Sexual Problems

Symptoms

Male and Female: Decreased sexual desire, interest in sex and/or sexual response (difficulty achieving orgasm).

Male:  Premature ejaculation, erectile dysfunction and/or fear of hurting partner.

Female:  Itching, burning, pain and/or bleeding with intercourse and/or vaginismus (involuntary pelvic muscle contraction as a response to fear of pain).

Complications

Loss of intimacy in relationship, avoidance from all sexual activity and/or feelings of inadequacy and being less desirable.

Risk Factors

  • Hysterectomy and other pelvic surgeries

  • Mastectomy which can cause changes in body image

  • Illness or disability of self or partner (heart disease, arthritis, diabetes, chronic pain)

  • Lack of available sexual partner

  • Anxiety, depression, other psychological disorders

  • Prescription drug side effects

  • Partner’s decreased sexual desire and/or decreased sexual function

  • Hormonal changes resulting from breast feeding, menopause, low testosterone

  • Alcohol intake which can affect central nervous system and affect sexual function

  • Fatigue

  • Relationship problems

  • Infertility

  • Chronic pelvic pain, endometriosis

  • Bladder or prostate problems

Treatment Options

    • Open, supportive communication with partner
    • Medical evaluation by a qualified healthcare provider
    • Avoid sex that hurts
    • Expand your sexual repertoire
    • De-emphasize orgasm as the goal of sexual intimacy
    • Counseling- relationship, sex therapy
    • Biofeedback to train voluntary pelvic muscle relaxation and contraction
    • Vaginal weights, Kegel exercises to strengthen pelvic floor muscles
    • Relaxation techniques
    • Water based vaginal lubricants
    • Testosterone therapy, erectile dysfunction medications, penile injections, urethral suppositories, penile surgical implant, noninvasive penile vacuum devices for men
    • Systemic and/or vaginal estrogen therapy for women

Resources

National Vulvodynia Association – www.nva.org

Vulvar Pain Foundation – www.vulvarpainfoundation.org

American Association of Sex Educators, Counselors and Therapists – www.aasect.org

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