Introduction
Sexual function is a vital aspect of every human being. Proper sexual function brings psychological fulfillment and raises personal self-esteem. Therefore, sexual dysfunctions can adversely affect a person’s well-being and have negative social impacts such as matrimonial or partners’ conflicts (McCool, Theurich, & Apfelbacher, 2014).
Studies show that sexual dysfunctions manifest in the form of disturbances of the normal sexual response sequence or discomforts/pain related to sexual activity (McCool, Theurich, & Apfelbacher, 2014). Evidence-based research has observed that normal sexual response cycles should not be associated with any pain/discomfort and should be in four stages, including excitement, plateau, orgasm, and resolution phases (Everaerd, 2015).
Sexual dysfunctions conditions can be categorized into six major classifications (depending on how they manifest), including arousal, pain, desire, erectile, ejaculation, and orgasm disorders.
As mentioned earlier, sexual function has psychological fulfillment and, therefore, sexual dysfunctions can lead to anxieties, depression, and social problems such as marital discords (Holley & Schmidt, 2010). As such, sexual dysfunctions can totally impair the quality of patients’ lives.
This research paper discusses sexual dysfunctions paying key interest on causes, signs and symptoms and remedies.
Literature review
Sexual dysfunctions affect both women and men. It is worth noting that the exact sexual dysfunctions prevalence may not be established since many victims do not seek medical help due to the awkwardness/privacy associated with personal sexual health (Sakineh Mohammad-Alizadeh Charandabi, Khaki-Rostami, Malakouti, Jafarabadi, & Ghanbari-Homayi, 2015).
Sexual dysfunctions in men
Some of the most common sexual disorders among men include erectile dysfunction, premature ejaculation, orgasmic disorders, ejaculation disorder, and sexual arousal/interest problems.
Erectile dysfunction (ED)
The highest numbers of men with sexual dysfunctions complain of ED (Gareri, Castagna, Francomano, Cerminara, & Fazio, 2014). ED is characterized by the male inability to achieve or uphold penile erection for a considerable time for satisfactory sexual intercourse (Ramlachan & Campbell, 2014). As such, a patient cannot “obtain and/or maintain an erection until the completion of sexual activity and a marked decrease in erectile rigidity” (Ramlachan & Campbell, 2014, p. 447).
Treatment of Erectile Dysfunction
Erectile dysfunction has been associated with psychological and physical causes. These factors result in sexual dissatisfaction and undesirable sexual experiences. The main aim of treating erectile disorder is to ensure that an individual enjoys his sexual experience (Ramlachan & Campbell, 2014).
In cases where the erectile disorder emanates from psychological causes such as anxiety due to lack of experience or unpleasant past encounters, psychotherapy can be applied. Situational anxiety leads to avoidance and fear of sexual intercourse. This results in sequences of anxiety, desensitization of the penis, and the inability to maintain an erection throughout the sexual activity. Therefore, psychotherapy looks at these underlying factors to address the problem. Counseling also helps to counter erectile dysfunction, especially when it is caused by marital disharmony.
Third, lifestyle changes can drastically increase ED patient results. As such, patients should avoid smoking, taking alcohol, and abusing harmful substances.
Additionally, educating and counseling patients helps in treating ED. In cases where the problem has advanced, patients can be treated using Viagra and other similar oral medicines (Ramlachan & Campbell, 2014).
Further, ED can be treated through intracavernous pharmacotherapy, where a vasodilator medication is injected into the penis to increase blood flow in the penis this facilitates easy muscle relaxation thus stimulating a penile erection. In case the above treatments are unsatisfactory or are ineffective, a patient may choose to have a penile implant (Ramlachan & Campbell, 2014).
Combination therapy
Treating ED with a single therapy may not give the desired outcomes. Therefore, it is prudent to adopt multiple therapies, especially when dealing with hard-to-treat ED cases. For instance, VEDs can be combined with oral/injectable erectogenic drugs. In addition, cAMP and the cGMP can be combined to optimize penile muscle relaxation. However, experts in dealing with ED, more so, physicians with adequate experience, are the only personnel who are recommended to use combination therapy (Elliott, 2011).
Erectile dysfunction and cardiovascular ailments
Research has revealed an interrelationship between ED and some cardiovascular ailments such as hypertension and coronary diseases (Javaroni & Neves, 2012). Many hypersensitive male patients are diagnosed with ED. In addition, ED is commonly regarded a preliminary indicator of cardiovascular ailments.
The link between ED and cardiovascular diseases is probably located in the endothelium that is incapacitated in generation of the required dilation in penile vascular bed that facilitate male sexual arousal and consequently affecting penile erection. Decisively, timely diagnosis of ED is crucial in treating male patients of cardiovascular diseases. Diagnosis help in the determination of appropriate prescriptions (Javaroni & Neves, 2012).
