Conditions

Sexual Dysfunction

Sexual dysfunction is the general inability to enjoy sexual intercourse. Sexual disorders include sexual desire (libido) problems, disorders in the psychophysiologic processes of the sexual response cycle (desire, excitement, orgasm, resolution), and pain with sexual intercourse.

Sexual dysfunctions are classified as primary (lifelong) or secondary (acquired after normal sexual functioning) and may be generalized (not limited to certain situations, partners, or stimulation) or situational.

The major types of sexual dysfunction include:

• Male erectile disorder (impotence) - the inability to attain or maintain an erection for sexual intercourse
• Ejaculation disturbances - primarily premature ejaculation in men
• Vaginismus - spasm of the vagina preventing penetration and sometimes causing pain during sex.
• Sexual aversion disorde r- the inhibition of sexual arousal and excitement
• Orgasmic disorders - delayed or absent orgasm in either males or females who otherwise have normal sexual desires and arousal
• Dyspareunia - sexual pain disorders
• Sexual dysfunction due to general medical condition
• Substance-induced sexual dysfunction

Signs and Symptoms:

Dependent on the disorder:

• Premature or retarded ejaculation in men
• Inability to maintain an erection
• Pain during intercourse
• Lack or loss of sexual desire
• Difficulty achieving orgasm
• Anxiety and/or depression
• Inadequate vaginal lubrication in women

Diagnosis:

Sexual dysfunction is usually diagnosed from symptom review and consultation on the medical history and lifestyle of the patient. Disorders in females that cause pain usually require a pelvic examination.

Treatment Options:

Depending on the type, severity, and duration of the sexual dysfunction, one or more of the following are recommended:

• Psychotherapy and sex therapy, especially interpersonal therapy
• Behavioral therapy
• Drug therapy
• Adjusting and or changing existing medications if they are a factor
• Surgery of penile venous system for severe cases in which venous leakage occurs
• Penile prostheses
• Vacuum/constrictive devices for erectile dysfunction

Traditional Treatments:

In cases of impotence, your doctor may prescribe sildenafil citrate (Viagra) to help enhance natural response to sexual stimulation by blocking the effect of enzymes that break down cyclic guanosine monophosphate. Other possible drug therapies for impotence are:

• Testosterone - for treating low androgen levels in erectile dysfunction and impotence.
• Vasodilators - such as papaverine, phentolamine, or prostaglandin E1 used alone or in combination and administered via penile injections for erectile dysfunction
• Tricyclics or MAOIs may be prescribed for treating the panic states that often lead to sexual aversion disorder.
• Nefazodone (Serzone) and other antidepressants-may help decrease psychological side effects of sexual dysfunction.
• Dibucaine (1%) or lidocaine (1%)-ointment applied externally for vulval distress.

Complementary and Alternative Therapies:

Alternative therapies have had some success with treating sexual dysfunction. In particular, those therapies that improve circulation or reduce stress are most beneficial.

Nutritional Supplementation:

• Vitamin C can support vascular integrity. Take 1,000 mg, three times daily.
• A combination of Vitamin E, vitamin B6, and zinc can support hormone production. Take 400 IU daily of Vitamin E, 5 0mg daily of vitamin B6, and 30 mg daily of zinc. Warning: If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily. If you are taking blood thinners, consult your doctor before taking supplemental vitamin E
• Magnesium supports hormone production and is a vasodilator. Follow the label directions.
• Vitamin B-complex helps to reduce the effects of stress and may improve symptoms of depression and/or anxiety. Take 50 to 100 mg daily.
• Essential fatty acid complex aids in the formation of sperm and seminal fluid in the prostate gland. Follow label directions.

Alternative Therapies:

• Ginkgo increases peripheral circulation and may improve sexual function related to arterial insufficiency.
  Warning: Ginkgo should be used cautiously with other blood-thinning agents,
• Hawthorn, rosemary, ginger root, and prickly ash bark are circulatory stimulants. Use singly or in combination.
• Yohimbe bark (Pausinystalia yohimbe) is used for sexual dysfunction; however, because of its side effects it should not be used without physician supervision.
• Ashwagandha and schizandra, both Ayruvedic herbs, are said to ensure potency and increase fertility.
• Damiana is good for improving blood flow to the genital area and increasing desire.
• Sarsaparilla contains a testosterone-like substance for men.
• There are a number of herbal products on the market that claim to help sexual potency. These may be worth investigating.

Warnings:

• If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily. If you are taking blood thinners, consult your doctor before taking supplemental vitamin E
• Ginkgo should be used cautiously with other blood-thinning agents.