Sexual Dysfunctions

Sexual Dysfunctions

• Common 

• Caused by biological and psychological factors

• Lifelong: present since beginning of sexual functioning

• Acquired: at some point, patient was able to have sex without dysfunction

• Generalized or situational

Additional factors: Partner factors

Sexual preferences, health status

Additional factors: Relationship factors

Poor communication, discord

Additional factors: Individual Vulnerability Factors

History of abuse, body image

Additional factors: Cultural/religious factors

Prohibitions against sexual activity

Male Hypoactive Sexual Desire Disorder

• Lack of erotic thoughts and desire for sexual activity

• May have history of sexual abuse

• Age considerations 

• 6 months with distress

Erectile Disorder

Almost always has marked trouble achieving or maintaining an erection adequate to consummate sex

Premature (Early) Ejaculation

• Almost always ejaculates before desired time, generally within a minute of penetration

  • Mild: 30-60 seconds

  • Moderate: 15-30 seconds

  • Severe: 15 seconds or less or before penetration

Delayed Ejaculation

• Almost always, with a partner a male experiences undesired, pronounced delay or absence of climax

• Generalized or situational

• Severity specifiers based on subjective levels of distress

Female Sexual Interest/Arousal Disorder

• Women’s low sexual interest or arousal indicated by:

  • Minimal interest in sexual activity or erotic thoughts

  • Minimal response to partner overtures 

  • Minimal enjoyment during sex 

• Generalized or situational

Genito-Pelvic Pain/ Penetration Disorder

• Major, repeated pain with efforts at vaginal intercourse 

• Marked tightening of the pelvic floor muscles (vaginismus) during attempted penetration

Female Organismic Disorder

Recurrent distress by orgasms that are nearly always too slow, too weak, or too rare

Best Treatments

• Identifying and treating underlying causes - these diagnoses tend to be somewhat secondary

• Psychoeducation on healthy sexual functioning 

• Emotion-Focused Therapy (EFT) if the issue is related to emotional intimacy