Sexual Problems, Prevention and Treatment

SEXUAL PROBLEMS

Sexual problems are defined as difficulty during any stage of sexual act (desire, arousal, orgasm and resolution), which prevents the individual or partner from enjoying sexual activity.

Information

Sexual difficulties can begin early in a person's sex life or may develop after the individual has experienced sex in a pleasant and satisfying way. The problem may develop gradually over time or may be sudden and present as a total or partial inability to participate in one or more stages of the sexual act. The cause of sexual difficulties can be physical, psychological, or both, says sexologist in Delhi.

Emotional factors that affect sex encompass both interpersonal and psychological problems within the individual. Interpersonal problems include marital or relationship problems between people or a lack of trust and open communication in the partner. Personal psychological problems include depression, sexual fears or guilt, or previous sexual trauma.

Physical factors that contribute to sexual problems include:

• Back injuries
• Increased prostate gland size
• Diseases (such as diabetic neuropathy, multiple sclerosis, tumors and, in rare cases, tertiary syphilis)
• Drugs, such as alcohol, nicotine, narcotics, stimulants, antihypertensives (blood pressure lowering drugs), antihistamines and some psychotherapeutic drugs (used to treat psychological problems such as depression)
• Endocrine disorders (problems with the thyroid, pituitary or adrenal gland)

• Insufficiency of various organs (such as the heart and lungs)
• Hormone deficiencies (low testosterone, estrogen or androgen levels)
• Neurological damage (such as spinal cord injuries)
• Problems with blood supply
• Some birth defects

Sexual dysfunction disorders are generally classified into four categories:

1.      Sexual desire disorders: Sexual desire disorders (decreased libido) can be caused by a decrease in normal estrogen production (in women) or testosterone (in both men and women). Other causes may include age, fatigue, pregnancy, medications: it is well known that antidepressants reduce sex drive in both men and women. Psychiatric illnesses, such as depression and anxiety, can also cause reduced libido, says the best sexologist in Delhi.

2.      Sexual arousal disorders: Sexual arousal disorders were formerly known as frigidity in women and impotence in men, although these terms have now been replaced by less punitive ones. Impotence is now known as erectile dysfunction and frigidity is currently described as one of several specific problems with desire, arousal or anxiety, explains sexologist doctor in Delhi.

For both men and women, these conditions can manifest as an aversion and rejection of sexual contact with a partner. In men there may be total or partial inability to achieve or maintain an erection or a lack of sexual arousal and pleasure in sexual activity.

There may be medical causes for these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic diseases can also contribute to these difficulties, as well as the nature of the relationship between couples. As confirmed by the success of Viagra, many erectile dysfunctions in man can be mainly physical, not psychological; as for women the most common causes are: Pain for lack of lubrification, for lack of well-made prolegomens; contraction or blockage, lack of appetite, for psycho-emotional problems, explains top sexologist in Delhi.

3.      Orgasm disorders: Orgasm disorders are persistent delay or absence of orgasm after a normal sexual arousal phase. The disorder occurs in both women and men. Again, antidepressants are common culprits, as they can slow the achievement of an orgasm or eliminate it altogether, describes sex specialist in Delhi.

4.      Sexual pain disorders: Sexual pain disorders affect women almost exclusively and are known as dyspareunia (painful sexual intercourse) and vaginismus (an involuntary spasm of the vaginal wall musculature that interferes with sexual intercourse). Dyspareunia can be caused by insufficient lubrication (vaginal dryness) in women. There may also be abnormalities in the pelvis or ovaries that can cause pain with sexual intercourse. Vulvar pain disorders can also cause dyspareunia and inability to have sex due to pain.

Poor lubrication can be the result of insufficient arousal and stimulation or hormonal changes due to menopause or breastfeeding. Irritation from birth control creams or foams can also cause dryness, as can fear and anxiety about sex.

It is unclear what causes vaginismus, but it is believed that previous sexual trauma, such as rape or mistreatment, may play a role. Another female sexual pain disorder is called vulvodynia or vulvar vestibulitis. In this condition, a woman experiences pain and burning during sex, which appears to be related to skin problems in the vulvar and vaginal areas. The cause is unknown, says sex doctor in Delhi.

