Sexual dysfunction refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm and resolution.
Causes of sexual dysfunction
Physical causes Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressants drugs, can affect sexual desire and function. Psychological causes These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.
The most common problems related to sexual dysfunction in men include ejaculation disorders, erectile dysfunction and inhibited sexual desire
There are different types of ejaculation disorders, including:
Premature ejaculation — This refers to ejaculation that occurs before or soon after penetration.
Inhibited or retarded ejaculation —This is when ejaculation does not occur.
Retrograde ejaculation — This occurs when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis.
In some cases, premature and inhibited ejaculation are caused by psychological factors, including a strict religious background that causes the person to view sex as sinful, a lack of attraction for a partner and past traumatic events . Premature ejaculation, the most common form of sexual dysfunction in men, often is due to performance anxiety during sex. However, organic causes are sometimes present. Certain drugs, including some anti-depressants, may impair ejaculation, as can nerve damage to the spinal cord or back.
Retrograde ejaculation is most common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backward. In other men, retrograde ejaculation occurs after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation.
Also known as impotence, erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis nerve disorders; psychological factors such as stress, depression and performance anxiety; and injury to the penis. Chronic illness, certain medications and a condition called Peyronie’s disease (scar tissue in the penis) also can cause erectile dysfunction.
Inhibited sexual desire (reduced libido)
Inhibited desire, or loss of libido, refers to a decrease in desire for or interest in sexual activity. Reduced libido can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone. It also may be caused by psychological problems, such as anxiety and depression; medical illnesses such as diabetes and high blood pressure; certain medications, including some anti-depressants; and relationship difficulties.
Tests help evaluate sexual dysfunction include:
Blood tests These tests are done to evaluate hormone levels. Vascular assessment This involves an evaluation of the blood flow to the penis. A blockage in a blood vessel supplying blood to the penis may be contributing to erectile dysfunction. Sensory testing Particularly useful in evaluating the effects of diabetic neuropathy, sensory testing measures the strength of nerve impulses in a particular area of the body.
Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following:
Agnus castus: This remedy may be helpful if problems with impotence develop after a man has led a life of intense and frequent sexual activity for many years. A cold sensation felt in the genitals is a strong indication for Agnus castus. People who need this remedy are often very anxious about their health and loss of abilities, and may have problems with memory and concentration.
Argentum nitricum: This remedy may be helpful if a man’s erection fails when sexual intercourse is attempted, especially if thinking about the problem makes it worse. People who need this remedy are often nervous and imaginative. A person who needs Argentum nitricum is usually warm-blooded, with cravings for both sweets and salt.
Caladium: This remedy may be helpful to a man whose genitals are completely limp, despite having sexual interest. Nocturnal emissions can occur without an erection, even if dreams are not sex-related. A person who needs this remedy often craves tobacco
Causticum: This remedy may be indicated if physical pleasure during sex has diminished and sexual urges are reduced. The person feels tired and weak, and may experience memory loss, with a compulsive need to check things (to see that doors are locked, etc.) Prostate problems may be associated with impotence, and urine may be lost when the person coughs or sneezes.
Lycopodium: People who need this remedy may have problems with erections because of worry, and can also be troubled by memory loss. They often lack self-confidence (though some may overcompensate by acting egotistically). People who need this remedy often have digestive problems with gas and bloating, and an energy slump in the late afternoon and evening.
Selenium metallicum: This remedy is often helpful to men who have diminished sexual ability, especially if the problem starts after a fever or exhausting illness. The person feels weak and exhausted, but interest is usually still present. Unusual hair-loss (body hair or eyebrows) can also suggest a need for Selenium.
Staphysagria: Gentle-natured, quiet men with deep emotions may respond to this remedy. Problems with impotence often occur from embarrassment or shyness. People who need this remedy often have a history of emotional suppression and very sensitive feelings.