Sex, sensuality and intimacy are an important part of any intimate relationship. Most human beings have a desire to love and be loved, and to participate in sensual and intimate activity. But difficulties can sometimes occur, and health professionals refer to such problems as ‘sexual dysfunction’
There are four main areas of sexual dysfunction that affect both men and women:
Desire disorders - lack of interest in having sex or participating in intimate activity. Such difficulties sometimes evolve due to desire differences between partners, when one person is less interested in sex and/or intimacy than the other.
Having an uncontrolled interest in sex is called “hypersexuality” or “compulsive sexual behaviour”. It is important to discuss such issues with your neurologist as your medication may need to be changed..
Arousal disorders - when you feel that you can't respond physically and emotionally to sexual stimulation or you do get aroused but can’t sustain it. Men who have arousal disorders can experience difficulties in getting an erection suitable for intercourse. Others may get a good erection, but lose it before they reach orgasm. These problems are known as ‘erectile dysfunction’. Medication for erectile dysfunction and appropriate sexual counseling may help. Women with arousal problems might experience vaginal dryness and the use of lubricants can enable them to experience intercourse.
- Orgasmic disorders - women who have difficulties with orgasm may be referred to as ‘anorgasmic’ or ‘preorgasmic’. If men are unable to reach orgasm, this is known as ‘inhibited ejaculation’, ‘delayed ejaculation’ or ‘retarded ejaculation’. If they cannot control their orgasm and come too soon, this is known as ‘premature ejaculation’ or ‘rapid ejaculation’. Quite often, medication used for treating depression and anxiety is associated with orgasmic problems. Changes to medication and sex therapy may assist in such cases.
- Sexual pain disorders - these interfere with the ability to have penile-vaginal intercourse. Consultation with a gynecologist, increased effective sexual stimulation and use of lubricants may solve sexual pain problems.
What causes difficulties with sex, sensuality and intimacy?
Difficulties with sex, sensuality and intimacy, can occur for many reasons including:
- Medical conditions, such as diabetes, high blood pressure or hormonal changes
- Medications, such as antidepressants or antiparkinson’s drugs
- Alcohol or drug abuse
- Vaginal infections
- Depression, anxiety, unhappy relationships, or negative sexual experiences in the past or present
- Temporary changes in sexual activity due major life events such as divorce, menopause, childbirth, death of a loved one, chronic disease or retirement
- Burn-out and a stressful life, job dissatisfaction, or being tired as a result of a heavy workload or looking after your family. This can affect your ability to initiate or perform sexual activity and may reduce your desire for sex.
We would like to thank the following for their contribution:
- Gila Bronner - Certified Sex Therapist and Director of the Sex Therapy Service in the Sexual Medicine Center, Sheba Medical Center, Tel-Hashomer, Israel, firstname.lastname@example.org