Folk remedies have long been advocated, with some being advertised widely since the s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil trade name Viagra , in the s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.
It is estimated that around 30 million men in the United States and million men worldwide suffer from erectile dysfunction. The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms. Premature ejaculation is when ejaculation occurs before the partner achieves orgasm, or a mutually satisfactory length of time has passed during intercourse. There is no correct length of time for intercourse to last, but generally, premature ejaculation is thought to occur when ejaculation occurs in under two minutes from the time of the insertion of the penis.
Historically attributed to psychological causes, new theories suggest that premature ejaculation may have an underlying neurobiological cause which may lead to rapid ejaculation. SSRI antidepressants are a common pharmaceutical culprit, as they can delay orgasm or eliminate it entirely. A common physiological culprit of anorgasmia is menopause , where one in three women report problems obtaining an orgasm during sexual stimulation following menopause. Further to this there are what is called post-orgasm disorders, which would better categorise the condition: postorgasm illness syndrome see post-orgasm disorders section.
Sexual pain disorders affect women almost exclusively and are also known as dyspareunia painful intercourse or 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 breastfeeding.
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. Post-orgasmic diseases cause symptoms shortly after orgasm or ejaculation.
Post-coital tristesse PCT is a feeling of melancholy and anxiety after sexual intercourse that lasts for up to two hours. Sexual headaches occur in the skull and neck during sexual activity, including masturbation, arousal or orgasm. In men, postorgasmic illness syndrome POIS causes severe muscle pain throughout the body and other symptoms immediately following ejaculation. The symptoms last for up to a week. Symptomology of POIS may present as adrenergic-type presentation; rapid breathing, paraesthesia, palpitations, headaches, aphasia, nausea, itchy eyes, fever, muscle pain and weakness and fatigue.
Dhat syndrome is another condition which occurs in men. It is a culture-bound syndrome which causes anxious and dysphoric mood after sex, but is distinct from the low-mood and concentration problems acute aphasia seen in postorgasm illness syndrome. Pelvic floor dysfunction can be an underlying cause of sexual dysfunction in both women and men, and is treatable by physical therapy.
Erectile dysfunction from vascular disease is usually seen only amongst elderly individuals who have atherosclerosis. Vascular disease is common in individuals who have diabetes , peripheral vascular disease , hypertension and those who smoke. Any time blood flow to the penis is impaired, erectile dysfunction is the end result. Hormone deficiency is a relatively rare cause of erectile dysfunction.
Any number of medical problems can contribute to inappropriate elimination, including sensory decline, neuromuscular conditions that affect mobility, brain tumors, kidney dysfunction and endocrine system disorders. Skip to content. Even after the infection gets better, fluid might stay in the middle ear for weeks or even months, causing difficulty hearing. Ryan has been ordered to wipe out an entire Toronto family, including a five-year-old boy. For other tests, the audiologist will place a small probe at the entrance of the ear canal and record tiny responses from the cochlea.
In individuals with testicular failure like in Klinefelter syndrome , or those who have had radiation therapy , chemotherapy or childhood exposure to mumps virus , the testes may fail and not produce testosterone. Other hormonal causes of erectile failure include brain tumors, hyperthyroidism , hypothyroidism or disorders of the adrenal gland.
Structural abnormalities of the penis like Peyronie's disease can make sexual intercourse difficult. The disease is characterized by thick fibrous bands in the penis which leads to a deformed-looking penis. Drugs are also a cause of erectile dysfunction. Individuals who take drugs to lower blood pressure or use antipsychotics , antidepressants , sedatives, narcotics, antacids or alcohol can have problems with sexual function and loss of libido.
Priapism is a painful erection that occurs for several hours and occurs in the absence of sexual stimulation. This condition develops when blood gets trapped in the penis and is unable to drain out. If the condition is not promptly treated, it can lead to severe scarring and permanent loss of erectile function. The disorder occurs in young men and children. Individuals with sickle-cell disease and those who abuse certain medications can often develop this disorder. There are many factors which may result in a person experiencing a sexual dysfunction.
