Sexual Problems

Sexual dysfunction or sexual malfunction (see also sexual function) refers to a difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including desire, arousal or orgasm. A thorough sexual history and assessment of general health and other sexual problems (if any) are very important. Assessing (performance) anxiety, guilt, stress and worry are integral to the optimal management of sexual dysfunction. When a sexual problem is managed inappropriately or sub-optimally, it is very likely that the condition will subside immediately but re-emerge after a while. When this cycle continues, it strongly reinforces failure which may eventually cause one to not want to seek further treatment and experience symptoms all their life. It is important to get a thorough assessment from professionals and therapists who are qualified to manage sexual problems.. Internet-based information is good for gaining knowledge about sexual functioning and sexual problems but not for self-diagnosis and/or self-management.


There are many factors which may result in a person experiencing a sexual dysfunction. These may result from emotional or physical causes.

Sexual dysfunction may arise from emotional factors, including interpersonal or psychological problems. Interpersonal problems may arise from marital or relationship problems, performance anxiety, or from a lack of trust and open communication between partners, and psychological problems may be the result ofdepression, sexual fears or guilt, past sexual trauma, sexual disorders,[11] among others.

Sexual dysfunction is especially common among people who have anxiety disorders. Ordinary anxiousness can obviously cause erectile dysfunction in men without psychiatric problems, but clinically diagnosable disorders such as panic disorder commonly cause avoidance of intercourse and premature ejaculation. Pain during intercourse is often a comorbidity of anxiety disorders among women.[1]

Sexual activity may also be impacted by physical factors. These would include use of drugs, such as alcohol, nicotine, narcotics, stimulants, anti-hypertensives, antihistamines, and some psychotherapeutic drugs.[12] For women, almost any physiological change that affects the reproductive system—premenstrual syndrome, pregnancy, postpartum, menopause—can have an adverse effect on libido.[12] Injuries to the back may also impact sexual activity, as would problems with an enlarged prostate gland, problems with blood supply, nerve damage (as in spinal cord injuries). Disease, such as diabetic neuropathy,multiple sclerosis, tumors, and, rarely, tertiary syphilis may also impact on the activity, as would 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.



1. Coretti G and Baldi I (August 1, 2007). “The Relationship Between Anxiety Disorders and Sexual Dysfunction”. Psychiatric Times24 (9).

11. Michetti, P M; Rossi, R; Bonanno, D; Tiesi, A; Simonelli, C (2005). “Male sexuality and regulation of emotions: a study on the association between alexithymia and erectile dysfunction (ED)”. International Journal of Impotence Research18 (2): 170–4. doi:10.1038/sj.ijir.3901386. PMID 16151475.

12. Saks BR (April 15, 2008). “Common issues in female sexual dysfunction”. Psychiatric Times25 (5).