Common Sexual Dysfunctions

The following are the most common forms of sexual dysfunction. They are all treatable with a high probability of success.

Male Dysfunctions

Inhibited Sexual Desire.

Inhibited sexual desire or response refers to the lack of desire for erotic sexual contact. In almost all cases when there is a lack of sexual desire, the underlying causes are psychological in nature. Avoidance of sexual contact because of fears of rejection, failure, criticism, feelings of embarrassment or awkwardness, body image concerns, performance anxiety, anger towards a partner or women in general, lack of attraction towards a partner, all play a part in reducing or eliminating the sexual response. Most men are too uncomfortable to talk to their partner or anyone else about these issues, preferring to simply avoid sex or attribute their lack of sexual appetite to stress, worries, etc. Some of these men have a very active fantasy life and prefer the solitude of masturbation to the intimacy of sexual relations.

Premature Ejaculation.

Premature ejaculation is the most common dysfunction and it is the easiest to treat. Masters and Johnson define premature ejaculation as the inability to delay ejaculation long enough for the woman to orgasm fifty percent of the time. (If the woman is not able to have an orgasm for reasons other than the rapid ejaculation of her partner, this definition does not apply.) Other therapists define premature ejaculation as the inability to delay ejaculation for thirty-seconds to a minute after the penis enters the vagina.

For the most part, premature ejaculation most often occurs as a function of a learned response. Early sexual experiences were often hurried in nature. Even masturbatory activity had to be hurried for fear of being caught. From youth onward men have trained themselves to be more concerned with the end result and their own pleasure rather than with the sexual process and their partner. The object of sex for most of these men, was and often continues to be, ejaculating as quickly as possible. This rapid ejaculating pattern can easily become a way of life after even only a few episodes. It then begins to create a pattern of anxiety in the male each time he engages in coitus thus increasing the probability of it occurring. Fearful of displeasing their partner and feeling inadequate as a function of it, men often would rather avoid sex rather than experience the humiliation and discomfort.

Retarded Ejaculation or Ejaculatory Incompetence.

Ejaculatory incompetence is the opposite of premature ejaculation and refers to the inability to ejaculate inside the vagina. Men with this difficulty may be able to maintain an erection for 30 minutes to an hour, but because of psychological concerns about ejaculating inside a woman, they are not able to achieve orgasm. Usually they do not experience sexual intercourse as satisfying. One of the reasons this dysfunction goes undetected is because the male's partner is satisfied and often is able to achieve several orgasms as a function of the man's inability to ejaculate. Most of the men who suffer from retarded ejaculation can readily achieve orgasm through masturbation or in some cases through felatio. Many factors contribute to this condition, some of which are religious restrictions, fear of impregnating, and lack of physical interest or active dislike for the female partner. In addition such psychological factors as ambivalence toward one's partner, suppressed anger, fear of abandonment, or obsessional preoccupation also play a significant role in developing retarded ejaculation.

Primary Secondary Erectile Dysfunction.

Primary erectile dysfunction refers to a man who has never been able to maintain an erection for purposes of intercourse either with a female or a male, vaginally or rectally. In secondary impotence a man cannot maintain or perhaps even get an erection, but has succeeded at having either vaginal or rectal intercourse at least one time in his life. The occasional failure to get an erection is not to be confused with secondary impotence. Familial, societal, and intrapsychic factors contribute to primary impotence. Some of the more common influences are (1) performance anxiety, (2) a seductive relationship with a mother, (3) religious beliefs in sex as a sin, (4) traumatic initial failure, (5) anger toward women, and (6) fear of impregnating a woman.

Female Sexual Dysfunctions

General Dysfunction.

These female dysfunctions, according to noted sexologist, Dr. Helen Singer Kaplan, "are characterized by an inhibition in the general arousal aspect of the sexual response. On a psychological level there is a lack of erotic feelings." Manifested by lack of lubrication, her vagina does not expand, and "there is no formation of an orgasmic platform. She may also be inorgasmic. In other words, these women manifest a universal sexual inhibition which varies in intensity."