When we talk about sexual dysfunctions we mean a set of problems that hinder the normal functioning of the individual in the phases of the sexual response cycle, as well as specific forms of pain associated with sexual intercourse.
What the sexual response cycle consists of
The sexual response cycle is the set of phases, or stages, through which sexual intercourse takes place and takes place. These stages include:
Sexual desire : This has to do with sexual fantasies and the desire to engage in sexual activity. It is a purely cognitive and volitional phase that can initiate physiological changes and sensations that initiate the next phase of excitement.
Sexual arousal: it is given by the set of sensations and physiological changes that produce a strong impulse to sexual behavior. The intensity of this stimulus can vary according to various factors. Realizing that you are in this phase is simple as the sexual organs behave in a way that prepares you for the sexual act (see table).
Orgasm: It is defined as a peak of sexual pleasure that is reached during intercourse with the other person. Also in this phase the sexual organs show a typical behavior.
Resolution: following orgasm, our body enters a physiological state of relaxation and people feel a pleasant sensation of well-being. During this time the male goes through a variable time period of refractoriness, during which he is not sensitive to stimulation and further erections and orgasms.
Sexual dysfunctions and their symptoms
Any sexual dysfunction is usually traced back to one or more phases of the sexual response cycle. The only exceptions are given by the resolution phase (for which no dysfunction is recognized) and by the genito-pelvic pain and penetration disorder, which is configured in a more general sense as painful or tension syndrome linked to penetration. For a brief description of the sexual dysfunctions currently recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) you can consult the table below.
|Desire||Male hypoactive sexual desire disorder||Insufficiency or absence of fantasies and sexual desire|
|Desire and excitement||Disorder of sexual desire and female arousal||Reduced interest in sexual activity, with fewer thoughts and fantasies about it; absence or reduction of desire and arousal and pleasure in response to erotic stimuli and / or during intercourse|
|Excitement||Erectile Disorder||Difficulty getting or maintaining an erection or marked decrease in erectile stiffness|
|Orgasm||Delayed ejaculation||Marked delay or absence of ejaculation during sexual intercourse|
|Orgasm||Premature ejaculation||Premature ejaculation that occurs before the individual desires it|
|Orgasm||Female orgasm disorder||Delay, infrequency or total absence of orgasm. Or markedly reduced intensity of orgasmic sensations|
|Pain from intercourse||Genitopelvic pain and penetration disorder||Pain or fear of vulvo-vaginal or pelvic pain during attempts at penetration or during intercourse. Or marked tension or contraction of the pelvic floor muscles during the acts described above|
How to know if you have sexual dysfunction
Recognizing that you have sexual dysfunction may seem relatively simple. However, the issue can be more complex than expected. Before answering this question, it is appropriate to ask what criteria are used to establish good or bad sexual functioning. Furthermore, sexual dysfunction is such if it has no organic origins. Only once these aspects have been clarified will it be possible to make a diagnosis and undertake a suitable treatment for the problem. For these reasons, if there are signs of a possible malfunction and if this does not resolve spontaneously after some time, the advice is to contact centers or professionals specialized in the treatment of these problems.
What are the causes?
It is now known that psychological factors are among the factors capable of significantly affecting sexual performance. Strong tensions within the couple, as well as the stress caused by daily life, anxiety and mood play a very important role and realize the usefulness of an intervention focused on the management and regulation of these aspects. Other times, however, the cause lurks in our mind and in the way it has of conceiving sex and how it should be. People often have expectations about the duration and quality of sexual performance, worry about the size of the sexual organs, and fear that they are inadequate. Nowadays many take as a model of performance and sexual behavior that of actors or actresses of hard films, ending up setting their own qualitative and quantitative standards in their image and likeness. However, the expectation of being able to obtain such performance is often disillusioned with reality and the person ends up being prey to the well-known performance anxiety, which only further worsens his performance. The sexual and intimate life of people is far from these models. Long-term sexual intercourse is usually more unpleasant than pleasant, both for one partner and the other. Among the beliefs that can cause concerns and problems, those of a religious-moral, cultural and role-playing nature should not be forgotten. We all come from cultural and family situations that provide us with precise regulatory frameworks on behavior in relation to various contexts, existential areas and based on one’s male and female role. Excessive rigidity and adherence to these patterns is often a source of problems in the sexual sphere, which in many respects still remains a taboo today. Ultimately, it is possible that sexual dysfunctions are the result of previous negative experiences. The fact of having experienced an unsatisfactory performance even once can create severe discomfort if it has generated a sense of guilt or shame. The resulting anxiety, fear and sense of inadequacy can hinder the proper sexual functioning of the individual. sexual dysfunction may be the result of previous negative experiences. The fact of having experienced an unsatisfactory performance even once can create severe discomfort if it has generated a sense of guilt or shame. The resulting anxiety, fear and sense of inadequacy can hinder the proper sexual functioning of the individual. sexual dysfunction may be the result of previous negative experiences. The fact of having experienced an unsatisfactory performance even once can create severe discomfort if it has generated a sense of guilt or shame. The resulting anxiety, fear and sense of inadequacy can hinder the proper sexual functioning of the individual.
