Sexual Health and Dysfunction

Sex is a satisfying and vital part of life, and it’s important to remember that a wide range of sexual desires, preferences, and interests are considered normal and healthy.

However, sometimes, sex can become stressful. Many people face challenges surrounding desire, arousal, and intimacy in sexual relationships. These challenges can arise for individuals of any sexual orientation or gender identity.

When sexual difficulties lead to mental health problems or interfere with your everyday life, therapy can help you manage your emotional health and improve your quality of life.

What is sexual dysfunction?

The term “sexual dysfunction” describes any difficulty occurring during the sexual response cycle that prevents individuals or couples from experiencing satisfaction.

According to the Cleveland Clinic, the four categories of sexual dysfunction are:

• Sexual desire disorders: Lack of sexual desire or interest in sexual activity
• Arousal disorders: Inability to become sexually aroused or excited during sexual contact
• Orgasm disorders: Delay or absence of orgasm (climax), e.g., anorgasmia and female orgasmic disorder.
• Pain disorders: Pain during intercourse (dyspareunia).

Sexual dysfunction is relatively common, with 43% of women and 31% of men reporting problems during the sexual response cycle. It’s important to remember that several treatment options are available, and sharing your feelings and concerns with your partner(s) and your doctor can help you find a solution.

What causes sexual dysfunction?

Sex therapists and specialists versed in sexual health and dysfunction can provide support for a wide variety of sexual difficulties. Some common problems related to sexual dysfunction include:

• Challenges surrounding sexual arousal and orgasm: You might find it difficult to feel aroused or achieve orgasm, or you might climax sooner than you want to. Erectile dysfunction, premature ejaculation, and sexual arousal disorder are examples of arousal-related challenges.

• Lack of sexual desire or different desires: You or your partner(s) may not feel as much sexual desire as you want to, or you might not share the same libido, sexual feelings, or sexual interest.

• Painful intercourse: Painful intercourse, or dyspareunia, is often caused by underlying medical conditions, However, it can sometimes be related to stress or anxiety surrounding sex.

• Sexual orientation and gender identity issues: If you’re struggling with any aspect of your sexual orientation or gender identity—such as discrimination or anxiety around coming out—these challenges may also affect your sex life. Although these challenges are more common among young people, questions surrounding identity can arise at any age.

• Paraphilic disorders: The Diagnostic and Statistical Manual of Mental Disorders outlines the diagnostic criteria for several sexual disorders, called paraphilic disorders. Some examples of sexual disorders include voyeuristic disorder and exhibitionistic disorder.

• Hormonal changes: Estrogen, progesterone, and testosterone affect sexual function and arousal. Changes in hormone levels, such as a drop in estrogen levels during menopause, can lead to vaginal dryness and painful intercourse. Similarly, a drop in testosterone levels after the removal of the ovaries can lead to female sexual dysfunction. Higher levels of estrogen can promote vaginal lubrication and boost sexual desire, while increases in progesterone can reduce sexual desire.

• Physical problems: Many health problems can cause sexual difficulties, including Peyronie’s disease (nerve damage to the penis), cardiovascular disease and heart disease, Parkinson’s disease, prostate cancer, sclerosis, bladder issues, obesity, vaginismus, STIs, and impotence.

• Psychological factors: Psychological factors, including work-related stress, concerns about sexual function, relationship problems, self-esteem issues, fatigue, and past sexual trauma or sexual assault, can lead to sexual dysfunction, loss of libido, and sexual intimacy issues.

Sexual Dysfunction and Mental Health

The mental health symptoms associated with sexual function and dysfunction vary widely, but some of the most common ones include:

• Anxiety and worry: You might feel overwhelmed with thoughts and worries about sexual problems, or you might even feel like your anxiety interferes with intimacy and sexual intercourse.

• Sadness or depression: Traumatic and/or unsatisfying sexual experiences can lead to feelings of sadness and depression.

• Self-esteem issues: Especially in cultures that place a high value on sex appeal, experiencing sexual problems or dysfunction can negatively affect an individual’s self-esteem.

• Relationship problems: Sexual difficulties can lead to relationship problems and conflicts in sexual relationships.

What should you do if you’re experiencing sexual problems?

Many issues related to sexual dysfunction can be resolved by treating the underlying physical and psychological problems. Some treatment options include:

• Therapy: Working with a therapist can help you navigate your mental health challenges and find strategies for improving your symptoms. You might choose to attend therapy on your own, or you and your partner(s) may attend couples counseling sessions.

• Check-ups: Since some medical conditions can lead to sexual difficulties, it’s important to stay up-to-date with your medical appointments. Scheduling regular check-ups with your primary care provider can help you rule out any health problems that may be contributing to your symptoms. Depending on your symptoms, your doctor may refer you to a specialist, such as an OB-GYN or urologist, for a pelvic exam and other diagnostic tests.

• Medication:  Certain medications—such as antidepressants, antihistamines, birth control, chemotherapy, oral medications, and injections for hormone imbalances—can affect a person sexually, with side effects including low libido and low sexual desire, erection problems, a reduction in vaginal lubrication, and difficulty achieving orgasm. Your doctor may recommend modifying the dose or taking another medication to counteract the problem such as medication to treat erectile dysfunction like Cialis, Viagra, or Levitra. Your doctor might also suggest alternative measures such as a vaginal lubricant.

• Education: Reproductive health and sexual health education can help provide people of all ages with the knowledge and skills needed to make healthy choices, avoid STDs and unintended pregnancy, and appropriately use birth control and emergency contraception, according to the United States Centers for Disease Control.

Therapy for Sexual Health

Mental health professionals differ in their approaches to treating sexual problems. While some specialists have extensive experience in sex therapy, others use general approaches to help individuals navigate mental health concerns. Some common types of therapy to treat challenges surrounding sexual health and intimacy include:

• Cognitive-behavioral therapy (CBT)
• Interpersonal psychotherapy
• Psychodynamic therapy
• Mindfulness practices
• Couples counseling

If you’re struggling with problems related to sexual health, reach out to a mental health professional through WithTherapy. Whether you’re interested in individual therapy sessions or couples counseling, we’ll connect you to a therapist you feel comfortable with, regardless of your personal preferences and requirements.

One of the therapists on the WithTherapy platform will help you create a custom treatment plan to navigate your mental health concerns, foster healthy relationships, and improve your quality of life.

Find a Therapist to Help With Sexual Health and Dysfunction