Sexual dysfunctions are defined as a group of disorders characterized by significant impairment in one’s ability to respond or enjoy sexuality. Since it is quite a broad definition, it might raise some questions for the reader such as: “What do we mean by ‘significant impairment’?”, “What causes sexual dysfunctions?”, “How common are sexual dysfunctions?”, “What are the treatments for sexual dysfunctions?” …
What kind of Sexual Dysfunctions are there?
Before diving into these questions, it would be wise to mention the subtypes of sexual dysfunctions defined in a diagnostic manual used by healthcare professionals. There are a variety of diagnostic tools, classification systems and manuals that aid healthcare professionals in the diagnosis and treatment.
One widely used manual for the assessment and diagnosis is the last version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In DSM-5, seven sexual dysfunctions were mentioned including four sexual dysfunctions that are specific to biological males (i.e., individuals who are born with male genitalia) and three sexual dysfunctions that are specific to biological females (i.e., individuals who are born with female genitalia). More specifically…
For biological males:
- Delayed ejaculation
- Erectile disorder
- Male hypoactive sexual desire disorder
- Premature (early) ejaculation
For biological females:
- Female orgasmic disorder
- Female sexual interest/arousal disorder
- Genito-pelvic pain/penetration disorder
After seeing this list, one might wonder why these subtypes even exist. Well… Firstly, each of these subtypes is marked and differ by specific symptoms, causes, development, course and risk factors. Thus, to find an appropriate treatment of a given sexual problem, a healthcare professional requires specific input regarding all aspects stated above. Secondly, these definitions provide a common language for healthcare professionals to communicate about their patients. Lastly, it helps a unified, consistent and reliable way to pursue research. So, coming back to the questions one might have…
“What do we mean by ‘significant impairment’?”
When we talk about significant impairment, we basically mean serious impairment in functioning that limits or interferes with life activities. According to this definition, sexual dysfunctions are marked by significant disturbances in thoughts, feelings, and behaviours regarding one’s sexual life. Thus, when an individual is unable to enjoy their sex lives, for instance, because of lack of desire, physical pain during sexual activity, or an inability to reach orgasm, and there is significant subjective distress attached to these symptoms, one can suspect of sexual dysfunction. It should be noted that not everyone is concerned or distressed by their “sexual functioning” even though they are showing symptoms.
“What causes sexual dysfunctions?”
As it was mentioned before, each sexual dysfunction has different, sometimes overlapping, causes, and the cause of the problem might differ between individuals sharing the same diagnosis because sexual function involves a complex interaction between biological, psychological, social and cultural factors. Even though they might differ, and it is hard to understand the precise cause of a specific problem, there are some common factors that need to be considered such as:
- Partner factors (e.g., partner’s sexual problems; partner’s health status),
- Relationship factors (e.g., poor communication, mismatch in desire for sexual activity),
- Individual vulnerability factors (e.g., poor body image, history of sexual or emotional abuse)
- Presence of two or more conditions/diagnoses (e.g., depression, anxiety)
- Presence of stressors (e.g., job loss)
- Cultural or religious factors (e.g., attitudes toward sexuality)
- Medical factors (e.g., hormonal imbalances)
“How common are sexual dysfunctions?”
Population studies of the occurrence of sexual dysfunctions reported that sexual dysfunctions are highly prevalent in our society worldwide. These occurrences have been found to be increased by age, but the personal distress about the symptoms of these dysfunctions decreases as individuals become older.
“What are the treatments for sexual dysfunctions?”
The assessment and treatment of sexual dysfunctions might require a multidisciplinary approach by the healthcare professional since there are many factors to consider. Hence, once the assessment is completed, the healthcare professional develops a treatment strategy. The treatment might involve purely biological approaches, purely psychological approaches, or a mixture of biological and psychological approaches.
Sexual dysfunctions are normally treated by addressing the underlying problem(s) that are causing the dysfunctions. So, if the underlying problem is a biomedical problem, the treatment might include pharmacological agents. On the other hand, if the problems stem from a significant relationship conflict, the treatment might include couple’s therapy. As you can understand from the examples, the treatment depends on a variety of factors involved in the sexual problem at hand. Thus, if you are experiencing any type of sexual problem which is causing you distress, it would be good to consult with a healthcare professional. This way, they could help you to figure out how to move on with the treatment.
If you think a professional can also help answer some of your questions, you can book an appointment here.
Seray Soyman is working as a Trainee Psychosexologist within the Willingness team, providing psychosexual education and sexual support sessions, as well as delivering training and workshops. She is also pursuing her master’s on Clinical Psychosexology at Sapienza University, Rome. Seray’s research interests are sex-positive behaviour, sexual habits, LGBTQIA+ studies, and sexual communication.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
DeRogatis, L. R., & Burnett, A. L. (2008). The epidemiology of sexual dysfunctions. The journal of sexual medicine, 5(2), 289-300.
Hatzimouratidis, K., & Hatzichristou, D. (2007). Sexual dysfunctions: classifications and definitions. The journal of sexual medicine, 4(1), 241-250.
Lipshultz, L. I., Pastuszak, A. W., Goldstein, A. T., Giraldi, A., & Perelman, M. A. (Eds.). (2016). Management of sexual dysfunction in men and women: an interdisciplinary approach. Springer.
Wincze, J. P. & Weisberg, R. B. (2015). Sexual dysfunction: A guide for assessment and treatment. Guilford Publications.