What Are Sexual Disorders?
A sexual disorder is characterized as any ongoing issue with sexual pleasure, desire, or function that causes distress. There is a wide range of conditions that can be classed as sexual disorders. These come under four categories: desire disorders, arousal disorders, orgasm disorders, and pain disorders.
Sexual disorders aren’t uncommon, with one 2000 study finding they impact 43% of women and 31% of men. (1) However, people can be embarrassed to discuss sexual issues with health professionals, making these disorders more likely to go undiagnosed and untreated.
The different types of sexual disorders include:
- Fetishism: Recurrent and intense sexually arousing fantasies involving non-living objects
- Pedophilia: Constant arousing fantasies and urges involving sexual activity with a prepubescent child or children
- Paraphilia: Sexual interests that involve situations or activities that aren’t typical
- Hypoactive sexual desire disorder (HSDD): Little to no interest in thinking about or having sex
- Genital arousal disorder: Unwanted sexual arousal that isn’t relieved by orgasm
- Orgasm disorder: Inability to orgasm, or orgasms that are delayed or less intense than desired
- Erectile dysfunction (ED): Trouble achieving or maintaining an erection during intercourse
- Premature ejaculation: An orgasm that occurs earlier than the person expects or wants during intercourse
- Vaginismus: Inability to relax vaginal muscles to allow intercourse
People may have lifelong sexual disorders. Others may acquire a sexual disorder later in life, or find the condition only impacts them in certain situations. In all cases, steps can be taken to decrease symptoms and find sexual satisfaction.
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What Causes Sexual Disorders?
There are many different causes of sexual disorders, and they can be emotional, psychological, or physical. For most people, there’s more than one cause.
Certain medical conditions can impact a person’s sexual life. As arousal relies on blood moving to the genitals, any health issue that affects blood flow can lower sexual desire. This includes diabetes, heart problems, and cancer. Bladder issues can also be the cause of sexual disorder, especially among people assigned male at birth.
A change in hormone levels can also affect the libido. Hormone levels often drop in older adults, and around one-third of seniors have at least one complaint about their sexual function. (2) For those assigned female at birth, the physical rigors of pregnancy, childbirth, and breastfeeding can lead to a loss of sexual desire. Similarly, the changing hormone levels during menopause can also alter a person’s level of sexual desire.
As sexual arousal relies on the brain, anything that has an impact on mental health can cause sexual disorders. (3) Stress and overwork can both lead to a lower libido, as can relationship problems. (4) Fear and anxiety about sex can also lower sexual satisfaction. (5)
Many substances also impact sexual performance. Alcohol and tobacco use can both lower blood flow, leading to an inability to have intercourse. Some prescription medications lower sexual desire. Talking to a healthcare professional about adjusting the dosage or trying a different medication may help.
What Are the Symptoms of Sexual Disorders?
There are many potential sexual disorder symptoms to be aware of. Some common symptoms include:
- Difficulty getting aroused
- Lack of interest in having sex
- Pain during intercourse
- Inability to achieve or maintain an erection
- Premature or delayed ejaculation
- Inability to achieve orgasm
- Vaginal dryness
- Inability to feel sexual arousal
Anyone who has concerns about their sexual health can talk to a medical professional to discuss their experiences and possible causes. Symptoms must cause distress for a doctor to consider the problem a sexual disorder. If a patient doesn’t feel distressed, a doctor may still consider the physical causes of symptoms but won’t treat them as sexual dysfunction.
Do I Have a Sexual Disorder? How Are Sexual Disorders Diagnosed?
When a sexual disorder is suspected, a healthcare provider will talk to the patient about their medical history, sexual experience, and current symptoms. Other causes, such as medications or a physical illness, will be considered as well.
Next, the doctor looks at the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This guidebook lists the symptoms of different conditions and the guidelines practitioners can use to diagnose a disorder.
The DSM-5 states that to be officially diagnosed with a sexual disorder, symptoms must have persisted for at least six months. Those symptoms must also be experienced in 75%-100% of sexual encounters during this time. (6) Lastly, the symptoms must have caused clinically significant distress. It's important to remember that a sexual disorder is only present if there are problems with sex that are impacting the individual's life, mental health, or relationship.
What Is the Best Treatment for Sexual Disorders?
The best treatment for a sexual disorder depends on the type of disorder it is. A healthcare professional can identify both the cause of the disorder and possible treatment options. Types of treatment can include:
- Medication
- Medical treatment
- Mechanical aids
- Therapy
- Behavioral treatments
- Education and communication
How to Cope With a Sexual Disorder Diagnosis
As sexual performance is so often tied to both relationship success and ideas of masculinity and femininity, a sexual disorder diagnosis can be difficult to accept. There's nothing to be ashamed of, so it can be helpful to maintain open lines of communication between sexual partners. Keeping a diagnosis a secret can make individuals approach sex with trepidation, which can make symptoms worse.
It can help to focus on what’s possible and positive. Rather than thinking about physical limitations, concentrate on giving a partner pleasure. Don’t use frequency of sex as a measure of the health of a relationship. Also look at other ways to create intimacy.
How to Help Someone With Sexual Disorders
The partner of a person diagnosed with a sexual disorder should try to be nonjudgmental when discussing the condition. Focus on accepting the whole person, rather than just a person’s sexual abilities. During physical encounters, provide intimacy to the whole body. This can include massage, kissing, or simply holding each other.
If the person isn’t already getting help, encourage them to speak to a professional. A primary care physician is a good place to start. Urologists and psychiatrists are other specialists who often help with sexual disorders. If it's difficult to discuss the issue, couples therapy can facilitate healthy dialogue and make it easier to navigate a sexual disorder diagnosis as a team.
Sources:
- https://pubmed.ncbi.nlm.nih.gov/11122954/
- https://pubmed.ncbi.nlm.nih.gov/16391544/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908863/
- https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1742-1241.2008.01845.x
- https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1743-6109.2012.02698.x
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044769/
