Having issues with sex can feel like an isolating experience. However, “Sexual dysfunctions are highly prevalent, affecting about 43% of women and 31% of men” (Rosen, 2000).
Types of Sexual Disorders
According to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013), sexual disorders are diagnosed if the symptoms occur at least 75% of the time during sexual encounters and include the following:
- Female Orgasmic Disorder: Lack of or reduced intensity of an orgasm
- Female Sexual Interest/Arousal Disorder and Male Hypoactive Sexual Desire Disorder: Lack of desire in relation to sexual stimuli
- Genito-Pelvic Pain/Penetration Disorder: Pelvic or vulvovaginal pain, tensing of muscles, or anxiety concerning vaginal penetration
- Delayed Ejaculation: Difficulties ejaculating or being unable to ejaculate
- Erectile Disorder: Inability to have, maintain, or achieve a rigid erection
- Premature (Early) Ejaculation: Ejaculation that occurs within one minute of vaginal intercourse
- Substance Induced Sexual Dysfunction: Sexual dysfunction that results from the use or withdrawal of a substance
Variability in Sexual Dysfunction
Additionally, the DSM-5 explains the presentation of sexual dysfunction may vary. Depending on the level of distress a person’s symptoms cause them, sexual disorders are characterized as mild, moderate, or severe. Additionally, sexual issues can be:
- Situational: Issues with sex arise within a specific context (i.e., with a certain partner or during a specific situation)
- Generalized: Symptoms of sexual dysfunctions are experienced across all contexts
- Lifelong: Sexual dysfunction has occurred from a person’s first time of intercourse
- Acquired: A person did not experience distress when they first began having sex, but they acquired symptoms of a sexual disorder later in life
What Does Sex Therapy Entail?
For many, the thought of attending sex therapy can be nerve-wrecking. However, a qualified therapist will spend time building a relationship with a person and will gently assist them in recognizing what sexual topics they would like to address within therapy.
Specific interventions may include mindfulness, directed masturbation, cognitive-behavioral therapy, and psychoeducation (see female orgasmic disorder blog). Also, sex therapy entails taking an integrative approach, so a therapist will determine how a person’s biological, psychological, and social factors contribute to their problem.
Factors Contributing to Sexual Disorders
Below outlines contributing factors to sexual disorders that a therapist can help a client overcome (Weeks, 2005):
Biological Factors
- A therapist can work jointly with a medical professional to determine if a person’s biology is playing a role in their problem.
- Hormones (such as a decrease in estrogen or testosterone) can lead to sexual dysfunction
- Certain medications may lead to sexual issues. For instance, Selective serotonin reuptake inhibitors (SSRI’s), are commonly prescribed for anxiety and depression. However, they can reduce a person’s desire.
Psychological Factors
- Mental health issues (i.e., anxiety and depression) can prevent a person from actively engaging in sex or influence their ability to stay present during sex
- A person’s thought process when sex occurs may negatively contribute to the problem (i.e., thinking that they have to orgasm for their partner may lead to stress and prevent orgasm from occurring)
- Traumatic experiences can prevent a person from feeling safe when having sex
Social and Cultural Factors
- Family and/or Couple Therapy may benefit a person experiencing sexual dysfunction. The messages a person receives concerning sex/sexuality can greatly influence them.
- Communication between sexual partners may need to be adjusted in order to create a context that allows for sexual satisfaction to occur
- Cultural factors shape what many people view as a “normal” sex-life. For instance, people often characterize that having a high sex drive is vital for sexual health. However, many people do not experience arousal at the mere anticipation of having sex, and that is okay (Nagoski, 2015)!
References
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (5th ed.). American Psychiatric Publishing.
- Nagoski, E. (2015). Come as you are: The surprising new science that will transform your sex life. Scribe Publications.
- Rosen, R. C. (2000). Prevalence and risk factors of sexual dysfunction in men and women. Current Psychiatry Reports, 2(3), 189-195. https://doi.org/10.1007/s11920-996-0006-2
- Weeks, G. R. (2005). The emergence of a new paradigm in sex therapy: Integration. Sexual and Relationship Therapy, 20(1), 89-103. https://doi.org/10.1080/14681990412331333955
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