devil is in the treatment. Whichever treatment one receives when it comes to prostate cancer, it’s guaranteed that that treatment will cause sexual (erectile) dysfunction. Surgery to remove the prostate gland will do it, as the nerves that control a man’s erection are too close for comfort to the nerves that control the prostate. It’s impossible for them not to be affected, although there is a process called “nerve-sparing” that should allow a man to recover sexually within a year.
Radiation therapy is no better. The prostate being targeted for radiation is simply in the same area as a man’s sexual organs and it all gets affected. A man receiving radiation therapy will gradually lose his ability to get an erection. Another treatment for prostate cancer is hormone therapy to reduce testosterone. Naturally, this leads to a loss of libido.
Depression could be counted as one of the psychological reasons for sexual dysfunction, but as it is now recognized as an actual disease, we are listing it here as a physical reason. Depression basically is an imbalance of chemicals that exist in the brain called neurotransmitters. These chemicals affect every aspect and mood of our lives, including our desire to have sex. A person suffering from depression is often simply incapable of being able to have sex because his or her neurotransmitters are not sending a message to the brain that they want to. In turn, the brain is not sending a message to the heart to pump blood down to the genitals in order to form that erection or lubricate that vagina in order to get going. It’s really as simple as that, and put that way it’s as physical a reason as either cardiovascular problems, cancer, or diabetes for sexual dysfunction.
Women going through the menopause also experience sexual dysfunction. Menopause is a natural process—as a woman loses her ability to bear children as she ages, her body also changes to make her less interested in sex. That’s the plan, anyway, but obviously it doesn’t work like that and of course, many women remain interested in sex into old age and want to have as fulfilling and vibrant a sex life as anyone else. Unfortunately the body doesn’t listen to reason and it lowers the level of estrogen in the menopausal woman. This has exactly the same effect as diabetes and cardiovascular disease in that it inhibits blood from getting to the vaginal walls, which decreases lubrication, creating a dry vagina. The lack of blood also, as described above, decreases arousal and as such the menopausal woman will often just lose interest in sex.
Treatment for Physical Sexual Dysfunction
With all of the above physical causes of sexual dysfunction, there are treatments available that health care professionals can decide what works best for the patient. People with cardiovascular disease are encouraged to make those crucial lifestyle changes that will improve their blood flow and thus the chances of maintaining an erection or of having enough blood reach the vagina in order to turn it on enough to lubricate itself. These lifestyle changes include quitting smoking, drinking less, exercising more, eating more healthily and so on. This is the usual stuff that everyone should do anyway in order to live a more healthy life.
Diabetics also need to take care of themselves. Making the lifestyle changes mentioned above can prevent diabetes occurring in the first place, but if it’s already occurred, it can reduce the severity of the disease by leaps and bounds. The diabetic needs to control his or her blood glucose levels, and once that is under control, he or she can live a normal life and enjoy a normal, dysfunction-free sex life. Diabetic men can also take a number of pills that are on the market to treat erectile dysfunction such as Viagra, Levitra or Cialis. These drugs basically work by directing blood to the penis in order to sustain an erection, and are available by way of prescription from a doctor. These drugs are generally NOT recommended for those with heart problems and as such are not a solution for those with cardiovascular disease.
Viagra and the other drugs mentioned above are also available for men who have received treatment for prostate cancer. Other options for men in this situation can be quite drastic and include injecting the penis itself with medication in order to help it to “perform”, or the use of various devices or implants.
With depression, treatment for sexual dysfunction is quite different. The issue here is oftentimes a lack of desire in the first place because the brain’s neurotransmitters are not working properly. Sexual desire starts in the brain, so if there’s no desire, there’s no way that blood will even travel to the genitals in the first place. Ways to get around this are basically treatment for the depression itself, so that the brain will work properly again and the patient will feel sexual desire. Many anti-depressant medications also affect a patient’s sexual desire, so the key is to keep speaking with health professionals in order to find the right combination of drugs and treatments that work best.