These may result from emotional or physical causes. Emotional factors include interpersonal or psychological problems, which can be the result of depression , sexual fears or guilt, past sexual trauma, and sexual disorders,  among others. Sexual dysfunction is especially common among people who have anxiety disorders. Ordinary anxiousness can obviously cause erectile dysfunction in men without psychiatric problems, but clinically diagnosable disorders such as panic disorder commonly cause avoidance of intercourse and premature ejaculation. Physical factors that can lead to sexual dysfunctions include the use of drugs, such as alcohol, nicotine , narcotics , stimulants, antihypertensives , antihistamines , and some psychotherapeutic drugs.
Diseases such as diabetic neuropathy , multiple sclerosis , tumors , and, rarely, tertiary syphilis may also impact the activity, as could the failure of various organ systems such as the heart and lungs , endocrine disorders thyroid , pituitary , or adrenal gland problems , hormonal deficiencies low testosterone , other androgens , or estrogen and some birth defects. Pelvic floor dysfunction is also a physical and underlying cause of many sexual dysfunctions. In the context of heterosexual relationships, one of the main reasons for the decline in sexual activity among these couples is the male partner experiencing erectile dysfunction.
This can be very distressing for the male partner, causing poor body image, and it can also be a major source of low desire for these men. If a woman has not been participating in sexual activity regularly in particular, activities involving vaginal penetration with her partner, if she does decide to engage in penetrative intercourse, she will not be able to immediately accommodate a penis without risking pain or injury.
According to Emily Wentzell, American culture has anti-aging sentiments that have caused sexual dysfunction to become "an illness that needs treatment" instead of viewing it as the natural part of the aging process it is.
Dysfunction: Identify it. Discover the truth you've been hiding from yourself, probably most of your life. Own it. Admit your part in the problems that are holding you. BY: DENNIS C. LEWIS, PhD. Dysfunction: Identify it. Discover the truth you've been hiding from yourself, probably most of your life. Own it. Admit your part in the.
Not all cultures seek treatment; for example, a population of men living in Mexico often accept erectile dysfunction as a normal part of their maturing sexuality. Several theories have looked at female sexual dysfunction, from medical to psychological perspectives. Three social psychological theories include: the self-perception theory, the overjustification hypothesis, and the insufficient justification hypothesis:.
The importance of how a woman perceives her behavior should not be underestimated. Many women perceived sex as a chore as opposed to a pleasurable experience, and they tend to consider themselves sexually inadequate, which in turn does not motivate them to engage in sexual activity. These can include: race, her gender, ethnicity, educational background, socioeconomic status, sexual orientation, financial resources, culture, and religion.
A study has found that African American women are the most optimistic about menopausal life; Caucasian women are the most anxious, Asian women are the most inhibited about their symptoms, and Hispanic women are the most stoic. About one third of the women experienced sexual dysfunction, which may lead to women's loss of confidence in their sexual lives. Since these women had sexual problems, their sexual lives with their partners became a burden without pleasure, and eventually, they may completely lose interest in sexual activity.
Some of the women found it hard to be aroused mentally; however, some had physical problems. Several factors can affect female dysfunction, such as situations in which women do not trust their sex partners. The environment where sex occurs is crucial, since being in an extremely public or extremely private place may make some women feel uncomfortable. Inability to concentrate on the sexual activity due to a bad mood or burdens from work may also cause a woman's sexual dysfunction.
Other factors include physical discomfort or difficulty in achieving arousal, which could be caused by aging or changes in the body's condition.
The female sexual response system is complex and even today, not fully understood. The most prevalent of female sexual dysfunctions that have been linked to menopause include lack of desire and libido; these are predominantly associated with hormonal physiology. Androgen depletion may also play a role, but currently this is less clear.
The hormonal changes that take place during the menopausal transition have been suggested to affect women's sexual response through several mechanisms, some more conclusive than others. Whether or not aging directly affects women's sexual functioning during menopause is another area of controversy. However, many studies, including Hayes and Dennerstein's critical review, have demonstrated that aging has a powerful impact on sexual function and dysfunction in women, specifically in the areas of desire, sexual interest, and frequency of orgasm.
Testosterone, along with its metabolite dihydrotestosterone, is extremely important to normal sexual functioning in men and women. Dihydrotestosterone is the most prevalent androgen in both men and women. Sexual desire has been related to three separate components: drive, beliefs and values, and motivation. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders lists the following sexual dysfunctions:.
