What Is Sexual Dysfunction?
Both women and men can experience difficulty in achieving satisfying sexual intercourse. Sexual dysfunction refers to disturbance in any component of the sexual response cycle. The deficiency may be in one or more phases of the response cycle; i.e. some may have issue with sexual desire (libido), others with inability to be aroused, while still others are not able to achieve orgasm. The common problems affecting males include erectile and ejaculatory dysfunctions. In women, failure to consummate or to allow vaginal penetration, and painful intercourse are important concerns. For those of you who do not enjoy or have difficulty in enjoying sexual activity, the primary hurdle is the psychological inertia. Most would give up sexual fulfilment, rather than to seek help from trained medical doctor, psychiatrist and sexual therapist. We recognise the embarrassment you will have to overcome to broach on sensitive information of yourself. Loss of sexual interest, reduced quality of sexual arousal during intercourse and vaginal dryness and pain during intercourse are very prevalent as women reach the mid-forties and beyond. Most men seek help when they found difficulty in achieving adequate erection or when early ejaculation deprives the couple of sexual satisfaction. Loss of sexual interest in young men, though uncommon, challenges the therapist. There are many couples who complain of non-consummation, and came forth when childbearing or marital disharmony become urgent.
Causes Of Sexual Dysfunction
We cannot ignore that most sexual dysfunction has an underlying psychological component; you may be having ongoing anxiety, you may be depressed, you may be having excessive stress at work or you may be having interpersonal problem. Very often, a history of sexual abuse at an earlier age, or mal-adjustment to a previous sexual relationship may taint your current perception of sexual enjoyment. Nevertheless, in many, the sexual dysfunction is related to chronic medical diseases, long term use of certain medications, hormonal changes and modifiable lifestyle habits. To distil the exact cause of sexual dysfunction is often not possible, as the mind and body interact intimately before the distress expresses itself as a symptom.
Treatment For Sexual Dysfunction
Treatment generally begins with the first detail clarification of the presenting complaint. By drawing out the necessary information in a non-threatening environment, the process itself is therapeutic. We identify at the outset the various disease conditions that may contribute to sexual functioning and aim to get them under control. It may be necessary to refer to the attending physicians for their input. Women with vaginal dryness may find relief with topical gels and hormone containing creams. HRT is useful for post-menopausal women. There are drugs on trial in treating women with poor arousal response as well as poor dry. In men who come with erectile dysfunction, the use of sildenafil, vardenafil or tadalafil are very helpful when they are prescribed for short term and long term use. When you do not respond to these drugs, we will move on to other management options like intra-penile injections and vacuum devices. Premature ejaculation is treated with topical cream and certain centrally-acting drugs. When the libido is problematic, assessment of the hormonal profile may suggest the use of androgen replacement therapy. Above all these measures, we cannot under-estimate the premier role of couple therapy and counselling. To prevent sexual dysfunction, simply “stay healthy and live happy”. We need to avoid succumbing to hypertension, diabetes, obesity, high cholesterol and stiffened blood vessels; and if we already have them, it is important to keep them controlled and not progress rapidly. The drugs that we take should not be those that affect our sexual performance. It is helpful not to drink alcohol in excess, to stop smoking and to quit the use of recreational drugs. Regular exercises to stay physically fit, and learning to manage stress at work and at home are important. Obviously, the way we relate to our sexual partner emotionally, the way we communicate with each other and how we resolve conflicts together will affect us in both triggering and maintaining our sexual difficulties.