Psychological Causes of Sexual Dysfunction
The psychological causes of sexual dysfunction are much more difficult to pin down than the physical ones. It’s easy, after all, to blame sexual dysfunction on an outside, physical condition. It’s easier for someone to say that they can’t get an erection or can’t get aroused because of this reason or that reason. But what about if there’s no reason at all? What about if you’re perfectly physically healthy and still you’re suffering from sexual dysfunction? What then?
The truth is that sexual dysfunction always comes from somewhere. It could be deep-seated hang-ups about sex brought about through oppressive parents or schools. Being brought up to think that sex is a wicked sin that will send you to the depths of hell can sometimes scare the heck out of people throughout their lives, and turn what should be a wonderful experience into something traumatic. It really happens.
Other causes of sexual dysfunction could come from being sexually abused in either childhood or adulthood. This can cause feelings about sex that are anything but pleasurable.
Stress is also a big cause of sexual dysfunction. Stress about work, about money, about relationships. All these issues can cause someone to either lose interest in sex or just not be able to perform when it counts.
Talking of the word “perform”, that can be another cause in itself. There is great pressure to be a seen as a fantastic lover among a lot of people. This pressure can, on its own, build up and blow your chances of being able to perform at all.
Treatment for Psychological Sexual Dysfunction
The thing to remember concerning these psychological causes of sexual dysfunction is that they are very common. Pretty much everyone in the world has experienced a lack of sexual performance due to stress or pressure to perform at least once in their lives. Some people won’t admit it, but they’d be lying. As long as you take time to relax, to enjoy yourself, and to simply look after yourself and be as happy as you can be, most of these problems will clear up naturally.
When it comes to the more deep-seated psychological causes of course, those ones coming from sexual assault or guilt,
then counseling is needed and there are many counselors who can provide that specific service.
Prevalence of Sexual Dysfunctions
Sexual dysfunction of some sort or another is a common condition that affects many people—if not most people—at least once in their life. Pretty much most men, even if they will never admit it, will have experienced a case of “brewer’s droop” in their lives, for example. But that’s at the mild, non-serious end of things. What are the numbers and statistics for people for whom sexual dysfunction is a serious, ongoing problem? Who is suffering from sexual dysfunction?
Most studies show that sexual dysfunction is more prevalent in women than in men. This makes some sense in that all women go through the menopause, some later in life than others. But out of sexually active people who are affected by sexual dysfunction of some sort or another, it appears that 43 percent of woman and 31 percent of men suffer from the condition.
The chances of becoming affected with some type of sexual dysfunction increase with age. This is due to the obvious fact that most of the diseases that cause sexual dysfunction occur as one gets older. Sexual dysfunction is not something that is wasted on the young! In men suffering from erectile dysfunction—again, the inability to get or maintain an erect penis before and during sexual intercourse—the numbers of people under the age of 40 affected are negligible (unless drink or drugs are affecting them). Over the age of 40, it’s estimated that five percent of men are affected with erectile dysfunction, with that number leaping up to between 15 and 25 percent for the over-65s.
In women the numbers can be broken down in a few different ways. Given that female sexual dysfunction (FSD) mostly comes from the vagina not being able to lubricate itself due to a number of different reasons discussed above, it was found that 27 to 32 percent of women who suffer from FSD have lost interest in, or have no interest in sex. Between 22 to 28 percent of women are unable to achieve orgasm and between 8 and 21 percent experience pain during sex. 17 to 27 percent of women affected by FSD say that they just don’t find sex pleasurable at all. These numbers came from a study of US women seeking treatment for female sexual dysfunction in the 1990s.
So overall, the chances of any of us suffering from sexual dysfunction at any time in our lives is high and the condition is extremely prevalent.
Types of Sexual Dysfunctions
There are numerous types of sexual dysfunction, but they can be split into four principal categories. Within each category you can find a specific condition. These categories are labeled as disorders and are listed as follows:
- Desire disorders
- Arousal disorders
- Orgasm disorders
- Pain disorders.
