Sexual Dysfunction

Common presentations of sexual dysfunctions are as follows.

• Delayed ejaculation: Significant delay in ejaculation, infrequency, or absence of ejaculation during sexual activity.
• Premature ejaculation: Ejaculation that occurs too early during sexual activity or before the individual desires it.
• Difficulty with sexual interest and arousal: A noticeable decrease or lack of interest in sexual activity and/or diminished arousal response to sexual cues.
• Female orgasmic disorder: Significant delay, infrequency, absence of orgasm, or a marked reduction in the intensity of orgasmic sensations.

The condition may present with one or more of the following:

• Trouble achieving or maintaining arousal.
• Difficulty reaching orgasm or unsatisfying orgasms.
• Ejaculation problems (too early or delayed).
• Reduced interest in intimacy.
• Distress or relationship strain due to sexual difficulties.

The causes may be physical or psychological:

• Physical causes
  • Diabetes
  • Heart diseases
  • Neurological disorders
  • Hormonal imbalance
• Psychological causes
  • Stress
  • Depression
  • Concerned of sexual performance
  • Trauma or abuse
  • Relationship issues.
• Medications: Certain antidepressants, blood pressure drugs, and other medicines may contribute.

Sexual dysfunction is diagnosed based on the following:

• Physical examination: To check for underlying health conditions.
• Medical or sexual History: Understanding symptoms, lifestyle, and relationship concerns.
• Diagnostic tests: To rule out hormonal, neurological, or cardiovascular causes.

Sexual dysfunction is treated through:

• Medications: For hormone balance or erectile dysfunction.
• Behavioural therapy: To modify habits affecting intimacy.
• Psychotherapy: To address anxiety, stress, or past trauma.
• Communication: Helping couples improve understanding and reduce relationship stress.
• Mechanical aids: Devices like vacuum pumps or lubricants to improve comfort and function.
• Sex therapy: Guided sessions with trained therapists to work through specific concerns.

Patients should seek medical advice if sexual difficulties are persistent and problems are causing emotional distress or relationship strain.

While not all causes can be prevented, healthy lifestyle choices can the lower risk of sexual dysfunction:

• Performing regular exercise/physical activity.
• Consuming a balanced diet.
• Managing stress through relaxation techniques.
• Avoidance of excessive alcohol consumption and smoking.

For management of sexual dysfunction, patients may consult a Urologist (for male sexual dysfunction), Gynaecologist (for female sexual dysfunction), or Psychiatrist/Psychologist (for mental health-related causes) or Psychologist/Therapist (for counselling and psychotherapy).