Sexual Disorders

Sexual health is a vital part of a person’s overall well-being, but concerns in this area can often be challenging to talk about. Unfortunately, stigma and fear of judgment stop many people from seeking help. As a result, a lot of sexual health issues go undiagnosed and untreated, and this can negatively impact a person’s quality of life. Creating open, supportive conversations is key to breaking down these barriers.

Understanding Sexual Dysfunction

Sexual dysfunction can affect people of any age, gender, or background. However, research shows it becomes more common with age, particularly among those over forty ^[1]. In fact, these conditions are more common than often assumed, with an estimated 43% of women and 31% of men experiencing some form of sexual dysfunction, according to a 2000 study ^[2]. 

It’s estimated that between 30–40% of people will experience some form of sexual dysfunction at some point in their lives ^[1]. Contributing factors may include stress, certain medications, underlying health conditions, and a history of sexual trauma.

Sexual dysfunction is typically categorized into four main types ^[3]:

• Desire disorders: A type of disorder characterized by reduced or absent interest in sexual activity. 

• Arousal disorders: Difficulty becoming or staying physically aroused during sexual activity, even when desire is present. For people with a penis, this may include challenges with achieving or maintaining an erection.
  
• Orgasm disorders: Delayed, infrequent, or absent orgasms, despite adequate arousal and stimulation.
  
• Pain disorders: Physical discomfort or pain during sexual activity, which can lead to decreased desire and emotional strain.

This classification helps people and healthcare providers better identify the nature of the issue and advise patients on the most effective treatment and support. 

Commonly Diagnosed Sexual Disorders  

Sexual disorders can manifest in different ways depending on factors such as sex, anatomy, and personal history. While some conditions are more commonly associated with males or females, others can affect people of any gender. 

Sexual Disorders Affecting Males

Two common sexual disorders affecting males include premature or early ejaculation (PE) and erectile dysfunction (ED) ^[4]. PE involves ejaculating sooner than desired during sexual activity, often leaving the person or their partner feeling frustrated or unsatisfied. ED refers to difficulty achieving or maintaining an erection, which can be distressing and may impact emotional intimacy and sexual confidence.

Sexual Disorders Affecting Females

Two common sexual disorders affecting women include genito-pelvic pain/penetration disorder (GPPPD) and vaginismus ^[4]. GPPPD involves persistent or recurring difficulties with vaginal penetration, often involving pain, fear, or anxiety about pain, or involuntary tightening of the pelvic floor muscles. Vaginismus is marked by involuntary contraction of the vaginal muscles, making penetration painful or difficult, even when the person feels aroused. 

Overlapping Sexual Disorders

Examples of sexual disorders affecting both males and females include persistent genital arousal disorder (PGAD) and orgasm disorder (anorgasmia). PGAD involves unwanted and persistent feelings of genital arousal, which occur without sexual desire and may continue despite orgasm, often causing distress or discomfort ^[4]. Orgasm disorder refers to difficulty reaching orgasm or experiencing orgasms that feel less intense or unsatisfying, despite sufficient arousal and stimulation.

Sexual Disorder Causes

Emotional, psychological, and physical factors often contribute to sexual disorders. In many cases, multiple issues affect a person simultaneously.

Certain medical conditions can affect sexual function, especially those that impact blood flow, which is essential for arousal. Conditions like diabetes, heart disease, cancer, and even bladder problems can interfere with sexual desire or performance, particularly in people assigned male at birth.

Hormones also play a key role in sexual health. Changes in hormone levels, which are common with aging, can reduce libido. About one-third of older adults report at least one concern related to sexual function. For those assigned female at birth, experiences like pregnancy, childbirth, breastfeeding, and menopause can affect desire, often due to both hormonal shifts and physical changes ^[5]. 

Because sexual arousal begins in the brain, mental and emotional health matter, too. Stress, anxiety, relationship struggles, or feeling overwhelmed by life can all impact libido. Fear around sex, whether from past experiences or pressure to perform, can also reduce sexual satisfaction.

Substances and medications can also affect sexual function. Alcohol and tobacco may reduce blood flow, which can make arousal or intercourse more difficult. Some prescription medications can lower desire or interfere with sexual performance ^[5]. If medication might be contributing to the problem, discussing dosage adjustments or trying an alternative with a healthcare provider may help.

Sexual Disorders Symptoms

Sexual disorders can manifest through a range of physical and emotional symptoms, often affecting desire, arousal, or the ability to engage comfortably in sexual activity. These symptoms may be temporary or ongoing and can vary in severity and impact. Below are some of the more common signs associated with sexual dysfunction.

Some common symptoms of sexual disorders include ^[2]:

• Difficulty getting aroused: Feeling physically unresponsive or disconnected during sexual activity, even when one wants to be engaged.
  
• Lack of interest in sex: A persistent absence of sexual thoughts, desire, or motivation, which can feel confusing or frustrating.
  
• Pain during intercourse: Experiencing discomfort, soreness, or sharp pain during or after sex, which can lead to fear or avoidance.
  
• Inability to achieve or maintain an erection: Difficulty getting or keeping an erection firm enough for sex, which may affect confidence or emotional well-being.
  
• Premature or delayed ejaculation: Ejaculating sooner than desired or having trouble reaching ejaculation at all, which can impact satisfaction.
  
