Female Sexual Dysfunctions
Lack of Sexual Desire - (Inhibited Sexual Desire, ISD)
Other terms: hypoactive sexual desire; sexual apathy; sexual aversion.
Inhibited sexual desire is one of the most common complaints of couples seeking sex therapy. ISD refers to the lack of sexual appetite or response, together with a low rate of sexual activity. They usually do not fantasize about sex or initiate sex.
There are usually underlying psychological issues with ISD, such as avoidance of sexual contact because of fear of rejection, performance anxiety, embarrassment, fear of criticism or body image concerns. A person with ISD often participates in intercourse only as a marital duty. Affection is sometimes withheld, because there is a fear it might lead to the other partner starting sexual activity.
Sexual aversion, the most extreme form of ISD , is characterized by a person finding sex distasteful or repulsive. This person may have been traumatized by past experiences, such as molestation or rape.
ISD occurs in both men and women and can cause emotional distress or serious relationship problems. When one person is less interested in sex than the other, it can be a source of conflict, communication problems and power struggles.
Sex Therapy/relationship counseling and psychotherapy can help resolve this condition before the relationship becomes further strained.
by Carol Boulware, Ph.D.
ABS Board Certified Sex Therapist - Clinical Fellow, American Academy of Clinical Sexologists
Los Angeles - Santa Monica & Redondo Beach, California
Male Sexual Dysfunctions
Impotence
What is it?
Not having an erection at the “right” time, i’e. inability to ever get an erection or to get one in a certain situation, losing an erection before or during penetration, not being “hard enough.”
What causes it?
- Most men have this happen occasionaly for no apparent reason.
- Erections can’t be commanded or willed, they normally occur when a certain amount of sexual excitement is present.
- Lack of an erection therefore can be a signal that a man isn’t sufficiently excited.
- This may mean that it isn’t the right time/place/partner/activity for him.
- Anxiety about anything, wheter related to the immediate situation or not, may interfere with getting or sustaining and erection.
- Some men may have erectile problems because of physical reactions to relashionship issues or to past negative sexual experience including previous problems with erections.
- Biological factors, i.e. illness, effects of drugs and alcohol, trauma may play a role in young but they are the least likely causes.
What can be done to improve matters?
- Recognition that “sex” doesn’t equal “intercourse”, i.e. enjoyable sex can consist of a variety of different activities, so consideration can be given to not doing anything that requires a “hard” penis for a time.
- Taking more time and trying different kinds of stimulation can help to increase the sexual excitement necessary to get an erection.
- Masturbation is one way a man can become more aware of what kinds of stimulation are most exciting for him.
- Openess to discussion and problem solving around relationship issues or specific sources of anxiety may help.
Premature Ejaculation
What is it?
- Ejaculation occuring before one/both partners wants it to.
- Therefore wide variation in what different individuals would call “coming too soon” and may differ with different partners or stimulations.
- May mean anything from coming during foreplay, to being able to thrust for many minutes - but still not long enough to satisfy the partner.
What causes it?
- May simply be due to a difference in the needs/wants of the partners as opposed to “dysfunction.”
- Younger men often have less control over ejaculation.
- Highly stimulating situations or long time since last ejaculation may result in isolated episodes of premature ejaculation.
What can be done to improve matters?
- Educate about and encourage realistic expectations in both partners, and communication with each other about these and how to meet them.
- Refer to physician or counsellor if this is not sufficient or if there is significant distress over the problem.
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