Sexual dysfunction or sexual malfunction (see also sexual function) is difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Sexual function is a medical term used when assessing sexuality (mainly human sexuality) in clinical context. ... Sexual behavior is a form of physical intimacy that may be directed to reproduction (one possible goal of sexual intercourse) and/or to the enjoyment of activity involving sexual gratification. ... Look up desire in Wiktionary, the free dictionary. ... Sexual arousal is the process and state of an animal being ready for sexual activity. ... It has been suggested that Dry orgasm be merged into this article or section. ...

Onset

Sexual difficulties can begin early in a person's sex life or they may develop after an individual has previously experienced enjoyable and satisfying sex. A problem may develop gradually over time, or may occur suddenly as a total or partial inability to participate in one or more stages of the sexual act. The causes of sexual difficulties can be physical, psychological, or both.

Emotional factors affecting sex include both interpersonal problems (such as marital/relationship problems, or lack of trust and open communication between partners) and psychological problems within the individual (depression, sexual fears or guilt, past sexual trauma, and so on). Clinical depression (also called major depressive disorder) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ...

Physical factors include drugs (alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, and some psychotherapeutic drugs); injuries to the back, problems with an enlarged prostate gland, problems with blood supply, nerve damage (as in spinal cord injuries); or disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis); failure of various organ systems (such as the heart and lungs); endocrine disorders (thyroid, pituitary, or adrenal gland problems); hormonal deficiencies (low testosterone, estrogen, or androgens); and some birth defects. Nicotine is an alkaloid found in the nightshade family of plants (Solanaceae), predominantly in tobacco, and in lower quantities in tomato, potato, eggplant (aubergine), and green pepper. ... The term narcotic, derived from the Greek word narkotikos, meaning benumbing or deadening, originally referred to a variety of substances that induced sleep (such state is narcosis). ... An antihistamine is a drug which serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions, through action at the histamine receptor. ... Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. ... Tumor (American English) or tumour (British English) originally means swelling, and is sometimes still used with that meaning. ... Syphilis is a sexually transmitted infection (STI) caused by a spirochaete bacterium, Treponema pallidum. ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... Grays Fig. ... Testosterone is a steroid hormone from the androgen group. ... Estriol. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ...

Sexual dysfunction disorders are generally classified into four categories: sexual desire disorders, sexual arousal disorders, orgasm disorders, and sexual pain disorders.

1. Sexual desire disorders or decreased libido can be caused by a decrease in normal estrogen (in women) or testosterone (in both men and women) production. Other causes may be aging, fatigue, pregnancy, medications (such as the SSRIs) or psychiatric conditions, such as depression and anxiety.
2. Sexual arousal disorders were previously known as frigidity in women and impotence in men, though these have now been replaced with less judgmental terms. Impotence is now known as erectile dysfunction, and frigidity has been replaced with a number of terms describing specific problems with, for example, desire or arousal.
   For both men and women, these conditions can manifest as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.
   There may be medical causes to these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease can also contribute, as well as the nature of the relationship between the partners. As the success of sildenafil (Viagra) attests, most erectile disorders in men are primarily physical, not psychological conditions.
3. Orgasm disorders are a persistent delay or absence of orgasm following a normal sexual excitement phase. The disorder can occur in both women and men. Again, the SSRI antidepressants are frequent culprits -- these can delay the achievement of orgasm or eliminate it entirely.
4. Sexual pain disorders affect women almost exclusively and are known as dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the muscles of the vaginal wall that interferes with intercourse). Dyspareunia may be caused by insufficient lubrication (vaginal dryness) in women.

Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by menopause, pregnancy, or breast-feeding. Irritation from contraceptive creams and foams can also cause dryness, as can fear and anxiety about sex. Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders and some personality disorders. ... Sildenafil citrate, sold under the names Viagra, Revatio and generically under various other names, is a drug used to treat male erectile dysfunction (impotence) and pulmonary arterial hypertension (PAH), developed by the pharmaceutical company Pfizer. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Dyspareunia is painful sexual intercourse, due to medical or psychological causes. ... Vaginismus is a condition which affects a womans ability to have sexual intercourse, insert tampons and undergo gynaecological examinations. ... Vaginal lubrication is the naturally produced lubricating fluid that reduces friction during sexual intercourse. ... Menopause is the physiological cessation of menstrual cycles associated with advancing age in species that experience such cycles. ... A pregnant woman near the end of her term Pregnancy is the carrying of one or more embryos or fetuses by female mammals, including humans, inside their bodies. ...

