Sexual Dysfunctions
Roughly 43% of women and 31% of men suffer from a clinically significant impairment to their ability to experience sexual pleasure or responsiveness as outlined by the SRC (Rosen, 2000). The Diagnostic and Statistical Manualof Mental Disorders, 5th edition (DSM) refers to these difficulties as sexual dysfunctions.
The most commonly reported male sexual dysfunctions are premature ejaculation (PE) and erectile dysfunction (ED), whereas females most frequently report dysfunctions involving desire and arousal. Females are also more likely to experience multiple sexual dysfunctions (McCabe et al., 2016).
PE is a pattern of early ejaculation that impairs sexual performance and causes personal distress. In severe cases, ejaculation may occur prior to the start of sexual activity or within 15 seconds of penetration (American Psychiatric Association, 2013). PE is a fairly common sexual dysfunction, with prevalence rates ranging from 20-30%. Relationship and intimacy difficulties, as well as anxiety, low self-confidence, and depression, are often associated with PE. Most males with PE do not seek treatment (Porst et al., 2007).
ED is the frequent difficulty to either obtain or maintain an erection, or a significant decrease in erectile firmness. Normal aging increases the prevalence and incidence rates of erectile difficulties, especially after the age of 50 (American Psychiatric Association, 2013). However, recent studies have found significant increases in the prevalence of ED in young men, less than 30 years of age (e.g., Capogrosso et al., 2013).
Treatments
When it comes to treating sexual dysfunctions, there’s some good news and there’s some bad news. The good news is that most sexual dysfunctions have treatments—however, most people don’t seek them out (Gott & Hinchliff, 2003). So, the further good news is that—once you have the knowledge (say, from this module)—if you experience such difficulties, getting treatment is just a matter of making the choice to seek it out. Unfortunately, the bad news is that most treatments for sexual dysfunctions don’t address the psychological and sociocultural underpinnings of the problems, but instead focus exclusively on the physiological roots. For example, Montague et al. (2007, pg. 1-7) make this point perfectly clear in The American Urological Association’s treatment options for ED: “The currently available therapies…for the treatment of erectile dysfunction include the following: oral phosphodiesterase type 5 inhibitors, intra-urethral alprostadil, intracavernous vasoactive drug injection, vacuum constriction devices, and penile prosthesis implantation.”
Treatments that focus solely on managing symptoms with biological fixes neglect the fundamental issue of sexual dysfunctions being grounded in psychological, relational, and social contexts.
Relationship issues like frequent disagreement and conflict can lead to sexual dysfunction. [Image: Ed Yourdon, https://goo. gl/9e8YU5, CC BY-NC-SA 2