What Is Sexual Dysfunction?

Sexual function is a complex physiological process. The maintenance of normal sexual function depends on the coordination of the human body's multiple systems, which involves the coordination of the nervous system, cardiovascular system, endocrine system and reproductive system. In addition, it must have a good mental state and a healthy mentality. When abnormal changes occur in the above-mentioned system or psychology, it will affect the normal sexual life, affect the quality of sexual life, and show sexual dysfunction. Sexual dysfunction is a disorder of sexual behavior and sexual sensation, which is usually manifested as abnormal or lack of sexual psychological and physiological responses, and is a collective term for many different symptoms. Male sexual dysfunction mainly includes sexual desire disorders, penile erectile dysfunction, and ejaculation disorders. According to statistics, 52% of men aged 40 to 70 have different degrees of sexual dysfunction. The incidence of female sexual dysfunction is also very high. Some people think that it can account for 30% to 60% of adult women. Among them, sexual desire and orgasmic disorders are the most common. Some women may never enjoy orgasm in their lifetime.

TA says

He always said that he didn't want to have sex, what happened? 2019-08-27 21:08

Perhaps many men have experienced this confusion: they do not want to have sex, lose their desire, or each sex can only last for a few minutes ... Do they really have sexual dysfunction? Or is there any general myth about male sexual dysfunction? Today's article will talk about what is male sexual dysfunction, how it is generated, and what sexual concepts are reflected behind it. ... more

Basic Information

English name: sexual dysfunction
Visiting department: Andrology, Urology, Gynecology
Common causes: Genetics, health status, hormone levels, age, disease, drugs, alcohol, drug use, psychosocial factors, religious and cultural background, etc.

Common symptoms: Sexual desire disorders, erectile dysfunction, sexual intercourse disorders, etc.
Contagious: no

Causes of sexual dysfunction

The causes of sexual dysfunction can be roughly divided into three categories: biological factors, psycho-psychological factors and cultural factors.

Biological factor

Sexual dysfunction may be caused by a variety of reasons including heredity, health status, hormone levels, age, diseases (including chronic diseases, neuropsychiatric disorders, endocrine diseases, reproductive organ diseases) and other reasons. Sexual dysfunction can also occur with drugs, long-term heavy alcohol or drug use.

2. Psychological factors

Psychological and psychological factors have a more prominent impact on sexual function, including wrong sexual perception, the impact of past sexual experiences, environmental factors, interpersonal tension, and negative emotions caused by various external factors.

3. Cultural factors

Due to the influence of religious and cultural backgrounds, some people have prejudice against sexual life (such as "one drop of fine blood and ten drops of blood"), and believe that sexual intercourse will lose vitality. Subjectively giving up or reducing sexual activity will easily cause sexual depression.

Clinical manifestations of sexual dysfunction

Sexual dysfunction can be divided into two categories: functional dysfunction and organic sexual dysfunction. Male sexual dysfunction includes sexual desire disorders, erectile dysfunction, sexual intercourse disorders, and ejaculation disorders. Female sexual dysfunction includes sexual desire disorder, sexual arousal disorder, orgasmic disorder, pain during intercourse and so on.

Sexual desire disorder

Including sexual aversion, low libido, hypersexuality.

2. Penile erectile dysfunction

It means that the penis continues to fail to reach and maintain a sufficient erection to obtain a satisfactory sex life.

3. Intercourse disorder

The clinical manifestations of sexual intercourse disorder include sexual intercourse fainting, sexual intercourse aphasia, sexual intercourse rickets, sudden sexual intercourse death, and sexual intercourse phobia.

4. Ejaculatory disorders

Including non-ejaculation, delayed ejaculation, retrograde ejaculation, weak ejaculation, premature ejaculation and painful ejaculation. Among them, non-ejaculation refers to that the penis can erect normally and have intercourse, but cannot ejaculate, or in other cases can ejaculate, but does not ejaculate in the vagina. Retrograde ejaculation is the ability of the penis to erect and perform sexual intercourse, and ejaculate with orgasm, but the semen fails to exit outside the urethra and retrogradely flows into the bladder through the bladder neck.

5. Sexual Arousal Disorder

Refers to persistent or repeated inability to obtain and maintain sufficient sexual excitement, manifested as subjective sexual excitement, lack of sexual response in the sexual organs and other parts of the body. Including vaginal lubrication, the feeling of the clitoris and labia, and the reduction of vaginal smooth muscle relaxation.

