Sexual Problems and Dysfunctions

Introduction Our sexuality is certainly one of the most basic aspects of our existence. It is the component of life we share with all other living things on this planet. At the core of human sexuality is our biological drive to continue the species a drive we can never completely escape or suppress, even if we wanted to. But it is a drive that varies greatly from one person to the next one stage of life to the next and, one moment to the next. The wonderful difference of being human is the capacity to be self-aware to observe ourselves so to speak, and to analyze our own thoughts, feelings, behaviors and motives. But it is this difference that can interfere with our capacity to enjoy our sexuality because this powerful sexual drive can be negatively influenced by experiences, medical conditions and thought.

What Causes Sexual Problems? While some problems of sexual functioning (erection, lubrication, orgasm, pain, etc.) may be related to biological or chemical (prescription or illicit drugs, or alcohol) problems, the majority of the sexual problems treated by sex therapists can be generally placed in the psychological or relationship category. It is estimated that as many as half of the sexual problems that damage peoples lives and relationships are, in part, the result of inadequate knowledge. We know that the sexual functioning of even very highly educated people is adversely affected by a lack of accurate information. In some cases a rigid or fearful "sex education" in childhood from parent, teacher, church or media can lead to very serious problems later in life. In addition, the widespread occurrence of rape, incest, and sexual assault in our society quite often results in a profoundly negative effect on self-esteem and sexual functioning. Add to this the high incidence of physical abuse, neglect and sexual abuse that happens to children and adolescents and we begin to understand why studies show that half of all long-term intimate relationships will experience at least one sexual dysfunction. Finally, significant problems not directly related to sex within a relationship can result in diminished or absent sexual pleasure. Fortunately, advances in psychological and sexual science have led to a reasonable potential for healing the damage wrought by these destructive events and influences.

What Are The Most Common Sexual Problems? Among males, especially among younger men, the most common problem is Premature Ejaculation the inability to exert consistent control over the timing of his orgasm. Although some males learn ejaculatory control more quickly than others, the important fact is that it must be learned by all males. Given the importance of mutual sexual pleasure to modern relationships, it is vital that men learn to control the timing of their orgasm, at least three-fourths of the time, in order to have good ejaculatory control. Sex therapy can most often help resolve this problem relatively quickly.

The next most common male sexual problem is Erectile Dysfunction (ED), the incapacity to achieve or maintain an adequate erection. Although all men experience occasional difficulties achieving or maintaining an erection, for many it is a frequent or chronic problem causing problems within a relationship. It is important to determine if the problem is primarily medical or psychological and related to stress. It is not unusual to find that the problem is a combination of the two. While many men have been helped a great deal by the prescription erectile dysfunction medications currently available, some have discovered that personal and relationships problems continue to have a negative influence on their sexual performance.

Female Sexual Arousal Disorder is receiving a good deal of recent research. Many women report that they experience adequate sexual desire and genuinely wish that they were responsive, or much more responsive with their partner, but find that sexual excitement rarely or never happens during sexual interactions. If this problem continues for more than six months, or has always been the case regardless of partner, she should consult with a sex therapist.

Although more common among females, both men and women experience Anorgasmia, the inability to experience an orgasm. It is likely that the majority of females who report an inability to orgasm during heterosexual intercourse are perfectly normal especially if they don't have orgasm problems when with other sources of genital stimulation. It is estimated that only 30-40% of women are able to consistently orgasm due to intercourse alone that is, without additional sensory attention to the clitoris. However some people report that they have never or only very rarely orgasm regardless of a substantial number of attempts and no matter the stimulation source self or partner. They may report that they get adequately or even highly sexually aroused, but orgasm doesn't occur. In these cases it would be best to consult a sex therapist.

Men and women both might experience Inhibited Sexual Desire or sometimes called Hypoactive Sexual Desire people who report they never or almost never think about sex in a positive way. Fear, past sexual trauma, severe psychological depression, and relationship problems are frequent causes of ISD, usually requiring general psychotherapy specific to the actual cause, and sex therapy following successful psychotherapy or relationship counseling.

Physical pain during sex called Dyspareunia is almost always caused by a medical problem and should be investigated by a gynecologist or urologist. An exception to this rule is the female disorder called Vaginismus, the spastic and painful tensing of the muscles surrounding the vagina whenever any penetration begins, or is about to begin. Sex therapists can effectively treat this problem.

For many couples, the "sexual problem" is not a specific dysfunction such as those listed above, but instead the problem is that there is little or no passion in their relationship and/or that sexual activity rarely occurs. If this is the case, the therapist will focus with you on Sexual Enhancement techniques to help you either get started or get back on track with the sexually intimate component of your relationship.

What To Do? There are other sexual problems in addition to those listed above. In most cases, if appropriate, it is advised that the person experiencing a problem of sexual functioning consults a sensitive trained physician to rule out the possibility of medical causes. If the problem is obviously related to serious difficulties within a relationship, getting some professional assistance from a couples counselor may greatly enhance the sexual component. If the sexual problem is not primarily medical, but of long duration (over six months, or there has never been adequate functioning) it is probably best to consult with a trained board certified sex therapist. Finally, since useful sex education is extremely rare in our culture, accurate sex information must be provided since it leads to increased comfort and confidence.

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Comfortable, healthy and exciting sexual functioning does not easily happen for many individuals and couples. Very few of us have been taught how to have a healthy relationship, and few people have the basic knowledge regarding male and female sexual functioning that could make a relationship blossom. Fortunately, these are skills that can be learned, and sex therapy can be an effective way to learn them. In almost all cases, people and relationships experiencing sexual problems are found to have a pattern of increasing avoidance of sex and even affectionate behaviors that might lead to sex. These problems almost always get worse and rarely go away on their own. The passionate component of your relationship has been discovered by researchers to comprise one-third of the overall health of your relationship.

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