Sexual malfunction: in detail

Emotional factors affecting sex include both interpersonal problems (such as marital/relationship problems, or lack of trust and open communication between partners) and psychological problems within the individual (depression, sexual fears or guilt, past sexual trauma, and so on).

Orgasm disorders are a persistent delay or absence of orgasm following a normal sexual excitement phase. The disorder can occur in both women and men. Again, the SSRI antidepressants are frequent culprits -- these can 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 that interferes with intercourse). Dyspareunia may be caused by insufficient lubrication (vaginal dryness) in women.

Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by menopause, pregnancy, or breast-feeding. Irritation from contraceptive creams and foams can also cause dryness, as can fear and anxiety about sex.

It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma (such as rape or abuse) may play a role. Another female sexual pain disorder is called vulvodynia or vulvar vestibulitis. In this condition, women experience burning pain during sex which seems to be related to problems with the skin in the vulvar and vaginal areas. The cause is unknown.

Sexual dysfunction is more common in people who abuse alcohol and drugs. It is also more likely in people suffering from diabetes and degenerative neurological disorders. Ongoing psychological problems, difficulty maintaining relationships or chronic disharmony with the current sexual partner can also interfere with sexual function.

Impotence

The problem of an inadequate erection is probably one of the biggest issues a man confronts. Most men experience erectile problems on occasion, but impotence, also called erectile dysfunction, is defined as "the persistent failure to develop and maintain erections of sufficient rigidity for penetrative sexual intercourse." Of course, men have other kinds of sexual problems including lack of desire and problems with ejaculation, yet impotence is the most common and troubling.

A recent study estimates that 30 million men suffer from various degrees of erectile dysfunction. This can range from mild to severe. It is clearly an age-related phenomenon with the prevalence of erectile dysfunction increasing significantly with age. Surprisingly, by the time men reach 40, 5% of them are completely impotent never achieving an erection rigid enough for penetration. Approximately 15% have significant problems achieving or maintaining an erection.

The best way for men to begin solving erectile problems is by reading about men's sexual system - anatomy, physiology, diseases, drugs, diagnosis and treatments. Some problems may be solved simply and others may require a visit to your family doctor or a urologist. In either case, we encourage you to become an educated health care consumer, which should help you regardless of the cause or cure for your problem.

The creation of an erection is an extremely complicated cascade of events that requires many different things to happen. There are numerous chemical transmitters involved in this including epinephrine, norepinephrine, acetylcholine, prostaglandins and nitric oxide. The exact mechanism by which erection occurs is still unclear but we do know that the neural input from the brain is extremely important. Reflex erections, as seen in people with cord damage such as paraplegics, are often poor erections and not sustainable for prolonged periods of intercourse.

In order to increase the size of an erection, there must be an increase in blood flow and, at the same time, the blood has to be prevented from leaving the penis.

Nerves must be working normally for a man to get and keep an erection. Nerve damage can result from diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord.

There are many effective treatments for erectile dysfunction. The most popular option is a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors, which includes sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). These drugs, taken in pill form from zero to 60 minutes before sexual activity, work in approximately 70 percent of men, though they are less effective in men with neurological causes of erectile dysfunction such as nerve damage from prostate surgery, diabetes or spinal cord injury.

Terms interpreting

Anxiety

• A state of uneasiness and apprehension, as about future uncertainties.


• Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.

Impotence

• The inability to achieve and sustain penile erections.

Thyroid

• A gland in the throat that produces hormones that regulate growth and metabolism.


• A large gland in the neck that functions in the endocrine system. The thyroid secretes hormones that regulate growth and metabolism.

Antihistamines

• A drug used to counteract the physiological effects of histamine production in allergic reactions and colds.

Antihypertensives

• Reducing or controlling high blood pressure.

Depression

• In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.

Ejaculation

• The expulsion of seminal fluid from the urethra of the penis during orgasm.


• The process of ejecting semen from the penis, and is usually accompanied by orgasm as a result of sexual stimulation.

Erection

• The firm and enlarged condition of a body organ or part when the erectile tissue surrounding it becomes filled with blood, especially such a condition of the penis or clitoris.

Estrogen

• Any of several steroid hormones produced chiefly by the ovaries and responsible for promoting estrus and the development and maintenance of female secondary sex characteristics.


• Any one of a group of hormones synthesized by the reproductive organs and adrenal glands in females and, in lesser quantities, in males.

Frigidity

• The state of marked or abnormal sexual indifference.


• Sexual unresponsiveness (especially of women) and inability to achieve orgasm during intercourse.

Hormone

• A substance, usually a peptide or steroid, produced by one tissue and conveyed by the bloodstream to another to effect physiological activity, such as growth or metabolism.

Orgasm

• The peak of sexual excitement, characterized by strong feelings of pleasure and by a series of involuntary contractions of the muscles of the genitals, usually accompanied by the ejaculation of semen by the male.


• The highest point of sexual excitement, marked by strong feelings of pleasure and marked normally by ejaculation of semen by the male and by vaginal contractions within the female.

Paraplegics

• Complete paralysis of the lower half of the body including both legs, usually caused by damage to the spinal cord.

Penis

• The male organ of copulation in higher vertebrates, homologous with the clitoris. In mammals, it also serves as the male organ of urinary excretion.


• The organ of the male reproductive system through which semen passes out of the body during sexual intercourse. The penis is also an organ of urination.

Prostate

• Gland in males that surrounds the urine tube (urethra) at the base of the bladder.


• A firm partly muscular chestnut sized gland in males at the neck of the urethra; produces a viscid secretion that is the fluid part of semen.

Stress

• A state of extreme difficulty, pressure, or strain.


• A physical and psychological response that results from being exposed to a demand or pressure.

Testosterone

• A white crystalline steroid hormone, C19H28O2, produced primarily in the testes and responsible for the development and maintenance of male secondary sex characteristics. It is also produced synthetically for use in medical treatment.

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