Sex Disorders

There are many different types of sexual disorders. This does not mean that there is something ‘wrong” with you, only that you are experiencing the kind of issue that can suddenly affect anyone at any time in their lives. While many sexual issues can be traced back to a physical problem or a sudden change in one’s life circumstance, many sexual disorders’ causes are not well known or understood. There is no cause for concern because there are a wide variety of treatments – from medications to different forms of psychotherapy – that can help virtually everyone with a sexual disorder, no matter what the concern.

Dyspareunia

This is a recurrent or persistent genital pain associated with sexual intercourse in either male of female. This can cause marked distress or interpersonal difficulty.

This may occur for a variety of reasons raging from structural problems to psychological concerns.

Symptoms:

If you experience painful intercourse, you may feel:

  • Pain only at sexual penetration (entry)
  • Pain with every penetration, even while putting in a tampon
  • New pain after previously pain-free intercourse
  • Deep pain during thrusting
  • Burning pain or aching pain
  • Throbbing pain, lasting hours after intercourse

Causes

There could be physical factors that could affect pain during penetration such as:

  • Insufficient lubrication
  • Injury, trauma or irritation
  • Inflammation, infection or skin disorder
  • Vaginismus: Involuntary spasms of the muscles of the vaginal wall that can make attempts at penetration painful
  • Congenital abnormality

Emotions are intertwined with sexual activity and may play a role in any type of sexual pain. Emotional factors include:

  • Psychological problems: Anxiety, depression, concerns about your physical appearance, fear or intimacy or relationship problems can contribute to low level of arousal and a resulting discomfort or pain
  • Stress: Your pelvic floor muscles tend to tighten in response of stress in your life. This can contribute to pain
  • History of sexual abuse: Most women with dyspareunia don not have a history of sexual abuse, but if you have been abused, it may play a role.

Erectile Disorder Symptoms

This is the inability to get and keep an erection firm enough for sex. Having erection trouble from time to time is not necessarily a cause of concern. If this is an ongoing issue, it can cause stress, affect your self-confidence and contribute to relationship problems.

Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease down the road.

Symptoms:

Erectile dysfunction symptoms might include:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

Causes

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Stress and mental health concerns can cause of worsen erectile dysfunction.

Physical causes of erectile dysfunction:

In most cases, erectile dysfunction is causd by something physical. Common causes include:

  • Heart disease
  • Clogged blood vessels
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome – a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholestrol
  • Parkinson’s disease
  • Multiple sclerosis
  • Peyronie’s disease – development of scar tissue inside the penis
  • Certain prescription medications
  • Tobacco use
  • Alcoholism and other forms of substance abuse
  • Sleep disorders
  • Treatments for prostrate or enlargened prostate
  • Surgeries or injuries that affect the pelvic area of spinal cord

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

  • Depression, anxiety or other mental health conditions
  • Stress
  • Relationship problems due to stress, poor communication or other concerns
  • Guilt
  • Low self-esteem         

Source: Mayo Clinic

Exhibitionism

This involves recurrent, intense sexually arousing fantasies, sexual urgers or behaviors that involve the exposure of one’s genitals to an unsuspecting stranger. This will last over a period of at least six months.

This falls under the psychiatric sexual disorder category of paraphilias, which is an unnatural attraction of obsession with unusual sexual practices that involve non-consenting or inappropriate partners.

Social and sexual relationships may suffer if the behavior is found disturbing or if the individual’s sexual partner refuses to cooperate with this particular preference. These individuals rarely seek help on their own, and are likely to get professional assistance only when their behavior has brought them into conflict with sexual partners of society.

Symptoms

The key features of true exhibitionism are:

  • Sexual arousal directly related to surprising the victim
  • The victim is unwilling
  • No further sexual contact is desired

Clinical diagnosis is made is patient:

  •  Over the period of at least six months, has recurrent sexually arousing fantasies or behavior involving exposing genitalia to an unsuspecting stranger
  • The person has acted on these sexual urges or the fantasies cause marked distress or interpersonal difficulty in the workplace or in everyday social situations

Causes

There is no consensus on the cause of exhibitionism and the factors depend on the individual case.

A behavioral learning model suggests that a child who is the victim or obsrver of inappropriate sexual behaviors learns to imitate and later receive reinforcement for the behavior.

