Sexual dysfunction affects millions of people all over the world. Whether it's difficulty achieving or maintaining an erection, decreased libido, or inability to achieve orgasm, sexual dysfunction can have a significant impact on your quality of life. In this article, Womanly health educator, Jasmine Matos, BSN RN, explores different kinds of sexual dysfunction and shares insights on how to get help if you need it.
Accompanied by a visual essay from Womanly photographer, Nikk Rich. Featuring professional dancers, Owen Scarlett, Raymond Ejiofor, Nadia Maryam, and Kayla Gabrielle. This captivating and powerful photography series gracefully captures the physical and emotional struggles that individuals with sexual dysfunction may face. Through her lens, Nikk Rich explores the themes of intimacy, its complexities, and the societal pressures and stigmas surrounding sexual dysfunction.
What is Sexual Dysfunction?
Sexual dysfunction is defined as a set of symptoms related to sex that cause significant mental or emotional distress, over a 6 month period or more. Sexual dysfunctions can include:
Hypoactive Sexual Desire Disorder (HSDD)
Having little or no thoughts about sex, losing desire while having it or avoid sex all together. Low sex drive or no sex drive is a common sexual problem.
Erectile Dysfunction (ED)
When you have trouble getting or maintaining an erection. This means your penis can't get erect (hard) enough to have sex, or it can't stay hard enough to finish having sex.
Genital Arousal Disorder
Having trouble getting or staying aroused (turned on) and you feel sad or worried about it.
Orgasm Disorder
When you don’t have orgasms, it takes a long time for you to orgasm, you have orgasms less often than you’d like, or your orgasms aren’t as strong as you would like, and you feel sad, or worried about it.
Vulvodynia
A condition when you have pain in your vulva (AKA vulvar pain) that isn’t from an infection or other medical problem, and it lasts for 3 months or more.
Premature Ejaculation
When you ejaculate (cum) before you want to. This may be a cause of concern if you feel frustrated and anxious, and avoid sexual intimacy as a result.
How Do I Know If I Have Sexual Dysfunction?
It’s important to remember that sex drives fluctuate and sexual dysfunction is only a concern if it causes you distress. Sex can be an important part of your health and quality of life, so dealing with sexual dysfunction can be tough physically and emotionally. It’s important to remember that sexual disorders are very common, and most of the time they are treatable.
You may have sexual dysfunction if you experience:
Low libido
Decreased sex drive or interest
Sexual pain
Issues having an orgasm
Issues with becoming aroused or staying aroused.
What Is The Major Cause Sexual Dysfunction?
Factors that contribute to sexual dysfunction may include hormonal, neurological, vascular issues, as well as psychosocial factors such as:
Relationship issues which may include jealousy, conflict, infidelity, abuse or lying.
Stress, especially when experiencing stress for a long period of time
Mood, which can include anxiety or irritability
A history of sexual abuse or violence
A history of mental illness or ongoing mental health conditions
Is Sexual Dysfunction Caused By Chemical Imbalance?
Neurotransmitters such as dopamine (responsible for desire), epinephrine, norepinephrine, and serotonin (responsible for arousal and orgasm) play an important role in having healthy sexual experiences. Medications and disorders that disrupt the balance of these neurotransmitters may cause sexual concerns.
What Medical Conditions Cause Sexual Dysfuntion?
Many medical conditions such as cancer, thyroid disease, heart disease, urinary problems, gynecological conditions, multiple sclerosis, and other physical or mental disabilities can also cause sexual concerns. Recent research has also shown a possible connection between stomach issues and sexual dysfunction. Research has noted nearly 90% of serotonin, the hormone that controls libido, is produced by the gut. So, if your gut isn’t healthy, your body and brain will have difficulty responding to sexual stimuli or intimacy. There are studies that show conditions such as irritable bowel disease may cause erectile dysfunction and painful sexual intercourse.
What Medications and Substances Cause Sexual Dysfunction?
Medications that disrupt the neurotransmitters mentioned above can also cause sexual dysfunction. These medications include antidepressants, blood pressure medications, antihistamines, and chemotherapy drugs. Smoking, using recreational drugs, and drinking alcohol can also affect your sexual function.
Can Hormonal Imbalance Cause Sexual Dysfunction?
A decrease in estrogen may also cause a decrease in sexual responsiveness. This can happen due to childbirth, breastfeeding, menopause, or having a hysterectomy. A decrease in estrogen causes a decrease in blood flow to the pelvic region which can cause decreased genital sensation, requiring more time for arousal or getting sexually excited. For any person with a vagina, the lining can also become thinner, causing vaginal dryness or vaginal atrophy, mostly seen in people experiencing menopause. Vaginal dryness or vaginal atrophy can cause pain during sex. A person with external genitalia can also experience erectile dysfunction due to low blood testosterone caused by an endocrine disorder.
Psychological and Social Factors
Anxiety and depression are common causes of sexual dysfunction. Along with stress, a history of abuse, concerns about becoming pregnant, or the demands of being a new parent can decrease sex drive or sexual performance. Conflicts with your partner and cultural and religious issues can also contribute to sexual dysfunction.
What is the Treatment for Sexual Dysfunction?
Your health care provider may ask a number of personal questions and, with your permission, might want to include your partner in the interview. Many of us are fearful of sharing about our sexual problems for many reasons such as fear, embarrassment, non-traditional gender roles, or social stigma. A healthy trusting relationship with your provider is essential in order to address what is really going on and to get you the help you need. If a provider is unable to give you a safe space to open up about your issues, please know there are other options, such as requesting or seeking another provider.
Treatment for sexual dysfunction depends on the cause of your symptoms. Some other recommended strategies are:
Open communication with your partner, such as discussing likes and dislikes and providing feedback in a non-judgmental and non-threatening way, can create greater intimacy and a safe space to explore sexual concerns.
Being physically active can elevate your mood and decrease stress that causes sexual dysfunction.
Limiting alcohol and cigarettes.
Counseling and therapy to educate yourself on how to enhance intimacy and/or explore obstacles that may minimize your body’s sexual response.
Using lube if vaginal dryness and or sexual pain is a concern.
Trying sex toys to enhance stimulation and arousal.
Using mindfulness and meditation to increase your awareness and learn about ways to adapt and accept without judgment.
Making time for leisure and relaxation, as decreasing stress and relaxing can enhance your ability to focus on your experience. Decreasing stress also lowers cortisol levels, the stress hormone, which can improve functioning in certain areas of intimacy and sexual life.
Other examples of treatment include:
Adjusting your medications (done under a provider’s care)
Topical estrogen for people who are peri-post menopausal (prescribed under a provider’s care)
Getting prescription medications that address low sexual desire
Getting a referral to a gastroenterologist, urologist, or a urogynecological professional may be helpful if you’re experiencing gastric or urologic concerns which may be contributing to sexual pain.