Several decades ago the medical community believed the majority of sexual dysfunction cases were related to psychological issues. Although this may be true for a portion of men, the vast majority of cases have now been identified as having a physical cause or correlation. Situational anxiety arises from an earlier bad incident or lack of experience. This anxiety often leads to development of fear towards sexual activity and avoidance. In return evading leads to a cycle of increased anxiety and desensitization of the penis. In some cases, erectile dysfunction may be due to marital disharmony. Marriage counseling sessions are recommended in this situation.
Lifestyle changes such as discontinuing smoking , drug or alcohol abuse can also help in some types of erectile dysfunction. In the rest, the medications may not work because of wrong diagnosis or chronic history. When conservative therapies fail, are an unsatisfactory treatment option, or are contraindicated for use, the insertion of a penile prosthesis , or penile implant, may be selected by the patient. Technological advances have made the insertion of a penile prosthesis a safe option for the treatment of erectile dysfunction which provides the highest patient and partner satisfaction rates of all available ED treatment options.
Pelvic floor physical therapy has been shown to be a valid treatment for men with sexual problems and pelvic pain. In , flibanserin was approved in the US to treat decreased sexual desire in women. While it's effective for some women, it has been criticized for its limited efficacy, and many warnings and contraindications that limit its use. Many women with sexual dysfunction are also referred to a counselor or sex therapist.
Estrogens are responsible for the maintenance of collagen, elastic fibers, and vasoculature of the urogenital tract, all of which are important in maintaining vaginal structure and functional integrity; they are also important for maintaining vaginal pH and moisture levels, both of which aid in keeping the tissues lubricated and protected. Androgen therapy for hypoactive sexual desire disorder HSDD has a small benefit but its safety is not known.
However, like most treatments, this is also controversial. One study found that after a week trial, those women taking androgens had higher scores of sexual desire compared to a placebo group. In modern times, the genuine clinical study of sexual problems is usually dated back no further than when Masters and Johnson's Human Sexual Inadequacy was published. Louis, involving cases. Prior to Masters and Johnson the clinical approach to sexual problems was largely derived from the thinking of Freud. It was held with psychopathology and approached with a certain pessimism regarding the chance of help or improvement.
Sexual problems were merely symptoms of a deeper malaise and the diagnostic approach was from the psychopathological. There was little distinction between difficulties in function and variations nor between perversion and problems. Despite work by psychotherapists such as Balint sexual difficulties were crudely split into frigidity or impotence , terms which too soon acquired negative connotations in popular culture. The achievement of Human Sexual Inadequacy was to move thinking from psychopathology to learning , only if a problem did not respond to educative treatment would psychopathological problems be considered.
Also treatment was directed at couples, whereas before partners would be seen individually. Masters and Johnson saw that sex was a joint act. They believed that sexual communication was the key issue to sexual problems not the specifics of an individual problem. They also proposed co-therapy, a matching pair of therapists to the clients, arguing that a lone male therapist could not fully comprehend female difficulties.
The basic Masters and Johnson treatment program was an intensive two-week program to develop efficient sexual communication. Couple-based and therapist led the program began with discussion and then sensate focus between the couple to develop shared experiences. From the experiences specific difficulties could be determined and approached with a specific therapy.
In a limited number of male only cases 41 Masters and Johnson had developed the use of a female surrogate, an approach they soon abandoned over the ethical, legal and other problems it raised. In defining the range of sexual problems Masters and Johnson defined a boundary between dysfunction and deviations.
Dysfunctions were transitory and experienced by the majority of people, dysfunctions bounded male primary or secondary impotence , premature ejaculation , ejaculatory incompetence ; female primary orgasmic dysfunction and situational orgasmic dysfunction; pain during intercourse dyspareunia and vaginismus. According to Masters and Johnson sexual arousal and climax are a normal physiological process of every functionally intact adult, but despite being autonomic it can be inhibited.
Masters and Johnson treatment program for dysfunction was Despite the work of Masters and Johnson the field in the US was quickly overrun by enthusiastic rather than systematic approaches, blurring the space between 'enrichment' and therapy. Although it has been argued that the impact of the work was such that it would be impossible to repeat such a clean experiment. From Wikipedia, the free encyclopedia. Sexual dysfunction Other names Sexual malfunction, sexual disorder Specialty Psychiatry , gynecology , andrology Sexual dysfunction is difficulty experienced by an individual or a couple during any stage of a normal sexual activity , including physical pleasure, desire , preference, arousal or orgasm.
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