The Human Body

Sexual Dysfunctions

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Sexual dysfunctions are problems with sexual response that cause distress. Erectile dysfunction (impotence) refers to the inability of a man to have or maintain an erection. Premature ejaculation occurs when a man is not able to postpone or control his ejaculation. Inhibited male orgasm, or retarded ejaculation, occurs when a man cannot have an orgasm despite being highly aroused.

Female orgasmic dysfunction (anorgasmia, or inhibited female orgasm) refers to the inability of a woman to have an orgasm. Orgasmic dysfunction may be primary, meaning that the woman has never experienced an orgasm; secondary, meaning that the woman has had orgasms in the past but cannot have them now; or situational, meaning that she has orgasms in some situations but not in others. Vaginismus refers to a spastic contraction of the outer third of the vagina, a condition that can close the entrance of the vagina, preventing intercourse.

Dyspareunia refers to painful intercourse in either women or men. Low sexual desire is a lack of interest in sexual activity. Discrepant sexual desire refers to a condition in which partners have considerably different levels of sexual interest. These dysfunctions may be caused by physical problems such as fatigue or illness; the use of prescription medications, other drugs, or alcohol; or psychological factors, including learned inhibition of sexual response, anxiety, interfering thoughts, spectatoring (observing and judging one's own sexual performance), lack of communication between partners, insufficient or ineffective sexual stimulation, and relationship conflicts. In such cases, a qualified sex therapist can work with a physician, if necessary, to determine the cause and best treatment options.