How to deal with them
There are currently short-term therapies for the treatment of sexual dysfunctions that have a high probability of success, develop within a relatively short period of time, and involve absolutely reasonable costs. However, defining precisely the amount of time required by treatments of this type is difficult, as the path is always individualized, therefore adapted to the characteristics of the person and the problem presented. Each dysfunction requires the implementation of specific techniques of both practical and cognitive nature. The first consist of a series of behavioral exercises that the person must learn and then practice consistently in his daily life. Sometimes it is required to practice them individually, other times in pairs. Some of these techniques are aimed at obtaining a greater degree of relaxation and self-control, others at strengthening the muscles of the sexual organs. All this generally takes place according to gradual, structured and agreed procedures, in which it is possible that self-monitoring and self-observation during the course may also be required. This is accompanied by a cognitive work focused on questioning irrational and dysfunctional thoughts and beliefs that may play a role in causing or maintaining dysfunctions. Through this work of “cognitive restructuring”, the person is guided by the therapist to recognize the groundlessness and inconsistency of the beliefs and concerns related to the complained dysfunctions. These beliefs can be of different character: moral, aesthetic, performance, hygienic, hypochondriac, or being tied to excessively rigid role patterns. Through interventions of this type the person has a good chance of restoring a good level of functioning and satisfaction in their sexual relations.
Dysfunctions induced by substances
Drugs, including alcohol, opiates, sedatives, hypnotics or anxiolytics, amphetamines or other stimulants such as cocaine, also tend to cause sexual dysfunction. The table below shows the names of some substances that can have side effects related to the sexual function of the individual. The substances listed are active drug ingredients that are sold under different trade names. The same active ingredient can be marketed under a different name that depends on the distributor pharmaceutical company.
How common are sexual dysfunctions?
Sexual dysfunctions are quite common disorders. Their incidence tends to vary considerably depending on the type of dysfunction and is difficult to quantify in exact terms. Sexuality is a delicate sphere of our functioning, it affects one’s self-esteem and can generate feelings of shame or guilt, which is why many people remain closed and modest and are reluctant to ask for help. But since effective treatments are available, it’s important for people to share their problem with their partner and health services. Overcoming one’s fears by turning to specialized personnel is the first step to gain courage, confidence and to create favorable conditions for overcoming these problems.
At what age is the onset and which are the most affected groups?
Sexual dysfunction can exist in adolescents and adults of any age. However, their incidence appears to increase in young people and older adult groups. The reasons for this trend are likely related to the fact that young people often have inexperience in sexual relations or do not have adequate information about it. Aging, characterized by the decline of physiological function and the use of certain types of drugs linked to age, can lead to the development of problems of this type.
I think I suffer from sexual dysfunction, but it only happens to me with some people. What should I do?
Sexual dysfunctions can also be limited to relationships with particular partners. The reasons can often be found in factors related to dissatisfaction, poor communication, conflict in the couple and possible differences in the frequency and intensity of sexual desire. Sometimes the health conditions of the partner and any sexual problems can also play a role. If you think this may be the case, what you can try is to seek specialist advice.
Sometimes I have problems with sexual intercourse, but it only happens in certain situations. Do I suffer from sexual dysfunction?
It is possible, as sexual dysfunctions can also be limited to particular situations in which particular conditions systematically arise, for example the lack of adequate stimulation or uncomfortable, accommodating and relaxing environmental circumstances. Those who are dissatisfied with their body and are afraid of showing their defects, for example, may not feel comfortable having sexual intercourse in bright conditions, appearing tense and worried.
Is it possible to have more than one sexual dysfunction?
Absolutely yes and it’s not uncommon. Sexual dysfunctions often occur in association with each other and in these cases the level of impairment is clearly greater.
I have never had problems in sexual relations, yet my relationships have not been satisfying for some time. Is it possible that I have sexual dysfunction?
If the problem has been going on for some time and you recognize yourself as one of the ailments listed above, it could be that you are suffering from some form of sexual dysfunction. In this particular class of disorders the sexual problem can be present from the first intercourse and represent a constant in the life of the individual. Other times, however, the problem arises after some time and after the individual has already had fully satisfactory sexual intercourse. In cases like this the disorder is defined as “acquired” and it is important to identify causes and maintenance factors in the present moment.
Does sex therapy also involve the partner?
It is generally preferable that both partners collaborate in sex therapy to increase the chances of success. This is for at least three reasons:
- Performing some behavioral exercises requires the presence of another person;
- The effectiveness of some behavioral exercises is greater if they are carried out together with a partner;
- Without being aware of it, the partner can play a role in causing or maintaining the problem.