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Sexual dysfunctions cover a wide variety of disorders, including male impotence, premature ejaculation in males, spasms of the vagina, pain with sexual intercourse, and problems with sexual desire (libido) and response. Men over age 65 are at increased risk for impotence. Impotence, however, is not a normal part of aging. The causes of sexual disorders vary, and include psychological causes and some medical conditions, such as illness or injury.
Signs and Symptoms
• Premature or abnormal ejaculation in men
• Inability to achieve or maintain an erection (impotency)
• Pain during intercourse
• Lack or loss of sexual desire
• Difficulty achieving orgasm
• Inadequate vaginal lubrication in women
What Causes It?
• Age 65 and over in men
• Depression or anxiety
• Stressful life events
• Certain medical conditions
What to Expect at Your Provider's Office
Your health care provider will do a physical examination. He or she may ask about your ethnic, cultural, religious, and social background, which can influence your sexual desires, expectations, and attitudes. Blood tests can help distinguish between psychological and physical causes for sexual dysfunctions. Other tests for men may include penile tumescence measurements, which are done while you are sleeping to determine whether an impotence problem is psychological or physical.
Treatment Options
Antidepressants can be taken by men and women whose sexual dysfunction is related to depression. Vasodilators administered by injection are sometimes used for impotence. Viagra® (sildenafil citrate), a relatively new drug for treating impotence, can have serious side effects in some men. Over-the-counter products are available as creams or gels for women whose bodies produce inadequate lubrication.
A variety of psychological, behavioral, and interpersonal therapies are also available for many sexual disorders.
Surgery on the veins in the penis can be performed in severe cases, but this treatment is still considered experimental. An implant in the penis may help impotence if the problem does not respond to other treatment.
Special Considerations
Certain drugs and herbs used for treating these psychological or physical disorders may have serious side effects. Marital counseling and other forms of interpersonal therapy are also important.
Reviewed By
Participants in the review process include: Richard A. Lippin, MD, President, The Lippin Group, Southampton, PA; Marc Micozzi, MD, PhD, College of Physicians, Philadelphia, PA; Pamela Stratton, MD, Chief, Gynecology Consult Service, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
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About Sexual Dysfunction