It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma (such as rape or abuse) may play a role. Another female sexual pain disorder is called vulvodynia or vulvar vestibulitis. In this condition, women experience burning pain during sex which seems to be related to problems with the skin in the vulvar and vaginal areas. The cause is unknown. The term vulvodynia is used to describe pain in the vulva, often severe, of unknown cause. ... Vulvodynia refers to a disorder of vulvar pain, burning, and discomfort that interferes with the quality of life. ...

Sexual dysfunctions are more common in the early adult years, with the majority of people seeking care for such conditions during their late twenties through thirties. The incidence increases again in the geriatric population, typically with gradual onset of symptoms that are associated most commonly with medical causes of sexual dysfunction.

Sexual dysfunction is more common in people who abuse alcohol and drugs. It is also more likely in people suffering from diabetes and degenerative neurological disorders. Ongoing psychological problems, difficulty maintaining relationships or chronic disharmony with the current sexual partner can also interfere with sexual function. Sexual function is a medical term used when assessing sexuality (mainly human sexuality) in clinical context. ...

Symptoms

Psychological sexual disorders

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders lists the following psychological sexual disorders: The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States. ...

• Hypoactive sexual disorder (see also asexuality)
• Sexual aversion disorder (avoidance of or lack of desire for sexual intercourse)
• Female sexual arousal disorder (failure of normal lubricating arousal response)
• Male erectile disorder
• Female orgasmic disorder (see Anorgasmia)
• Male orgasmic disorder (see Anorgasmia)
• Premature ejaculation
• Dyspareunia
• Vaginismus
• Secondary sexual dysfunction
• Paraphilias
• Gender identity disorder
• PTSD due to genital mutilation or childhood sexual abuse

Inhibited sexual desire (ISD), sometimes called frigidity, sexual aversion, sexual apathy or hypoactive sexual desire, refers to a low level of sexual desire and interest manifested by a failure to initiate or be responsive to a partners initiation of sexual activity. ... Asexuality is a general term or self-designation for people who lack sexual attraction or otherwise find sexual behavior unappealing. ... Inhibited sexual desire (ISD), sometimes called frigidity, sexual aversion, sexual apathy or hypoactive sexual desire, refers to a low level of sexual desire and interest manifested by a failure to initiate or be responsive to a partners initiation of sexual activity. ... Female sexual arousal disorder is the condition of decreased, insufficient, or absent lubrication in females during sex, even despite normal sexual arousal. ... Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. ... Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ... Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ... Premature ejaculation (PE), also known as rapid ejaculation, premature climax, early ejaculation, or by the Latin term ejaculatio praecox, is the most common sexual problem in men affecting 20%-30% of men. ... Dyspareunia is painful sexual intercourse, due to medical or psychological causes. ... Vaginismus is a condition which affects a womans ability to have sexual intercourse, insert tampons and undergo gynaecological examinations. ... This article or section does not cite its references or sources. ... Gender identity disorder, as identified by psychologists and medical doctors, is a condition in which a person has been assigned one gender (usually at birth on the basis of their sex, but compare intersexuality), but identifies as belonging to another gender, or does not conform with the gender role their... Posttraumatic stress disorder (PTSD), is a term for the psychological consequences of exposure to or confrontation with stressful experiences, which involve actual or threatened death, serious physical injury or a threat to physical integrity and which the person found highly traumatic. ...

Other sexual problems

• Lack of a sexual partner
• Sexual dissatisfaction (non-specific)
• Lack of sexual desire
• Anorgasmia
• Impotence
• Sexually transmitted diseases
• Infidelity
• Delay or absence of ejaculation, despite adequate stimulation
• Inability to control timing of ejaculation
• Inability to relax vaginal muscles enough to allow intercourse
• Inadequate vaginal lubrication preceding and during intercourse
• Burning pain on the vulva or in the vagina with contact to those areas
• Unhappiness or confusion related to sexual orientation
• Transsexual and transgender people may have sexual problems (before or after surgery), though actually being transgendered or transsexual is not a sexual problem in itself.
• Persistent sexual arousal syndrome
• Post SSRI Sexual Dysfunction
• Sexual addiction
• Hypersexuality
• Female genital cutting has occurred more in the USA than previously thought
• Male circumcision alters the natural sexual function for both partners