Sexual dysfunctions are more common in early adulthood: most people seek medical attention for these conditions when they are close to age 30 and throughout their lives. The incidence increases again in perimenopausal and postmenopausal years in women, and in the geriatric population, typically with gradual onset of symptoms most commonly associated with physical causes of sexual dysfunction.

Sexual dysfunction is more common in people who abuse alcohol and drugs. It is also more likely to occur in people with diabetes and degenerative neurological disorders. Progressive psychological problems, difficulty maintaining a relationship, or a chronic lack of harmony with the current sexual partner can also interfere with sexual function, explains sexologist in South Delhi.

Prevention

Open, informative and accurate communication on sexual issues and body image between parents and their children can prevent children from developing anxiety or feelings of guilt about sex and can help them develop healthy sex.

Review all over-the-counter and prescription medications for possible side effects related to sexual dysfunction. Avoiding excessive alcohol and drug use also helps prevent sexual dysfunction, suggests sexologist in East Delhi.

Couples who are honest and open about their sexual preferences and sensations are more likely to avoid some form of sexual dysfunction. Ideally, sexual partners should be able to communicate their sexual desires and preferences.

People who are victims of sexual trauma such as abuse or rape at any age are urged to seek psychiatric counselling urgently. Individual counselling with a trauma expert can demonstrate that it is beneficial in allowing victims of sexual abuse to overcome sexual difficulties and enjoy voluntary sexual experiences with a partner of their choice, says sexologist in Delhi.

Symptoms

• Men or women

• inability to feel excitement
• lack of interest or desire in sex (loss of libido)
• painful sexual intercourse (less common in men than in women)
• Men
• delay or absence of ejaculation, despite adequate stimulation
• inability to control the timing of ejaculation
• inability to achieve an erection
• inability to maintain an adequate erection to develop sexual intercourse
• Women
• urtial pain in the vulva or vagina upon contact with these areas
• inability to achieve an orgasm
• inability to relax the muscles of the vagina enough to allow sexual intercourse
• inadequate vaginal lubrication before and during sexual intercourse
• low libido due to physical/hormonal problems, psychological problems or relationship problems

SIGNS AND EXAMS

The sexologist in Delhi will investigate any physical problems and perform tests based on the particular type of sexual dysfunction you are experiencing. In any case, a complete medical history should be developed and an examination carried out to:

• Highlight specific fears, anxieties, or blame for sexual behaviour or performance.
• Identify any disease or condition that causes predisposition.
• Bring out any history of sexual trauma.

A physical examination of the couple should include the whole body and not be limited to the reproductive system.

Treatment

Sex treatment in Delhi depends on the cause of sexual dysfunction.

For men who have difficulty achieving an erection, the drug sildenafil (Viagra), which increases blood flow to the penis, can be very useful. It should be taken 1 to 4 hours before intercourse. Men who take nitrates for coronary artery disease should not take it.

Mechanical aids and penis implants are also an option for men who can't get an erection and find that sildenafil doesn't help them.

Women with vaginal dryness can be helped with lubricating gels, hormone creams and, in cases of pre-menopausal or menopausal women, with hormone therapy. In some cases, women with androgen deficiency may be helped by taking testosterone. Kegel exercises can also increase blood flow to vaginal/vulvar tissues, as well as strengthen the muscles involved in orgasm.

Vulvodynia can be treated with numbing cream, biofeedback or low doses of some antidepressants that also treat neuralgia.

Simple, open, accurate and supportive education about sex and sexual behaviours or responses can be all that is needed in many cases. Some couples may require joint counselling to address interpersonal problems and communication styles. Psychotherapy may be required to address anxieties, fears, inhibitions, or poor body image.

Complications

Some forms of sexual dysfunction can cause infertility.

Persistent sexual dysfunction can lead to depression in some individuals. It is necessary to determine the importance of the disorder to the individual (or partner, as the case may be). Decreased sexual function is important only if it is a cause for concern for the partner. Also, sexual dysfunction that is not addressed correctly can lead to conflicts or breakups of the partner, warns sexologist in Delhi.