Another biological theory holds that testosterone, the hormone that influences the sexual drive in both men and women increases the likelihood of males to develop deviant sexual behaviors.

Several studies suggest that emotional abuse in childhood and family dysfunction are both significant risk factors in the development of exhibitionism.

Treating Exhibitionism

Cognitive therapies include restructuring cognitive distortions and empathy training. This involves correcting beliefs by the patient such as the victim deserves to be party to the deviant act. Empathy training involves helping the offender take on the perspective of the victim to understand the harm that has been done.

Group therapy can help patients past the denial frequently associated with paraphilias, and as a form of relapse prevention. Exhibitionists who feel guilty and anxious about their behavior are often helped by the social support.

Orgasmic Dysfunction

This is a condition that occurs when someone has difficulty reaching orgasm, even when they are sexually aroused and there’s sufficient sexual stimulation. It is more commonly experienced by women.

Causes

This may be due to a physical, emotional or psychological factors. Contributing factors might include:

  • Older age
  • Medical conditions such as diabetes
  • (For women) A history of gynecological surgeries, such as a hysterectomy
  • The use of certain medications, particularly selective serotonin reuptake inhibitors (SSRIs) for depression
  • Cultural or religious belies
  • Embarrassment or shyness
  • Guilt about enjoying sexual activity
  • History of sexual abuse
  • Mental health conditions, such as depression or anxiety
  • Stress
  • Poor self-esteem
  • Relationships issues, such as unresolved conflicts of lack of trust

Compulsive sexual behavior

Compulsive behavior is sometimes called hypersexuality, hypersexual disorder, nymphomania or sexual addiction. It is an obsession with sexual thoughts, urges or behaviors that may cause you distress or that negatively affects your health, job, relationships or other parts of your life.

This behavior may involve a commonly enjoyable sexual experience (for example, self-stimulation) that becomes an obsession and disruptive or harmful to you others. Other compulsive sexual behaviors are outside the bounds for commonly accepted conduct (e.g., paying for sex or extramarital affairs) and cause distress.

Symptoms:

These are some indications that may be struggling with compulsive sexual behavior include:

  • Your sexual impulses are intense and feel as if they’re beyond your control
  • Even though you feel driven to do certain sexual behaviors, you may or may not find the activity a source of pleasure or satisfaction
  • You use compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety or stress
  • You continue to engage in sexual behaviors that have serious consequence, such as the potential for getting or giving someone else a sexually transmitted infection, the loss of important relationships, trouble at work or legal problems
  • You have trouble establishing and maintaining emotional closeness, even if you’re married or in a committed relationship

Cause

Although the causes of compulsive sexual behavior are unclear, they may include:

  • An imbalance of natural brain chemicals: certain chemicals in your brain such as serotonin and dopamine. High levels may be related to compulsive sexual behavior.
  • Conditions that affect the brain. Certain diseases of health problems such as epilepsy, Huntington’s disease and dementia may cause damages to parts of the brain that affect sexual behavior.
  • Changes in brain pathways: this addiction might cause changes in the brain’s neural circuits. These changes may cause pleasant reactions by engaging in sexual behavior and unpleasant reactions when the behavior is stopped.

It may occur in people who have:

  • Alcohol or drug abuse problems
  •  Another mental health conditions, such as a mood disorder (depression or bipolar) or a gambling addiction
  •  A history of physical or sexual abuse

Treatment

This typically involves psychotherapy, medications and self-help groups. This helps you manage urges and reduces excessive behaviors while maintaining healthy sexual activities. 

People with compulsive sexual behavior often have alcohol or drug abuse problems or other mental health problems that need treatment – such as obsessive-compulsive behaviors, anxiety or a mood disorder such as depression.

Psychotherapy: This can help you manage your compulsive sexual behavior. This helps to identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.

Medication: This can be helpful because they act on brain chemicals linked to obsessive thoughts and behaviors and reduce the chemical ‘rewards’ these behaviors provide when you act on them.

Group therapy: This can help individuals learn about their disorder, find support and understanding of their condition, as well as identify treatment options and resources.

Source: Health LineMayo Clinic, Psych CentralPsych CentralPsychology Today