To meet Wikipedias quality standards, this article or section may require cleanup. ... Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ... Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. ... Sexually transmitted diseases (STDs) — also known as sexually transmissible diseases, sexually transmitted infections (STIs) or (infrequently) venereal diseases (VD) or social disease — are diseases or infections that have a significant probability of transmission between humans by means of sexual contact, vaginal intercourse, oral sex, and/or anal sex. ... In a religious context, infidelity is an absence of faith in the beliefs or teachings of a religion, such that one who lacks such faith is an infidel. ... This article does not cite its references or sources. ... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... The word intercourse refers to: Look up intercourse in Wiktionary, the free dictionary. ... Labeled picture of external human female reproductive anatomy. ... Sexual orientation describes the direction of an individuals sexuality, often in relation to their own sex or gender. ... A transsexual (sometimes transexual) person establishes a permanent identity with the opposite gender to their assigned (usually at birth) sex. ... Transgender (IPA: , from trans (Latin) and gender (English) ) is an overarching term applied to a variety of individuals, behaviors, and groups involving tendencies that diverge from the normative gender role (woman or man) commonly, but not always, assigned at birth, as well as the role traditionally held by society. ... Sex reassignment surgery (SRS) includes the surgical procedures by which a persons physical appearance and function of their existing sexual characteristics are changed to that of the other sex. ... Persistent Sexual Arousal Syndrome results in a spontaneous and persistent genital arousal, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire. ... Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused by the previous use of SSRI antidepressants. ... Sexual addiction, also sometimes called sexual compulsion, is a catch-all term for a postulated form of psychological addiction to sexual intercourse and other compulsive sexual behaviors including, but not limited to, viewing pornography, compulsive masturbation, serial cheating, cyber- and phone sex. ... Hypersexuality is a desire for human sexual behavior at levels high enough to be considered clinically significant. ... Female genital cutting (FGC) refers to amputation of any part of the female genitalia for cultural rather than medical reasons. ... This article is being rewritten at Circumcision/temp Circumcision is the removal of some or all of the prepuce or foreskin though often the frenulum is also excised. ...

Other related problems

• Infertility
• Paraphilias

Infertility is the inability to naturally conceive a child or to carry a pregnancy to full term. ... This article or section does not cite its references or sources. ...

Clinical studies

Since people tend not to talk to one another about their sexual problems, many people imagine that they are "abnormal", or that their sexual problems are unique or shameful. Images of sexuality presented by society and the media often present people with unrealistic ideals of sexual behavior, whether of the ideals of chastity and sexual fidelity presented by religion, or the ideal of sexual inexhaustibility and promiscuous availability presented by pornography. Neither image appears to be representative of human behavior in real life: this has been summed up in the phrase "everyone lies about sex". Shame is a psychological condition and a form of religious, political, judicial, and social control consisting of ideas, emotional states, physiological states and a set of behaviors, induced by the consciousness or awareness of dishonor, disgrace, or condemnation. ... Human relationships within an ethnically diverse society. ... Allegory of chastity by Hans Memling. ... Promiscuity is the practice of making relatively casual and indiscriminate choices. ... Pornographic movies Pornography (from Greek πόρνη (porni) prostitute and γραφή (grafi) writing), more informally referred to as porn or porno, is the representation of the human body or sexual activity with the goal of sexual arousal. ...

The genuine clinical study of sexual problems is usually dated back no further than 1970 when Masters and Johnson's Human Sexual Inadequacy was published. It was the result of over a decade of work at the Reproductive Biology Research Foundation in St. Louis, involving 790 cases. The work grew from Masters and Johnson's earlier Human Sexual Response (1966). Time magazine, May 25, 1970 Gynecologist William Howell Masters (December 27, 1915 – February 16, 2001) and psychologist Virginia Eshelman Johnson (born February 11, 1925) pioneered research into human sexual behavior during the 1950s and 1960s. ... Time magazine, May 25, 1970 Gynecologist William Howell Masters (December 27, 1915 – February 16, 2001) and psychologist Virginia Eshelman Johnson (born February 11, 1925) pioneered research into human sexual behavior during the 1950s and 1960s. ... Sexual arousal is the process and state of an animal being ready for sexual intercourse. ...

