It's true without reasonable doubt that sexual dysfunction is sometimes a psychological issue than organic. Sexual dysfunction includes low sexual desire(female hypoactive sexual desires), orgasmic abnormalities( premature ejaculation ) and of course erectile dysfunction. It shouldn’t be quoted wrongly nutrition, physical exercises and conditions like diabetes and heart diseases play a big role on the whole sexual activity (biogenic), but so does psychology(pyogenic, intrapsychic, interpersonal), hence the importance.

One individual may have more than one disorder like one can have male erectile dysfunction as well as premature ejaculation.

The function/ disoders include;

Sexual desire disorders- it has two categories; one means a very low or complete absence of sexual fantasies or yearnings for sexual activities ( no horniness) this is hypoactive sexual desire disorder. Another category is sexual aversion disorder where one avoids genital sexual contact, sometimes by masturbation. Hypoactive sexual desire disorder is more common than the other and even more common among women. However, if the desire is triggered during sex this not a disorder. Factors that can lead to inhibition of sexual desires are;

  • Unconscious fears of sex- vagina-dentate as stated by Sigmund Freud is a condition where men unconsciously believe that a vagina has teeth and they can be castrated if they approach it, therefore avoid it any cost. 
  • Unresolved developmental and oedipal conflicts(complex sexual desires by a child to a parent of the opposite sex) can also inhibit sexual desire
  • Celibacy; abstaining from sex for a very long period can lead to inhibition of sexual desires and impulses
  • Hostility/ hate from a partner- many dying relationships have this hypoactive sexual desires and slowly leads to no sex at all. however, this is not a rule some people have normal sexual desires than others and can have sex as minimal as once in two months yet they are in happy relationships. So unless this lack of desire causes distress, clinicians cannot diagnose hypoactive sexual desires.
  • Other causes include stress, depression and anxiety

Female sexual arousal disorder; it can be both normal and dysfunctional to women. Hormonal pattern may contribute to women who have excitement phase dysfunction. Some women have reported feeling sexual excitement before or after menses while others during ovulation. Shifts of testosterone, estrogen, prolactin and thyroxin levels are factors causing female arousal disorder

Male erectile disorder (erectile dysfunction and impotence)-this means failure to obtain an erection sufficient for vaginal insertion, this is called a lifelong erectile disorder. Situational erectile disorder is when a man can have an adequate erection in some circumstances while failing in others ( can have coitus with a mistress or prostitute but fail to do so with his wife or can do it his home but not unfamiliar environment). Acquired erectile dysfunction is when a man had successful sexual intercourse at appoint in his life but currently unable to do so. Erectile dysfunction is very wide effects from 10- 20 percent of all men. The psychological causes include;

  • Anxiety – erectile dysfunction can be caused when a man is anxious before sexual intercourse. Thoughts like will I be good enough to do anyone any good.
  • Difficulties between partners- failure of a man to communicate due to anger, anxiety, stress at work of life in general with his partner can lead to erectile dysfunction. Communication is the key.
It should be noted that Freud identified one of impotence due failure to reconcile feelings of affection towards a woman he has feelings for. This is known as Madonna- putana complex where men can only function with women they see degraded.
  • Other factors include failure to have sexual impulse are punitive superego, lack of trust, inadequate feelings, feeling undesirable ass a partner.
Female orgasmic disorders. Refers to the continuous inhibition or absence of female orgasm. This is a failure to achieve orgasm by either masturbation or sexual intercourse. Those who can attain orgasm by one of these methods is not considered anorgasmic, many women achieve coitus by a combination of clitoral(manual) and vaginal orgasm. According to feud theory women must give up clitoral orgasm to attain vaginal orgasm for sexual maturity; however, this theory was found to be inaccurate.
A woman with who has never had an orgasm all her life is has a life long female orgasmic disorder while a woman who has experienced at least one orgasm in her life has acquired orgasmic disorder regardless the measure either masturbation or dreaming during sleep.

Male orgasmic disorder, the chances of a man with this disorder achieving an ejaculation are slim to none. A man with life long male orgasmic disorder has never been able to ejaculate all his life, while for acquired is termed when he was ejaculating normally. Some researchers say ejaculation and orgasm should be differentiated especially since there have been some complaints from men who ejaculated and yet didn’t feel pleasure. Patients having this order are fewer compared to those of erectile dysfunction premature ejaculation. 
Reasons may be;
  •  For life long orgasmic disorder it shows  a man is from a  difficult background that  perceives sex sinful and genitals dirty(disgusting)
  • Unconscious or conscious wishes to incest and guilt
  • Attention deficit disorder can worsen the situation
Premature ejaculation-this is when a man achieves orgasm or ejaculation before they wish to ( before or immediately after entering the vagina). A man is considered a premature ejaculator if he can not retain ejaculation long enough in the vagina to satisfy his partner at least half their. episodes with coitus.
A strange fact is premature ejaculation is more common in college-educated men than among men with less education. Some argue because of their concern to satisfy their partners though this cause inst proved. This (premature ejaculation is the chief complaint (35 to 40 percent of men are being treated). Psychogenic causes include
  •  Unconscious fears about vaginas
  •  Men who were initially used to a sexual encounter with prostitutes who demanded it to be quicky, or in an unfriendly environment where they had to have sex quickly because being caught would be embarrassing ( public toilets near the road, parental home.
  • Stressful marriage or relationship influences the disorder, a partner can influence this there its crucial to choose wisely
Young inexperienced men are likely to suffer from this but it goes away with time.
 Individuals especially men are not that open to talk to sexual dysfunction to specialists and at times even their partners. There is no shame in it, talk to your partner or specialist, and enjoy the best in sex.
Some treatments don't need medications rather advice and communication.

References: Concise textbook of clinical psychiatry; Third edition
Kaplan&Sadock's

No comments

Post a Comment