• Inability to achieve orgasm: Struggling to reach climax even with adequate stimulation, which may feel distressing or disheartening.
  
• Vaginal dryness: Lack of natural lubrication, which can make sex uncomfortable or painful.
  
• Inability to feel sexual arousal: Not feeling physically or emotionally “turned on,” even in situations that used to be pleasurable.

Diagnosing Sexual Disorders 

When a sexual disorder is suspected, a healthcare provider will begin by asking about the patient’s medical history, sexual experiences, and current symptoms. They’ll also consider other possible causes, such as medications or underlying health conditions.

From there, the provider will refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which outlines the criteria used to diagnose mental and sexual health conditions. 

According to the DSM-5, symptoms must meet three key criteria to be officially diagnosed as a sexual disorder ^[6]:

• They must have lasted for at least six months.
• They must occur in 75% to 100% of sexual encounters during that time.
• And they must cause significant distress to the person.
  

Healthcare providers consider sexual difficulties a disorder only when the symptoms persist and cause significant distress, affecting a person’s well-being, relationships, or mental health. If the person isn’t bothered by the symptoms, a provider may still explore possible physical causes, but they wouldn’t diagnose it as a sexual disorder ^[6].

Treating Sexual Disorders

Being diagnosed with a sexual disorder can be challenging, especially since sexual health is closely linked to one’s sense of self and relationship identity. It’s important to remember there’s no shame in seeking help. Effective treatments are available, and a doctor or healthcare professional can guide you toward the right approach.

Treatments for sexual disorders include ^[6]: 

• Medication: Sometimes, prescribed medicines can help balance hormones, improve blood flow, or address other physical causes of sexual difficulties.

• Medical treatment: Treating underlying health conditions or adjusting current medications can often improve sexual function and overall well-being.

• Mechanical aids: Devices like pumps or rings can support physical responses and make sexual activity more comfortable and satisfying.

• Talk therapy: Talking with a counselor or therapist can help address emotional or psychological factors affecting sexual health in a safe, supportive space.

• Behavioral treatments: Learning new ways to respond to sexual cues or practicing relaxation techniques can reduce anxiety and improve intimacy.

• Education and communication: Understanding sexual health and openly discussing needs and concerns with a partner can strengthen connection and ease tension.

Maintaining Relationships and Intimacy 

A sexual disorder can affect more than just physical intimacy. It can also bring up emotional challenges within a relationship. However, with care, effective communication, and a shared effort to stay connected, couples can maintain strong, fulfilling bonds that extend far beyond the bedroom.

Nurturing Intimacy Beyond Sex

When a sexual disorder enters a relationship, it can shift the way partners connect. But intimacy isn’t limited to sex, and building emotional closeness becomes even more critical. Exploring new ways to stay connected can deepen a couple’s bond and bring them closer in meaningful, lasting ways.

Keeping communication open is one of the most important steps. Talking honestly about feelings, needs, and concerns builds trust and emotional safety. Regular check-ins, whether about emotional well-being or physical closeness, help ensure both partners feel seen, heard, and supported.

Making time for each other also matters. Shared experiences can strengthen a couple’s connection. Whether it’s cooking together, going for walks, enjoying a shared hobby, or planning a regular date night, spending quality time nurtures the companionship that forms the heart of many relationships.

Embracing physical affection can be just as powerful. Simple, non-sexual touch like holding hands, cuddling, or hugging can be deeply reassuring. These small gestures help maintain a sense of closeness, love, and emotional comfort even when sex isn’t part of the equation.

Finally, showing appreciation often goes a long way. Taking time to acknowledge each other through kind words, gratitude, or affirmations can make a big difference. Feeling valued and appreciated helps reinforce the emotional bond between partners, especially during times of change or challenge.

Supporting a Romantic Partner

Being there for a partner who is navigating a sexual disorder takes patience, empathy, and open-hearted communication. Taking time to learn about the condition can help someone see things from their partner’s perspective. It also sets the foundation for realistic expectations and more thoughtful, informed support. 

Encouraging open and judgment-free conversations about needs, comfort levels, and preferences can reduce pressure, build trust, and help both partners find ways to stay connected both physically and emotionally.

Letting a partner know it’s okay to seek help and reminding them they don’t have to face it alone is also important. Encouraging professional support and even offering to attend appointments if desired can be a powerful way to show support. Working with a healthcare provider or therapist who specializes in sexual health can make a big difference.

Nurturing non-sexual intimacy is another meaningful form of connection. Intimacy isn’t just about sex. Small gestures, such as cuddling, sharing quiet moments, laughing together, or engaging in meaningful activities, can help maintain closeness and strengthen the emotional bond between partners. 

Most of all, practicing patience and reassurance, and reminding a partner through both words and actions that care and commitment go far beyond the physical, is essential.

Sexual Health and Support

Sexual disorders can affect many areas of a person’s life, including their self-image, romantic relationships, and self-confidence. It’s important to remember that sexual dysfunction is more common than most people realize and that there is nothing to be ashamed of. Understanding the common causes and symptoms of sexual disorders can help determine if and when to seek support. Treatment options vary and can include prescribed medication, talk therapy, and lifestyle changes.

If someone suspects they have a sexual disorder, the best first step is to talk to a healthcare provider for a thorough evaluation and personalized treatment plan. Under the proper care, people experiencing sexual dysfunction can lead healthy, fulfilling sexual lives.