Sexual dysfunction

The inability to engage in or to enjoy sexual encounters.


Any impairment in sexual response that causes emotional distress and prevents an individual or couple from experiencing satisfaction as a result of sexual activity. Sexual dysfunction can be present throughout life or develop after a period of normal responsiveness. The problem may develop gradually or suddenly. Sometimes both partners are aware that conflict is the cause, but they have not found a way to make peace so they can make love again.


Inadequate sexual response may be due to a lack of sexual desire (LIBIDO) or to an inadequate performance; or it may be that there is a lack of satisfaction or orgasm. Lack of sexual desire may be due to any generalized illness or endocrine disorder, or to the taking of drugs that antagonize endocrine function. Disorders of performance in men can occur during arousal, penetration and ejaculation. In the female, dyspareunia and vaginismus are the main disorders of performance. diabetes mellitus can cause a neuropathy which results in loss of erection. Impotence can follow nerve damage from operations on the prostate gland and lower bowel, and can be the result of neurological diseases affecting the autonomic system. Disorders of satisfaction include, in men, impotence, emission without forceful ejaculation and pleasureless ejaculation. In women such disorders range from the absefice of the congestive genital response to absence of orgasm. Erectile dysfunction in men can sometimes be treated with sildenafil citrate (Viagra), a drug that recent research suggests may also be helpful to women with reduced libido and/or inability to achieve orgasm.


The state in which an individual experiences a change in sexual function during the sexual response phases of desire, excitation, and/or orgasm which is viewed as unsatisfying, unrewarding, inadequate. There may be multiple causes, including lack of sexual interest or desire; impairments in sexual arousal (e.g., erectile function in men or vaginal lubrication or clitoral enlargement in women); inability to achieve orgasm or to delay orgasm until one’s partner is satisfied; pain during intercourse; medical or hormonal conditions that impair sexual function; substance abuse issues; or prescription drug-related problems. A careful history and physical examination will help to determine the possible pathological aspects of the various phases.


 


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