Sexual Problems

Symptoms-

Male and Female Symptoms:

  • Decreased sexual desire

  • Decreased interest in sex

  • Decreased sexual response, difficulty achieving orgasm

Male Symptoms:

  • Premature ejaculation

  • Erectile dysfunction

  • Fear about hurting partner

Female Symptoms:

  • Itching, burning, pain and bleeding with intercourse

  • Vaginismus- involuntary pelvic muscle contraction as a response to fear of pain

Complications of Sexual Problems-

  • Loss of intimacy in relationship

  • Avoidance from all sexual activity

  • Feelings of inadequacy and being less desirable

Risk Factors for Sexual Problems-

  • 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

Steps to address Sexual Problems:

  • Medical evaluation by a qualified healthcare provider

  • Referrals for counseling, sex therapy as needed

  • Open, supportive communication with partner

  • Relationship counseling as needed

  • Avoid sex that hurts

  • Expand your sexual repertoire. Experiment with a sexually stimulating activity that avoids pain. Focus on sensual pleasure as well as sexual pleasure.

  • De-emphasize orgasm as the goal of sexual intimacy

Treatment Options:

  • Counseling, sex therapy

  • Biofeedback to train voluntary pelvic muscle relaxation and contraction

  • Vaginal weights, Kegel exercises to strengthen pelvic floor muscles

  • Relaxation techniques

  • Systemic and/or vaginal estrogen therapy for women

  • Testosterone therapy, erectile dysfunction medications, penile injections, urethral suppositories, penile surgical implant, noninvasive penile vacuum devices for men

  • Water based vaginal lubricants

Resources Available:

National Vulvodynia Association

www.nva.org

Vulvar Pain Foundation

www.vulvarpainfoundation.org

American Association of Sex Educators, Counselors and Therapists

www.aasect.org

www.vaginismus.com

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