Sexual Dysfunction is very common among both men and women. It is estimated that 43% of women and 31% of men report having at least one symptom. Sexual dysfunction disorders are generally classified into four categories: sexual desire disorders, sexual arousal disorders, orgasm disorders, and sexual pain disorders.
Sexual desire disorders (decreased libido) may be caused by a decrease in the normal production of estrogen (in women) or testosterone (in both men and women). Other causes may be aging, fatigue, pregnancy, and medications; the SSRI anti-depressants, which include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), are well known for reducing desire in both men and women. Psychiatric conditions, such as depression and anxiety, can also cause decreased libido.
Sexual arousal disorders are also known as frigidity in women and impotence in men. Impotence is now called erectile dysfunction, and frigidity is now described as any of several specific problems with desire, arousal, or anxiety. For both men and women, these conditions may appear as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity. There may be medical causes for these sexual dysfunction disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease and the nature of the relationship between partners can also increase these difficulties. As the success of Viagra attests, many erectile disorders in men may be primarily physical, not psychological conditions.
Orgasm disorders are a persistent delay or absence of orgasm following a normal sexual excitement phase. The disorder occurs in both women and men. Again, the SSRI antidepressants are frequent culprits –these may delay the achievement of orgasm or eliminate it entirely.
Sexual pain disorders affect women almost exclusively, and are known as dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the muscles of the vaginal wall, which interferes with intercourse). Dyspareunia may be caused by insufficient lubrication (vaginal dryness) in women. There may also be abnormalities in the pelvis or the ovaries that can cause pain with intercourse. Vulvar pain disorders can also cause dyspareunia and inability to have intercourse due to pain.