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Psychosexual Dysfunction

(Sexual Aversion; Sexual Apathy; Hypoactive Sexual Desire)

Definition

Psychosexual dysfunction is the inability to become sexually aroused or achieve sexual satisfaction in the appropriate situations because of mental or emotional reasons.
Although psychosexual dysfunction is not life threatening, it can have a major effect on your relationships and self-esteem.

Causes

Psychosexual dysfunction is a sexual dysfunction that is due to psychological causes rather than physical problems, medical illnesses, or the side effects of medication.
Some of the psychological conditions include:
  • Depression
  • Anxiety—feelings of nervousness, fear, or worry
  • Traumatic sexual experience, such as abuse or rape
  • Guilty feelings
  • Stress
  • Negative body image
Isolated Brain
Brain in silhouette
In psychosexual dysfunction physical problems have been ruled out. Mental or emotional problems are at the center of the dysfunction.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Reduced sexual desire or activity is common among women and men. Before treatment can begin, it is necessary to determine whether the dysfunction may be caused by physical causes like diabetes, heart disease, alcoholism, heavy smoking, side effects of medications, or hormonal problems. Only sexual dysfunction due to psychological factors is called psychosexual dysfunction.
Factors that may increase your chances of developing psychosexual dysfunction include:
  • Stress or anxiety from work or social situations
  • Recent pregnancy—This can result from the changes in hormone levels that occur after pregnancy, from postpartum depression, or from stress and fatigue that follow pregnancy because of adjusting to a new baby.
  • Depression
  • Uncertainty about your sexual orientation
  • Worry about how you are able to perform sexually
  • Fear due to previous disturbing or painful sexual experiences or encounters
  • Conflict with your spouse
  • Religious, social, or cultural restrictions
  • Guilt
  • Financial worries
  • Family problems
  • Abusive relationship with partner
  • Negative body image

Symptoms

Symptoms of psychosexual disorder may differ for men and women.
Symptoms for men include:
  • Not able to keep an erection
  • Ejaculations occur too soon
  • Ejaculations do not occur
  • Not able to become aroused when appropriately stimulated
  • Not able to achieve orgasm
  • Inhibited sexual desire
Symptoms for women include:
  • Not able to become aroused when appropriately stimulated
  • Not able to achieve orgasm
  • Inhibited sexual desire
  • Vaginismus—an unconscious spasm or tightening of the muscles around the vagina that interferes with sexual intercourse
  • Experiencing pain during sex
  • Dry vagina

Diagnosis

Your doctor will ask about your symptoms, your medical history, and your sexual history. A physical exam will be done. Make sure to tell your doctor about all the medications you are currently taking. Your doctor may also ask questions about your partner.
Your bodily fluids may be tested. This can be done with blood tests.
You may have a psychological assessment. This can be done with:
  • A depression scale
  • A mini mental state examination (MMSE)
Men may have tests done to assess erection ability. This can be done with:
  • A snap gauge
  • A vascular assessment
Women may have additional tests done, such as:
  • A vaginal exam
  • Tests of bodily fluids, such as cultures or vaginal samples
If your doctor does not find anything significant from the examination or these tests, your doctor may refer you to a psychologist or psychiatrist.

Treatment

Talk with your doctor about the best treatment plan for you. The most appropriate treatment will depend on the cause of the psychosexual dysfunction.
Some medications can alleviate the symptoms. However, to successfully manage psychosexual dysfunction, it is important to treat and manage mental and emotional issues.
Treatment options for psychosexual dysfunction include the following:

Medication

Medications may be prescribed to treat the symptoms, such as medications used to treat psychological like anxiety and depression.

Psychotherapy

Psychotherapy allows you to talk and work with a psychiatrist, psychologist, social worker, or licensed counselor to figure out ways to deals with stressful or painful issues.

Sex Therapy

Sex therapists assist you by encouraging communications, teaching you about sexual fantasies, and helping you focus on sexual stimuli.

Behavioral Therapy

A psychiatrist, psychologist, social worker, or licensed counselor works with you to unlearn automatic behaviors.

Marriage or Relationship Counseling

Couples meet with a psychologist, social worker, or other type of mental health professional to discuss issues, including communications problems.

Prevention

There are no known ways to prevent psychosexual dysfunction.
To help reduce your chances of developing psychosexual dysfunction, take the following steps:
  • Stay aware of your psychological or emotional health.
    • Call your doctor or mental health provider if you feel the problems surfacing again, you are experiencing excessive stress, or you anticipate a stressful situation in the near future.
  • Spend time alone with your partner often, especially nonsexual intimate time, to help maintain the relationship. This will most likely lead to increase sexual interest.
  • Continue to communicate openly with your partner about intimacy and sexual issues.

RESOURCES

American Psychological Association http://www.apa.org

Mental Health America http://www.mentalhealthamerica.net

CANADIAN RESOURCES

Canadian Psychological Association http://www.cpa.ca

Sex Information and Education Council of Canada http://www.sieccan.org

References

AACE male sexual dysfunction task force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple’s problem–2003 update. Endocrine Practice. 2003; 9(1):77-94.

Crenshaw TL, Goldberg JP, et al. Pharmacologic modification of psychosexual dysfunction. Journal of Sex & Marital Therapy. 1987;13(4):239-252.

Cutler SJ, Smith W, et al. Treatment of sexual dysfunction. US Pharmacist. 2002;23(5).

Female sexual problems. American Association for Marriage and Family Therapy website. Available at: http://www.aamft.org/imis15/content/Consumer%5FUpdates/Female%5FSexual%5FProblems.aspx. Accessed August 12, 2013.

Glass CA. Addressing psychosexual dysfunction in neurological rehabilitation settings. Journal of Mental Health. 1995;4(3).

Phillips NA. Female sexual dysfunction: evaluation and treatment. American Family Physician. 2000;62(1):127-136.

Reiner WG, Gearhart JP, et al. Psychosexual dysfunction in males with genital anomalies: Late adolescence, Tanner states IV to VI, Journal of the American Academy of Child & Adolescent Psychiatry. 1999;38(7):865-872.

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