Premature ejaculation (PE)
Approximately 25% men population suffer premature ejaculation (Ramlachan & Campbell, 2014). PE is a male sexual dysfunction characterized by ejaculating before vaginal penetration or within the first minute of penetration. PE, therefore, is the male incapability to delay ejaculation during sexual intercourse (Ramlachan & Campbell, 2014).
Oftentimes, PE results in frustrations, distress, and low self-esteem among patients. In addition, PE is a major reason for the lack of sexual intimacy.
The causes of PE are varied, including physical, health, and social factors. Leading causes of PE include urological problems, thyroid malfunctioning, and interpersonal relationship issues.
It is worth noting a considerable percentage (approximately 33%) of PE patients complain of ED (Ramlachan & Campbell, 2014). As such, it is imperative to judiciously screen for erectile dysfunction in men suffering from PE. The coexistence of PE and ED in a patient can be attributed to both psychological and health reasons. For instance, an ED patient attempting to achieve an erection may end up experiencing PE.
Treating PE
Controlling excitement is the key focus in treating PE. As such, therapies should be provided to PE patients with the capabilities of achieving penile erections.
First, PE can be treated using oral medication. Some of the most efficient and safe oral agents available for treating PE include paroxetine, sertraline, citalopram, and fluoxetine. Studies have linked these oral agents to ejaculation delay, with paroxetine having the best outcomes (Ramlachan & Campbell, 2014).
Second, PE can be treated using psychotherapy. Psychotherapy is more efficient, especially when PE is caused by anxiety or other psychosocial factors. In addition to teaching PE patients on how to delay ejaculation, it is prudent for care providers to give psychosexual therapies. Psychotherapy assists PE patients in fighting anxiety, augmenting interpersonal/partners’ communication, and improving self-confidence (Ramlachan & Campbell, 2014).
Male orgasmic dysfunction
Orgasmic dysfunction (OD) is a sexual condition where male patients have trouble achieving orgasm or with extremely reduced intensity of orgasm. OD manifest in various ways, including delayed orgasm, and delayed ejaculation. Some of the uncommon manifestation of OD include retarded/inhibited ejaculation. Apparently, some of the conditions associated with OD are not adequately studied and/or understood (Ramlachan & Campbell, 2014).
Treating OD
OD is associated with lifestyle practices and, therefore, it should be treated by addressing lifestyle issues. In addition, a medical breakthrough in addressing OD is yet to be achieved. As such, OD patients should be guided to consider lifestyle changes. Some the practices that can remedy OD conditions in male patients include minimizing drug/substance/alcohol consumption, augmenting partners’ intimacy, avoiding sexual intercourse when extremely exhausted, and learning penile stimulation methods (Ramlachan & Campbell, 2014).
Male sexual desire disorder
Male patients with sexual desire disorder persistently or repeatedly lack erotic fantasies and cravings for sensual and sexual activities and, therefore, they hardly engage in sexual intercourse. The lack of desire for sex and other sexual activities can be attributed to medical conditions, relationship factors, and use of some drugs or even posttraumatic stress (Yehuda, Lehrner, & Rosenbaum, 2015).
Treating male sexual desire disorders
For effective treating of sexual desire disorder, all underlying medical and/or psychosocial factors should be established. For instance, a patient should be scanned for sexual disorders such as ED, PE, and pain and treated. Moreover, the patients with sexual desire disorders should be trained on interpersonal techniques to augment partners’ intimacy, sexual communication, and stimulating abilities. All sexual inhibitors, therefore, should be minimized and sexual enhancer optimized. Lastly, hormonal replacement therapy should be done but with proper medical guidelines and recommendations (Ramlachan & Campbell, 2014).
Female sexual dysfunctions
Sexual dysfunctions among women result from varied issues, including age, health, menopause, menstruation cycles, psychosocial status, interpersonal relations, and prior sexual experiences such as childhood sexual abuse (Ma, et al., 2015). Some of the most common sexual dysfunctions in women include interest/arousal disorders, orgasmic disorder, and penetration/pain disorders among others.
Female sexual interest/arousal disorder
This condition is manifested by lack of or considerably low sexual urge.
Various symptoms are associated with arousal disorders in women, including lack of or reduced sexual activity, lack of or minimal erogenous fantasies, lack of initiation of sexual activity. In addition, female patients with interest/arousal problems are less likely to respond to partners’ initiation of sexual activity. They, therefore, do not react to any internal or external erotic cues. As such, patients lack sexual excitement and, therefore, they get minimal or no pleasure during sexual activity (Boa, 2014).
Treating arousal disorders in women
Treating should be aimed at giving specific information, which is pertinent to remedying desire deficiency. The information provided should be specific to patients depending on their age, lifestyle, and/or sexual response cycle. In addition, patients should be trained on augmenting their interpersonal skills to improve sexual intimacy (Boa, 2014).
