The normal sexual response cycle has four phases:
- excitement
- plateau
- orgasm
- resolution.
The research shows that sexual disfunctions are common in both men and women.About 43% of women and 31% of men have some degree of difficulty.The reason is that most people hasitate to discuss this topic.
As the most of the sexual disfunctions are treatable so one should share their concern with one's partner and health care provider.
Causes of sexual dysfunction
Physical causes : In most of cases sexual disfunction has physical cause.certain diseases can affect the blood flow to penis.e.g. diabetes, heart and vascular disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism.Certain drugs such as antidepressant and blood pressure medications can cause sexual disfunction.Drug abuse also leads to sexual disfunction.
Psychological causes :The psychological causes of sexual disfunction includes; stress, anxiety, depression, Concern about sexual health,feelings of guilt, past sexual trauma.
The types of sexual disfunctions:
The most common sexual disfunctions in male are
- Ejaculation disorders (delayed or absence of ejaculation and inability to control the timing of ejaculation)
- Erectile dysfunction (Inability to achieve or to maintain the suitable erection for intercourse)
- Inhibited sexual desire (lack of desire or interest in sex)
Ejaculation disorders are the most common of them
Ejaculation disorders: These Includes
- Premature Ejaculation :which means the ejaculation occurs before or soon after penetration.
- Inhibited or retarded ejaculation :when Ejaculation does not occur.
- Retrograde ejaculation:At orgasm,the ejaculate forced back into the bladder instead of coming though urethra out of the penis.(this type is mostly due to psychology cause.
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.
Erectile dysfunction ia also known as impotence and is defined as the inability to attain maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis (hardening of the arteries); 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.
Diagnosis:
The doctor likely will begin with a physical exam and a thorough history of symptoms. some diagnostic tests may perform to rule out any medical problems that may be contributing to the dysfunction.e.g.
Blood tests to evaluate hormone levels.
Vascular assessment to evaluate 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 is particularly useful in evaluating the effects of diabetic neuropathy, sensory testing measures the strength of nerve impulses in a particular area of the body.
Nocturnal penile tumescence and rigidity testing to monitor erections that occur naturally during sleep. This test can help determine if a man’s erectile problems are due to physical or psychological causes.
Treatment :
Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems.
Medical treatment :treatment of any physical problem that may be contributing to a man’s sexual dysfunction. New medications, such as sildenafil (Viagra™), varderafil (Levitra™), or tadalafil (Cialis™ ) may help improve sexual function in men by increasing blood flow to the penis.
Men with low levels of testosterone may benefit from hormone injections. The use of a testosterone patch applied to the scrotum or other parts of the body has been approved by the Food and Drug Administration to help increase testosterone levels to a normal range. Testosterone replacement by pills and implantable pellets also is being evaluated.
Psychological therapy :Therapy with a trained counselor can help a person address feelings of anxiety, fear or guilt that may have an impact on sexual function.
Mechanical aids :Aids such as vacuum devices and penile implants may help men with erectile dysfunction.
Education and communication:Education about sex, and sexual behaviors and responses may help a man overcome his anxieties about sexual function. Open dialogue with your partner about your needs and concerns also helps to overcome many barriers to a healthy sex life.
Preventions:
- Follow your doctor’s treatment plan for any medical/health conditions.
- Limit your alcohol intake.
- Quit smoking.
- Deal with any emotional or psychological issues such as stress, depression and anxiety.
- Increase communication with your partner.
Many men experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the man and his partner, and have a negative impact on their relationship.If u are experiencing the problem,dont hasitate to share it with your partner and with your health care provider.