6. Orgasm disorder

Refers to the difficulty, delay, or absence of continuous or repeated orgasm that still occurs after sufficient sexual stimulation and sexual arousal.

7. Pain disorders during intercourse

Including sexual intercourse pain (repeated or persistent vaginal pain during sexual intercourse), vaginal spasm (repetitive or persistent extravaginal 1/3 smooth muscle involuntary spasmodic contraction, interference with penis insertion), non-contact sexual intercourse pain (indirect sexual activity Recurrent or persistent genital pain).

The above symptoms can occur alone or at the same time, which is called mixed sexual dysfunction.

Sexual dysfunction test

General inspection

Blood tests, urine tests, blood glucose, blood lipids, liver, kidney function, endocrine hormones, semen, prostate fluid, leucorrhea, cervical fluid and other tests may be required depending on the specific condition.

2. Imaging examination

Color Doppler ultrasound may be required to check the genitals. When considering central nervous system lesions, perform a CT or MRI examination of the brain.

3. Special inspection

When patients have erectile dysfunction, audiovisual sexual stimulation tests, nocturnal penile erection monitoring, penile hemodynamic testing (penile arterial blood pressure index, color bifunctional ultrasound, penile cavernous vasoactive drug test, cavernous body) Angiography), erectile nerve function test, etc. Women may need to perform female reproductive tract blood flow, vaginal pH, vaginal compliance, and female reproductive organ vibration sensation threshold tests. These checks can be used as appropriate on a case-by-case basis.

Sexual Dysfunction Diagnosis

It is not difficult to make a diagnosis based on the patient's corresponding clinical manifestations and examination results. It is especially important to ask a detailed medical history.

Sexual Dysfunction Treatment

A comprehensive approach is needed to treat patients with sexual dysfunction. Patients with organic diseases should actively treat the primary disease, and those who cause the drug should stop using the drug.

1. Sex education and psychotherapy

Strengthen sexual knowledge guidance, eliminate concerns and fears about sexual problems, correct wrong sexual ideas and methods of sexual intercourse, and coordinate the sexual life of husband and wife. Psychotherapy emphasizes individualized treatment schemes. Psychoanalysis, aversion therapy, systematic desensitization therapy, and home therapy are commonly used.

2. Sexual Behavior Therapy

It is mainly through sexy concentration training that gradually adapts and familiarizes patients with the process of sexual intercourse, improves the patient's own feelings about sexual response, fully enjoys the pleasure of sexual intercourse, and reduces anxiety and fear of sexual intercourse. During treatment, the other party should avoid adverse stimulation to the patient's sexual experience, sexual self-esteem and sexual fantasies, and avoid harmful sexual inducement activities. Pubic coccyx training is especially effective for women with pelvic floor muscle relaxation or underdeveloped cochlear muscles after childbirth.

3. Drug treatment

For the treatment of erectile dysfunction, PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil are preferred. Premature ejaculation can use selective serotonin reuptake inhibitors. Oral administration of levodopa and ephedrine can promote ejaculation. Tricyclic antidepressants are the drugs of choice for treating phobias and depression. Estrogen replacement therapy can increase the sensitivity and sexual desire of the clitoris and reduce pain during intercourse. Appropriate medication for mental illness such as anxiety or depression.

4. Physical therapy

Electric massagers can promote ejaculation in men. The use of oscillators and penis models can increase female stimulation.

5. Surgical treatment

It is mainly aimed at the penile disease. For example, patients with a foreskin with a narrow foreskin and a phimosis can be treated with surgery. On the one hand, it is conducive to the full erection of the penis. At the same time, the removal of the foreskin to reveal the glans can increase its sensitivity to stimulation. Facilitates ejaculation.

6. Traditional Chinese Medicine Treatment

Traditional Chinese medicine treatment and acupuncture treatment have certain effects on sexual dysfunction, which can be treated with syndrome differentiation.

Prognosis of sexual dysfunction

Most of the functional dysfunctions are caused by mental and psychological factors, which can be cured by active treatment, and the prognosis is good. Organic patients are mostly caused by the primary disease, and their prognosis is generally poor.

Sexual Dysfunction Prevention

1. Both men and women should learn some sexual knowledge together to eliminate mental tension and anxiety to relieve the psychological burden. The man should give more comfort and caress.

2. Before exchanging sex, exchange feelings with each other, touch each other's body and touch each other, so as to achieve a sense of refined spirit and affection. During sexual intercourse, the man should be gentle and gentle.

3. Avoid using drugs that can cause sexual dysfunction.

4. Actively treat primary diseases.