Desire disorders are the types of sexual dysfunction that occur through simply losing interest in sex. A person with a desire disorder may no longer be interested in sex at all, with anyone, or they may have lost interest in having sex with their partner. Causes of desire disorders can come from the body producing less estrogen (for women) or testosterone (for men), causing a decrease in libido. The natural passage of time—aging—can be a cause of losing interest in sex, as can stress, fatigue or other factors. The main physical factor of a desire disorder comes from depression, other than that it’s mostly psychological.
People who have arousal disorders have many more physical symptoms than those with desire disorders. The most common types of sexual dysfunctions—erectile dysfunction in men and the inability to get aroused in women—fall under this umbrella. People who have arousal disorders want to have sex—it’s just that they are unable to do so. In men, the difficulty is achieving an erection and in women the difficulty is being able to lubricate the vagina in order to enjoy sex.
Orgasm disorders are also known as anorgasmia. This is a condition that affects both men and women and means that they are unable to climax at all during sex. The sex itself could be great—but the man or the woman cannot “cum”. With men the condition is called delayed ejaculation and it is about the rarest sexual dysfunction a man can have—men generally can’t achieve an erection at all or they ejaculate too quickly (premature ejaculation). Causes are generally psychological, but delayed ejaculation can result from certain types of surgery as well. Orgasm disorders are much more common in women. Almost five percent of women say that they never orgasm and don’t know how to. Again, with women, the causes are mostly psychological. In both men and women, some anti-depressant medicines cause anorgasmia, as well as addiction to opiate drugs such as heroin.
Pain disorders are suffered almost exclusively by women. Quite simply, it hurts to have sex. This is mostly caused by lack of lubrication of the vagina, making sex feel rough and uncomfortable. If sex feels this way, it makes it easy for the woman to think about giving up on having a sex life altogether. Another condition called vaginismus is also classified as a pain disorder. This occurs through involuntary spasms of the muscles in the vagina during sex that interferes with the process and causes physical pain. It’s often seen as a subconscious way to get the penis out of the vagina—a psychological issue coming from sexual abuse or perhaps rape or some other traumatic experience in the past.
There are also other types of less common sexual disorders that don’t fit neatly into the four boxes outlined above. Some of these dysfunctions include depression after sex— known as post-coital tristesse—to feelings of physical pain after sex as well, such as headaches or muscle pain.
All of these conditions and disorders add up to achieving a less than satisfactory result of sexual intercourse and so have to be described as dysfunctions.
Sexual Dysfunctions in Popular Culture
Sexual dysfunction seems to be everywhere and nowhere. As common as it is, no-one, understandably, wants to talk about it. Or at least not talk about it happening to them. We joke about it in bars but we don’t want to see it on our movie and TV screens just in case, maybe, it brings it all too close to home for us.
Still, there are a few movies that have explored the concept. Here are a few below:
- I Think I Love My Wife (2007). Comedian Chris Rock stars as a guy with erectile dysfunction who tries Viagra and ends up in hospital with an erection he can’t get rid of.
- Bonnie & Clyde. This classic crime movie from the 60’s starring Warren Beatty and Faye Dunaway has Clyde (Beatty) telling Bonnie that he’s “not much of a lover boy.”
- The Big Chill (1983). This movie portrays an ex-playboy, played by William Hurt who’s now impotent.
- The 40 Year-Old Virgin (2005). Steve Carell plays a 40 year-old man who’s never had sex. Although this doesn’t necessarily signify a sexual dysfunction, some hang ups about sex are implied throughout the movie and at the end, when he finally does “pop his cherry”, he cums in about two seconds—a severe case of premature ejaculation.
- Alfie (2004). This remake of the 1960’s classic took a bit of a darker tone than the original, exploring lead character Alfie’s (played by Jude Law) torment as he develops erectile dysfunction.
