An overview of male and female sexual dysfunction!

Some degree of erectile dysfunction (ED) affects around half of all men over 40 years. The common complaint in this group of patients is difficulty with either getting an erection or maintaining it long enough to allow for satisfactory sexual activity,says international sex expert Dr P Ganesan Adaikan.

In his paper at a recent sexual conference in Hyderabad, he said there are a number of causes for ED which includes physical / medical problems affecting the blood supply and neurological function in addition to psychological aspects such as stress, fatigue, anxiety, partner conflicts and unresolved family issues. Sexual dysfunctions could also be due to the side effect of prescription medications such as treatments for high blood pressure or depression.

Both alcohol and cigarette smoking have deleterious effects on sexual performance by complex mechanisms. Obesity and high cholesterol levels affect the blood circulation as well as the hormonal status of testosterone which is needed for libido and sexual arousal. In the process of restoring intimacy, ED and related sexual problems need to be understood and addressed from time to time.

Impotence can lead to secondary infertility, as afflicted individuals tend to avoid marital relationship, become depressed and lack normal desire and frequency of sexual intercourse. Hence, w ith holistic approach of counselling and couple therapy, the success rate in the treatment of ED can reach its full potential.

The other types of male sexual dysfunctions include ejaculatory and orgasmic disorders and impairments of libido / desire. Ejaculatory problems may be clinically classified according to the presence or absence of the sensation of orgasm. Orgasmic ejaculatory disorders include premature ejaculation, retrograde ejaculation, aspermia, retarded, weak or painful ejaculation . Anorgasmic ejaculatory disorders are less common and comprise primary and secondary anejaculation.

Fundamental scientific research in female sexual dysfunction (FSD) is an important area of sexual medicine that has been neglected over the decades at the expense of worldwide research and treatment interest for male sexual dysfunction (MSD). However, during the last 4 - 5 years, it is heartening to note that scientists have shifted part of their attention from MSD and have generated tremendous research interest in understanding the female sexual physiology and treatment options for FSD.

Irrespective of the age, a commonly encountered FSD is the sexual desire disorder, a component of which is sexual aversion. This disorder may be aggravated by subjective lack of lubrication and vasocongestion of the genitalia during the peri- and post-menopausal period. Currently, arousal disorder is the main area of pharmaceutical interest and drug development.

Other manifestations of FSD include orgasmic delays with aging and sexual pain disorder, which could also result from vaginal dryness and atrophic changes in this age group. With the holistic management of male and female complaints, couple satisfaction and sexual intimacy could be satisfactorily revived leading to improvements in quality of life.