Prior to Masters and Johnson the clinical approach to sexual problems was largely derived from the thinking of Freud. It was held with psychopathology and approached with a certain pessimism regarding the chance of help or improvement. Sexual problems were merely symptoms of a deeper malaise and the diagnostic approach was from the psychopathological. There was little distinction between difficulties in function and variations nor between perversion and problems. Despite work by psychotherapists such as Balint sexual difficulties were crudely split into frigidity or impotence, terms which too soon acquired negative connotations in popular culture. Sigmund Freud His famous couch Sigmund Freud (May 6, 1856 - September 23, 1939) was an Austrian neurologist and the founder of the psychoanalytic school of psychology, a movement that popularized the theory that unconscious motives control much behavior. ... Psychopathology is a term which refers to either the study of mental illness or mental distress the manifestation of behaviours and experiences which may be indicative of mental illness or psychological impairment. ... Inhibited sexual desire (ISD), sometimes called frigidity, sexual aversion, Sexual apathy or Hypoactive sexual desire, refers to a low level of sexual desire and interest manifested by a failure to initiate or be responsive to a partners initiation of sexual activity. ... Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. ...

The achievement of Human Sexual Inadequacy was to move thinking from psychopathology to learning, only if a problem did not respond to educative treatment would psychopathological problems be considered. Also treatment was directed at couples, whereas before partners would be seen individually. Masters and Johnson saw that sex was a joint act. They believed that sexual communication was the key issue to sexual problems not the specifics of an individual problem. They also proposed co-therapy, a matching pair of therapists to the clients, arguing that a lone male therapist could not fully comprehend female difficulties and vice versa.

The basic Masters and Johnson treatment program was an intensive two week program to develop efficient sexual communication. Couple-based and therapist led the program began with discussion and then sensate focus between the couple to develop shared experiences. From the experiences specific difficulties could be determined and approached with a specific therapy. In a limited number of male only cases (41) Masters and Johnson had developed the use of a female surrogate, an approach they soon abandoned over the ethical, legal and other problems it raised.

In defining the range of sexual problems Masters and Johnson defined a boundary between dysfunction and deviations. Dysfunctions were transitory and experience by the majority of people, dysfunctions bounded male primary or secondary impotence, premature ejaculation, ejaculatory incompetence; female primary orgasmic dysfunction and situational orgasmic dysfunction; pain during intercourse (dyspareunia) and vaginismus. According to Masters and Johnson sexual arousal and climax are a normal physiological process of every functionally intact adult, but despite being autonomic it can be inhibited. Masters and Johnson treatment program for dysfunction was 81.1% successful. Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. ... Premature ejaculation (PE), also known as rapid ejaculation, premature climax, early ejaculation, or by the Latin term ejaculatio praecox, is the most common sexual problem in men affecting 20%-30% of men. ... Dyspareunia is painful sexual intercourse, due to medical or psychological causes. ... Vaginismus is a condition which affects a womans ability to have sexual intercourse, insert tampons and undergo gynaecological examinations. ... Sexual arousal is the process and state of an animal being ready for sexual activity. ... It has been suggested that Dry orgasm be merged into this article or section. ...

Despite the work of Masters and Johnson the field in the US was quickly over-run by ethusiastic rather than systematic approaches, blurring the space between 'enrichment' and therapy. Although it has been argued that the impact of the work was such that it would be impossible to repeat such a clean experiment.

See also

• Post SSRI Sexual Dysfunction
• Agony aunt
• Female Sexual Dysfunction
• Sexually dysphemic youth
• Sexual function
• Anorgasmia

Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused by the previous use of SSRI antidepressants. ... An agony aunt is an advice columnist at a magazine or newspaper. ... Female sexual arousal disorder is the condition of decreased interest in sexual intercourse, sexual activity, and sexual contact in females. ... Sexual function is a medical term used when assessing sexuality (mainly human sexuality) in clinical context. ... Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ...

External links

• NIH site on sexual problems
• 100 FAQs about sexual dysfunction
• Information on various sexual dysfunctions
• Site for men with sexual dysfunction
• Sexual Medicine Society of North America's website: SexHealthMatters.org
• Persistent Sexual Arousal SyndromeLanguage: Dutch and English