- Leaving Las Vegas (1995). Nicholas Cage plays an alcoholic who can’t get an erection at all. He loves his girlfriend Sera, a prostitute, but is unable to make love to her.
- Midnight Cowboy (1969). This classic movie starring Jon Voight and Dustin Hoffman sees Voight’s character, Joe Buck, pimped out as a male prostitute at a party. Due to the drugs that he had been taking, he was unable to get an erection at all, causing him to become the subject of ridicule and derision.
- Forgetting Sarah Marhsall (2008). This comedy (why are so many movies that feature erectile dysfunction comedy movies?) explores a guy who can’t get an erection with his lover simply because he no longer desires her. He once saw her as perfect—and she broke his heart—and now he can’t even physically have sex with her.
There are also some reports that the original Toy Story movie—yes, that cartoon with Buzz Lightyear and Woody (again, please excuse the pun!)—was in some way, some how, a film about sexual dysfunction. Perhaps it needs to be watched again to figure out exactly how.
Sexual dysfunctions have also been explored on TV, notably in the long-running HBO comedy Sex and the City and also in a 1997 episode of Beavis and Butthead where they went to the doctor because they “couldn’t get boners huh huh”.
Back in the 1980s the comedy show Golden Girls also had an episode that dealt with sexual dysfunction. Entitled “The Importance of Being Earnest”, it centered around Rose going out on a date with a guy and Blanche being jealous about it. Rose later found out when they went on a weekend away that the guy was impotent and so Blanche no longer felt so bad. By all accounts, it was one of the more mediocre episodes of the show.
Outside of that, there’s really not that much out there. Again, it’s a topic that everyone wants to talk about and at the same time no-one wants to talk about.
As the whole subject of sexual dysfunction is somewhat taboo, there’s not a whole host of celebrities or famous people who would admit to being affected. I mean, it’s hardly good for business is it? However, there are reports that rapper Jay-Z was suffering from a permanent erection caused from taking too much Viagra. True or not? Who knows? He was pictured with an erection, though, and he didn’t sue anyone for speculating about the whole Viagra thing. When a man like Jay-Z DOESN’T take legal action about speculation as to whether he needs to take blue pills to maintain an erection or not, then that right there may well say something. Or not.
Actor Michael Douglas is one of the few celebrities who have been honest about his sexual dysfunction, when he told the world how thankful he was for Viagra. He’s well into his 70s now with a beautiful wife, so everyone can understand how he feels about this!
Republican ex-senator and one-time presidential candidate Bob Dole has also spoken of his erectile dysfunction in an attempt to make the subject more open and less taboo for people to mention.
Outside of these guys, there are very few people that have come out into the open about sexual dysfunction—although let’s face it—Jay-Z didn’t come out at all, he was just spotted with an erection and people speculated.
Perhaps if more people spoke out—especially women, who understandably want to avoid being called names like “frigid”—about sexual dysfunction, maybe more people would feel better about their own lives.
Sexual Dysfunction Humor
You have to admit it—sexual dysfunction jokes are funny. We’ve all heard jokes about sex before and we’ve all laughed. There’s plenty of great material out there on the internet. Here’s a few choice picks below:
A crate load of Viagra has been stolen from a distribution depot—police are looking for hardened criminals.
Q: What is the difference between your first honeymoon and your second?
A: The first: Niagara; the second: Viagra.
And you get the picture. There’s many more like this, all over the internet. Long jokes, short jokes, funny ones, boring ones. It seems there are myriad wags and wits out there, who see erectile dysfunction as being funny. And it is, as long as it’s not happening to you!
Sexual dysfunction is such a vast topic that affects so many people. It’s more than likely to affect a great many people reading this article at some point in the future. People laugh about it but it seems that no-one—precious few people, in fact—ever want to talk about it. The next time that we’re all laughing about it with our friends, we should take a moment to consider that maybe the person laughing across the table from you is only laughing on the outside.