Research has linked training patients on techniques that facilitate focusing on awareness of genital awareness, cognitive and psychosexual therapy to augmented patients outcomes. Although the use of pharmacotherapy has some limitation, the use of hormonal treatment therapy has had positive results, especially with patients who have attained menopause and have some of their hormones drastically reduced (Boa, 2014). For instance, estrogen treatment has been linked to improved vaginal lubrication to patients who had previously suffered vaginal atrophy. Further, tibilone hormone treatment has been proven to augment results, especially increased desire/arousal. Finally, patients can use clitoral therapy devices, which are designed to increase female arousal and clitoral blood flow (Boa, 2014).
Female orgasmic disorder
Female orgasmic disorder (FOD) is a sexual condition with various manifestations. Some of the most common symptoms of FOD include delays in, uncommonness of, deficiency of orgasm and minimized responsiveness intensity during sexual activity (Boa, 2014).
Treating FOD
Different methods can be adopted in treating FOD, including training on behavior techniques, professionally guided masturbation, and anxiety minimizing techniques. In addition, female patients with FOD should be trained on coital positioning that allows optimal clitoral stimulation during lovemaking. Further, hormonal therapy should be recommended, especially for FOD patients who have attained menopause (Boa, 2014).
Pain/penetration disorders
Genitopelvic pain/penetration disorder is a female condition where persistent or frequent problems in a number of sexual activities. Most common difficulties associated with pain/penetration disorders include difficulties in penile penetration, considerable vulvovaginal/pelvic discomfort and/pain during sexual intercourse, and extreme anxieties in anticipation of vaginal or pelvic pain (Boa, 2014).
Treating pain/penetration disorders
Sexual pain disorders may result from diverse reasons, including biological, psychosexual, and physical factors. Therefore, multidisciplinary approaches should be considered in treating patients with these conditions. Some of the most pertinent disciplines in treating sexual pain disorders include sexual pain field, mucous membrane expertise, pelvic floor experience, and psychosexual therapy. Appropriateness and relevance, however, should be vital, especially on techniques adopted and the type of disorder.
For instance, sexual pain can be managed through pharmacotherapy with medications such as tricyclic antidepressants or relevant lidocaine (Boa, 2014). In some cases, especially where mucosal involvement occurs, vestibulectomy is highly endorsed as a last remedy.
Physical and relaxation exercises are highly recommended as sexual pain disorder preventive measures. In addition, high standards of hygiene of the female genitals and the pelvis have been associated with reduced chances of sexual pain disorders. As such, soaps should be used appropriately while wearing underwear made of appropriate materials (Boa, 2014). It is also imperative to avoid sexual activity until when the condition is healed. Further, professional consent and guidance should be sought before the treated patients can restart sexual relationships.
In some cases, penile penetration phobia may be a contributing factor of sexual pain disorder, especially among women with a history of sexual abuse (Rellini & Meston, 2011). Sex education may be used to demystify sexual activity and reduce penetration fear and anxiety. Other recommended techniques for minimizing penetration phobia include progressive virginal dilatation or relaxation exercises.
Female sexual dysfunctions and other diseases
Research has linked female sexual dysfunction (FSD) to other diseases. For instance, non-malignant cervical cancer has been associated with sexual dysfunctions in women. A study done in China revealed that non-malignant cervical ailments significantly increased women’s risk of having (FSD) (Ma, et al., 2015). The results of the study among the Chinese women have been summarized in the table.
Conclusion
Sexual activity should be a fulfilling/exciting as possible. Healthy sexual cycles should be without pain or discomforts and should be in phases that include arousal, plateau, orgasmic and resolution stages. Nonetheless, sexual disorders are evident among men and women.
This paper has discussed female sexual dysfunction. Some of the most common disorders include orgasmic problems, arousal/excitement disorders. Sexual disorders limited to men include erectile dysfunctions and premature ejaculation while those specific to women include vaginal pain/penetration disorders.
The prevalence of sexual dysfunctions may be higher than estimated yet few patients seek medical help. The reluctance in seeking medical help among many victims of sexual disorders could be linked to the awkwardness and privacy associated with sexual health.
It is worth noting that many sexual disorders emanate from psychosexual, social, health, interpersonal, and/or age factors. In addition, many of the sexual disorders can be treated using pharmacotherapy, sexual education, and combined therapies among other techniques.
Recommendations
- Sex education should be emphasized in all communities in order to lessen the awkwardnesses that hinder patients from seeking help.
- Treating patients with sexual disorders should be done promptly and by qualified personnel using multidisciplinary approaches.
- Patients’ confidentially should be highly upheld.
- Sexual partners should seek medical help together even when only one of them is affected by sexual dysfunctions.
- Patients manifesting with sexual dysfunctions should be screened for other diseases such as hypertension among men and non-malignant cervical cancer among women.
References
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