Sexual Disorders
Several studies have found that one half or more couples have had or will eventually have sexual problems at some time of their relationship. Sexual problems are experienced because of individual differences - people are different in what they want and how often they want it!
We in Pakistan have lack of complete and correct information regarding growing up, such as nocturnal emission/wet dreams, masturbation, sexual intercourse and menstruation which can lead to sexual dysfunctions.
For example, people relate masturbation with ‘values’ which can lead them to feeling guilty. They believe in myths that this will make them weak, impotent or blind.
Traditionally females get information regarding hygiene but never about their sexuality. Their information needs on sexuality are never met. This makes them believe that sex is for reproduction and not for pleasure.
The Media is also creating confusion by projecting fantasies, reinforce stereotypes and therefore indirectly unsafe sexual behaviors.
While sexual dysfunctions rarely threaten physical health, they can take a heavy psychological toll, bringing on depression, anxiety, and debilitating feelings of inadequacy.
What is a Sexual Problem?
In general terms a sexual problem is defined as difficulty during any stage of the sexual act (which includes desire, arousal, orgasm and resolution) that prevents the individual or couple from enjoying sexual activity.
To understand this we need to have information about the normal Human Sexual Response Cycle:
Human Sexual Response Cycle
Human Sexual Response Cycle is a four phase model of physiological response during sexual stimulation. These phases in order of their occurrence are:
- Desire / Excitement
- Arousal
- Orgasm
- Resolution
Desire / Excitement Phase also known as the arousal phase is the first stage of the Human Sexual Response Cycle. It occurs as the result of any erotic, physical or mental stimulation. During this phase the body prepares for sexual intercourse.
Arousal Phase is the period of sexual excitement prior to orgasm. At this stage both males and females may begin to vocalize involuntarily by making sounds, grunting, moaning etc.
Orgasm Phase is the conclusion of the Plateau Phase and is experienced by both males and females. In males Orgasm is usually associated with ejaculation. It may also play a significant role in fertilization.
Resolution Phase Males and Females may not experience this refractory phase and further stimulation may cause a return to the Plateau stage. This allows the possibility of multiple orgasms in both sexes specially in females.
In addition, refractory periods range from human to human, with some being immediate (no refractory) and some being as long as 12 to 24 hours. (www.wikipedia.org/wiki/Human_sexual_response_cycle)
Is the Human Sexual Response Cycle same in Males and Females?
It is indeed somewhat different in males and females. Males need to discharge or stop the activity once Orgasm is reached. Women however have the capacity to move to and fro from excitement, orgasm, and plateau phases. This difference between men and women requires complete understanding because a lack of understanding forces men and women to focus on “performance” in sexual intercourse having a negative impact and creating sexual dysfunctions.
What are the causes of sexual difficulties?
The causes of sexual difficulty may be physical, emotional, psychological or a combination of all three.
Physical factors include drugs (like antihypertensive, anti histamines and some psycho therapeutic drugs), injuries to the back and large prostate problem with blood supply nerve damage and tertiary syphilis.
Emotional factors effecting sex include interpersonal problems such as lack of trust and open communication between partners.
Psychological factors include depression, sexual fears or guilt, past sexual trauma etc
How is lack of Communication a cause for Sexual Problems?
Sex is a difficult topic to discuss. Especially sexual problems. Most people have little experience talking about sex in an intelligent and mature manner. Inaccurate information about sexual health matter can lead to incorrect assumptions about the opposite sex.
What are some of the Sexual Challenges experienced by Males?
- Inability to attain an erection
- Inability to maintain an erection adequately for intercourse
- Delay or absence of ejaculation despite adequate stimulation
- Inability to control timing of ejaculation.
- Premature Ejaculation
- Impotence
- Retarded Ejaculation
What are some of the Sexual Challenges experienced by Females?
- Inability to relax vaginal muscle enough to allow intercourse which is vaginismus.
- Inadequate vaginal lubrication preceding and during intercourse
- Inability to attain orgasm
- Burning pain on the vulva or in the vagina with contact to those areas.
- Vaginismus, chronic pelvic pain, problem in female organism, no sex drive in woman and painful intercourse (Dyspareunia)
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Males and Females – General Sexual Problems
Inhibited sexual desire
Lack of interest in sex is a problem where there is persistent and pervasive inhibition of sexual desire. So what’s normal sexual desire?
“Inhibited” is a relative term that must take into account the partners frequency of desire and the level of desire of other people in the community. Some therapists classify a person as having inhibited desire if they initiate an average of two or fewer sexual experiences per month. This does not have to mean intercourse and can include masturbation and sex play.
Those with inhibited sexual desire not only show a complete lack of desire but also avoid the opportunity when presented.
The anticipation of any kind of sexual interaction causing great anxiety.
Hyper sexuality:
This refers to a persons approach to sex rather than the number of times they have sex. A hyper sexual individual is distinguished from other people by the compulsiveness with which he or she engages in sex. Hyper sexual individuals engage in sex repeatedly and compulsively usually finding little or no emotional satisfaction. They feel driven to have sex looking for something in sex that they can never find.
Hyper sexuality interferes with the ability to deal with normal daily affairs and results in an inability to break a pattern of compulsive behavior.
Painful intercourse
Also called Dyspareunia this can occur in both males and females. In males the most common causes are prostrate or bladder infection or in uncircumcised males the foreskin of the penis being too tight, which causes pain during erection.
Dyspareunia in woman maybe due to vaginal dryness, use of anti histamine medication, use of tampons or water soluble lubricants, endometriosis, pelvic inflammatory disease vaginal infections, allergies to semen, powders and spermicide. If the physical factors responsible for Dyspareunia are not addressed, it can lead to sexual problems like erectile problems in males and vaginismus in woman.
Sexual Cephalgia
Sexual Cephalgia is the occurrence of severe headaches during sex.
The headaches are generally caused by contractions of muscles and of blood vessels in the head neck or upper body during intercourse. The headaches often disappear for weeks or months at a time and than suddenly reappear.
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